Let's hope Swine Flu becomes a pandemic

It's important to cut through the shrill 'Sky News' breathless scaremongering and establish some facts about Swine Flu.

Let me endeavour to do just that, because once the facts are known, it is likely that many people might join me in hoping that Swine Flu breaks out globally and becomes a dreaded pandemic.

Firstly, you should know how influenza works. It's a vast family of viruses, constantly changing, some of which affect birds, some pigs and some us.
Because it's always changing, and because there are literally hundreds of strains out there at any given time, it's not possible to create a perfect flu vaccine.

So Swine Flu is basically a pig flu that has jumped species to humans and is now being passed from person to person. So, no, eating Irish bacon is not a risk (unless they've filled it with dioxin again, of course.)

Every year, tens of thousands of people die from some version of the flu. They tend to be older, frailer people. But every now and again, a strain of flu comes along which most people have little or no immunity to.
Basically, it comes out of nowhere and is so different to the previous strains that no one's body has ever seen anything like it.
When that happens, a pandemic (global epidemic) can happen. And often with pandemics, it's mostly young, healthy people who die.

The last pandemic was in 1968, over four decades ago. That means that one is WAY overdue. But, the world, and especially our part of it, has never been better prepared for a pandemic.
We've got loads of anti-viral drugs that seem on first impression to be a bit effective against the Mexican Swine Flu strain.
And last year's flu jab contained a quite similar strain, so it might offer some protection to anyone who got the jab last Autumn.

But the best news is that this particular strain doesn't seem particularly fatal. When you consider that the Spanish flu of 1918 killed more people than World War I, then you can imagine what very fatal flus could do in this age of modern air travel and the global village.
But while many people have died in Mexico, it seems that for the most part they had delayed some time in getting medical help.
In other countries where travellers have returned with the illness, so far no one has died because they got medical help in time.

Since we're overdue a flu pandemic, I'd rather we had one that wasn't particularly fatal. And perhaps a successful global response to fighting a common enemy, like an epidemic, might be the catalyst the world requires to snap out of the recession slump.

In short, don't lose any sleep over Swine Flu. Equally, don't go holidaying on Mexican pig farms either.

This has been a JC Skinner public health announcement.

Where the cuts should fall (and what we need to spend more on, even in a recession)

1997 - 7,000 Administrators employed in Irish health service across ten health boards.
2008 - 18,000 Administrators employed in the Irish health service across a single Health Service Executive.

Conclusion: Sack no less than 12,000 of those Administrators.

1980 - Number of acute hospital beds in Ireland for a population of 3 million - 18,000
2008 - Number of acute hospital beds in Ireland for a population of 4 million - 12,000

Conclusion: We need at least 3,000 more beds in our acute hospitals, no matter what state the economy is in.

Is medical tourism the only answer to Ireland's health famine?

After years of fulminating against the Irish health service, I finally put my money where my mouth is.

For a long time, I have headed across the border to the North anytime I needed a check up, some primary care, or some minor emergency treatment. Who wouldn't, given the opportunity, since the British NHS is actually free? No fifty quid to see a doc, no fifty quid to get into A+E. Free to those who need it.

Not to mention shorter A+E queues, cleaner hospitals, more English-speaking staff, fewer flesh-eating bugs, etc, etc.

But I have needed a small operation on my toe for some years now. It wasn't the sort of thing you would get done quickly in the Irish health service, as I wasn't actually bleeding to death and don't have a VHI Plan E insurance card.

But increasingly, it was impeding my ability to walk. It's been years since I could kick a football. And because it is an existing complaint, even if I did sign up for private health insurance that I can't afford, the VHI or their corporate rivals wouldn't pay for the op.

I costed the operation in Ireland, and was quoted a significant four figure sum from a very well known private hospital in the greater Dublin area. This is a lot of money to me. So I decided to keep on suffering.

But the pain got progressively worse, so I looked further afield. In Britain, a number of private hospitals appeared able to do the minor operation required. They were, however, reticent to quote a price without my actually coming to them to be assessed. I can understand this need to assess first, but it is a very simple operation.

A doctor of my acquaintance warned me that it should be as easy to quote for such an operation as it would to quote for, say, laser eye surgery. He also warned that due to increasing medical tourism from Irish patients, and a perception that Irish patients are all loaded, some UK hospitals might possibly be guilty of inflating prices for Irish patients to the upper end of the scales.

Then I came across the Bumrungrad hospital in Bangkok. Go look at their website. This hospital is as good as anything anywhere on earth. Their doctors are nearly all American or UK trained. The facilities are second to none. Ex-pats living all over Asia flock to it when they need medical treatment.

And they're cheap. My operation took an hour and cost 230 euro. In perfect sterile conditions, by highly qualified staffd, and complete with two follow-up examinations and post-operative medication.

While I was there, I met a lad whose cousin tragically succumbed to a drug overdose and has been in a coma in intensive care at the hospital for seven months. A doctor relative had told the lad I spoke to that he didn't believe the patient would have survived in Britain (or, by extension, Ireland) because the quality of care at Bumrungrad so greatly exceeded what was available back home.

I can believe that.

On the one hand, I feel cheap and tawdry for using what little financial clout I have to fly away from the car crash of the Irish health service to avail of proper world class medical facilities. I feel sad for those who can't afford to do likewise, for all those poor people trapped in squalor on trollies in our crowded and dangerous A+E wards.

On the other hand, I was never going to get my operation if I hadn't flown to Thailand to have it done.

Today, Newstalk Radio are holding a themed broadcast day about the Irish health service, which they've rightly entitled the 'Health Famine.' They've been asking people to call in with their stories. I don't do call ins, so I'm putting my story here instead.

This country is infinitely richer than Thailand, yet we cannot even approach the quality of care available there, at a fraction of the cost of healthcare in Ireland. That fact alone ought to have long since accounted for Mary Harney's political career. Why it hasn't is simply beyond me.

Perhaps the people of Ireland are too complacent and accepting of appalling healthcare to demand better. Or perhaps I should fly back to Bangkok and have my head examined.

God knows, it would be inexpensive and the quality of care would be magnificent.

My toe's grand now, by the way. Thanks for asking.

Super Tuesday

It's a little shocking to my ears, having spent my childhood in the bosom of the British NHS, to listen to how Americans are responding to Hilary Clinton's plan for universal health entitlements.

She's been roundly lambasted by the Republicans for her 'Hilaryaid' proposals, which sound nothing more than the mildest, weakest version of what most Western Europeans would consider a fundamental human right.

While Barack continues to witter pointlessly about bringing 'change', without ever specifying what change he's bringing (loose change, perhaps?), at least La Clinton has put an actual concrete proposal on the table for discussion.

And to me, that discussion has been frightening.

If you were to listen to Mitt Romney or Huckabee, you'd think that she was proposing Communist totalitarianism. The idea of any form of universal state supported health care is anathema to these people. And their millions of supporters.

Those views, abhorrent as they are to most people on this side of the pond, are not unknown here, however. You could map our current Health Minister's agenda almost exactly over what Republicans believe is a functioning health system - ie a multi-tier affair based on ability to pay rather than need, bloated with inefficient beaurocracy and outrageously expensive due to rampant litigation against medics, the aforementioned paper-pushing and the need to generate profits for private entities.

There's something to think about, not only on Super Tuesday, but the next time you hear Harney trying to sell you some snake oil about 'co-location'.

Harney's not the only one should quit

Of course, Mary Harney should quit as Minister for Health with immediate effect. Her performance in the role has been little short of diabolical.

But it is worth recalling, as 97 more women fret about their cancer results, that there is a concept often cited by our Teflon Taoiseach known as collective cabinet responsibility.

They're all responsible for this mess we call a health service. All of them. Some of them are particularly responsible. Some of them, you could say, are more responsible than others.

On this list from the Department of Health, you can see that the two front runners to replace Bertie Ahern as Fianna Fail leader (and de facto Taoiseach of the nation) are BOTH former health ministers.

It is worth remembering how Micheal Martin, as health minister, commissioned over 200 reports which were not subsequently acted on while simultaneously robbing nursing home patients of up to €2 billion which the state had to pay back.

The senior civil servant in the Department said that he had told Micheal Martin about this scandal and had even given him the file in Martin's office. Martin denied this utterly. The file has never been found since, needless to say. Martin remains a cabinet minister. The civil servant moved sideways to the Higher Education Authority.

Brian Cowen, who charmingly called the Department of Health 'Angola', due to the amount of political landmines to be found underfoot, was also Minister for Health for three years. His time in Hawkins House is notable by its lack of anything notable. He didn't do a thing, tiptoeing around hoping no bombs went off until he could scamper for the safety of another Department.

If you were to believe some people, the Irish health system is permanently a wreck, unfixable and always was. This is nonsense.

A potted history of Irish health would run something like this:

The churches ran health provision forever, then the state, having missed the opportunity to create a National Health Service like the UK have, finally and belatedly intervened and the health boards were created in 1970.

Things remained okay for a while, then Charles Haughey slashed a quarter of all hospital beds, because we all had to tighten our belts.

Since then, those beds, that infrastructure, has never been replaced, while the population has exploded. In the Eighties, the scandals began. Organ retentions, blood infections, the lies, the spin. This was the period when the administrators came to power in health. But at least they were monitored by public representatives on the health boards.

When Mary Harney rationalised the health boards into the HSE, in itself not a bad idea, she made two massive errors. Firstly, she eradicated the ability of people to be elected to monitor the administrators. All of a sudden, no one was watching the watchmen.

Then she vowed that no jobs would be lost. The result was that we now have up to eight times as many health administrators as are needed, most aren't doing anything to justify their salaries, and none of them can be sacked.

This led directly to scandals varying from the millions upon millions spent on IT projects that either didn't work or didn't exist to the fact that neither Harney nor her overpaid mudguard Brendan Drumm even knew about the 97 more women whose cancer tests were wrong until yesterday.

By all means, by any means necessary, Mary Harney should quit with immediate effect. Her poodle Drumm, the €400,000 man, must also go.

But so should those who share collective cabinet responsibility for this unholy mess costing Irish lives. I'd start with Martin and Cowen, who have both directly contributed to the ongoing horror. But I wouldn't end there.

Ahern himself interfered in the decision of where to place the national children's hospital by making public statements, with the result that it went to the Mater, in his constituency, and his former employer.

Cullen ensured that Waterford would not get public radiotherapy but a privatised system instead. He even turned the sod on the site of their private hospital for them.

The entire cabinet share responsibility for the beleaguered state of our health service. If any one of them had a single shred of honour, they'd leave now.

Meet Gwen Baker

Gwen loves life by the shore. Whether its her lakeside apartment, or the harbour views from her second home in England, or indeed the clifftop Italian hotels, five star naturally, in which she likes to holiday, Gwen loves to have water nearby.

I'd love to post a picture of Gwen Baker in one of her spectacular Venetian masks or swanning around in a stunning Mediterranean villa, so you could truly appreciate just how much she enjoys her life.

I'm not allowed to, though. I'd link to some pics of Gwen, but she's taken them all down off the web. She's taken down her CV too. This is also a pity, because if it were online I could link to it and then you could see for yourself why she and her fantabulous lifestyle should be of interest to every taxpayer in Ireland.

Gwen, an American lady of a certain age, is what's known as an SAP consultant. They design complicated IT systems. This much you can confirm online at her website here.

But you'll have to trust me when I tell you that Gwen was one of the leading designers of the Irish health service's PPARS computer system. A system that cost the Irish taxpayer over €180 million and has never worked.

It has been uncovered that IT consultants like Gwen walked away with millions of euro each for designing a system that ran rapidly out of control and never worked. People like Gwen were even hired via shady off-shore recruitment firms, and so it is unclear if they even paid tax on the millions they made.

It was announced today that the whole thing will have to be scrapped and a new system created. God forbid that they permit the morons of the HSE to oversee the replacement system. Yet, they will.

Those morons are the same morons who greenlighted every increase in budget for PPARS while they were in the old Southern or North-Western Health Boards. Yup, that's right, folks. They haven't been sacked. They're not going to be sacked. And they're probably going to oversee another scandal like PPARS all over again, because nothing has changed.

And probably people like Gwen Baker will come along again and siphon millions of taxpayers money from our health service - that's the HEALTH SERVICE, you know, the one that tries to help sick people but is starved of staff and resources? - by creating another IT system that doesn't work.

And probably people like Gwen will continue to enjoy their fabulously wealthy lives of luxury. And probably the same goons in the HSE will keep signing the cheques mindlessly. And the same fat lump of a health minister will nod and greenlight everything.

And the same poor, sick people will be stuck on the same trolleys in the same squalid hospitals waiting for the same beleaguered staff to look after them.

Because this is the Irish health service and no one is ever held to account. No one is ever to blame. And we the people are paying the price.

Half-crocked Bertie goes off half-cocked

The Taoiseach Bertie Ahern revealed today what we all already knew - he's half-crocked.

Discussing BUPA's pull-out from Ireland, he said: "I’m not acting tough at all, I’m just saying that somebody wants to come along and say great, sure, listen, if insurance is all about going out and getting 100 people who are likely to get sick for the next 10 years, and sure make greater profits, sure, that’s great, that’s marvellous. And I’m supposed to be impressed with that argument."

“Then you get 100 people who are like myself, are half crocked, and then we have to pay far more for it (insurance), and they say that’s fair. Market forces, competition ... who are they coddin’?”

Amidst the virtual incomprehensibility of that statement, clearly Ahern is unimpressed with BUPA's failure to take the profits they make in 137 other countries and plough it into the Irish health system in place of him doing so.

He also admits to being half crocked and pleads poverty. If the Taoiseach can't afford Irish health insurance, then what the hell was he and his cronies thinking when they forced the main competitor out of the market with their half-cocked scheme to get them to subsidise the VHI?

Here's another numpty we could do well without.

Harney - worst minister ever

Mary Harney, Europe's least healthy looking health minister, has really done it this time.

Not content with presiding over the further erosion of the Irish health system and selling off what bits she can to her developer pals, she must now watch in free marketeer horror as BUPA pulls out of Ireland today.

That's 300 jobs down the Swanee, half a million punters without health insurance and a big load of egg on the Minister's face, given her espousal of competition in the marketplace.

Thanks to a bonkers ruling in court the other week that BUPA should give a million quid a week to the dominant force in the marketplace VHI, this result was inevitable. Expect Vivas to follow shortly.

This health minister is a liability. Can someone please put her out to pasture immediately?

Not exactly Florence Nightingale

It seems that former Naas hospital nurse Noreen Mulholland has been found guilty on at least one charge relating to poisoning patients while working in Kildare in 2003.

As if it wasn't bad enough that people are dying while trying to gain admission to hospitals, then being infected with drug-resistant bugs and dying once they get a bed, do patients now need to worry about the staff killing them too?

This week alone, we've seen a surgeon taking out a patient's stomach by mistake, ten thousand people marching to complain about the continued downgrading of their local hospital, and a record number of complaints against doctors.

Years into the so-called reform of the Irish health service, when are we actually going to see a reversal in the slipping standards, never mind the long-promised improvements?

Suicide is painful

It's world mental health day today.

Normally, I'm don't go in for makey-uppy designated days. After all, Mother is mother all year round and not just some random Sunday chosen by greeting card manufacturers. And it's the same with this day. People suffering from mental ill health do so any time of the year, not just today.

Perhaps someone might want to tell Minister Tim O'Malley (pictured right, staring into space as usual.)

But at least it gives wonderful organisations like The Samaritans and Aware the chance to remind the majority of us who teeter just the right side of insanity most of the time that there is a minority out there who aren't coping.

Among the statistics to emerge today is that one in 13 Irish students suffer from clinical depression. Unlucky for some indeed.

You have to wonder what is really going on in a country experiencing unprecedented wealth, affluence and opportunity when the cream of the crop, the educated, intelligent golden youth, are suffering depression in their thousands and taking their own lives by the hundreds annually.

Last month, two brothers took their own lives in Belfast. One killed himself suddenly, without warning to friends or family, causing the inevitable tidal wave of grief, anger and agony that such deaths always do.

Within weeks, a matter of days really, his brother followed his example. This tragedy, one that is played out in hundreds of Irish homes every year, was particularly acute for the Mailey family, as they had lost not one cherished son but two.

Bravely, the boys' parents spoke out in the media about their unimaginable loss and anguish, in the hope that their pain might alert those suffering from depression to reach out and seek help.

But they did not spare their anger in describing how Mark, suffering dreadfully from the loss of his beloved brother, sought help from doctors and hospitals, only to be fobbed off with weeks of waiting and a handful of tranquilisers.

I fear that their words will fall on many deaf ears, including those who most need to listen - the politicians mismanaging mental health services and the disturbed, depressed and isolated young people who are suffering from mental ill health.

Years ago I ran an information and support service for people bereaved by suicide. I did this voluntarily, but it cost me a lot of money I didn't have.

I did it because people who have lost a loved one to suicide are many times more likely to die by their own hands than the general populace. And at that time in Ireland, there was little or no information, no group support meetings, and certainly no state funding for such services.

I was literally deluged. People who had lost brothers, sisters or parents decades earlier contacted me in tears, the pain as vivid and the loss as acute as it was when the suicide occurred. And then there were the people who had only just lost someone, often a child, and didn't know who to turn to.

The priest offered prayers, the doctor pills. The state offered nothing. The community turned away in an embarrassed silence from them. They came to me. It quickly became apparent that I needed to find counsellors, and lots of them, and to organise support groups for the suicide bereaved.

And I needed funds. But back then, over a decade ago, the state wasn't interested. I couldn't get the funding. I ran out of cash and beyond. I had to close the service and get a job to pay off the debts. In the meantime, the suicide rate hit record levels.

The Government might try to tell you that things have changed since, but they haven't. Last year, the Irish Minister with responsibility for Mental Health - that's the dozy looking chap pictured above - told the Dail "[the] constant reiteration and repetition about the problems in the mental health services is becoming a bit tiresome."

Amazingly, no paranoid schizophrenic unable to access proper care has chosen to kill Minister Tim O'Malley yet. Even more amazingly, he's STILL minister with reponsibility for mental health.

And while we do now have suicide support groups dotted like oases of mental calm around the country, the vast majority of money attached to suicide goes towards medical research. Let me explain something very simply so that even Dim O'Malley will understand:

Suicide is caused by people killing themselves. That's all there is to it. How do you stop people killing themselves? Well, try funding the mental health services for starters.

Mental health funding in the Republic of Ireland has deteriorated to such an extent that disturbed children are held as in-patients in adult psychiatric wards. And they now intend to sell off the grounds of psychiatric hospitals just to pay for the next few years service, such is the demand and the historic lack of investment.

Surely it is now time to divert some of our affluence away from material goods and towards crucial services like these. If you can't get proper help when you need it and reach out for it, like Mark Mailey did in Belfast last month, or if you seek it when young enough only to find yourself in an adult psychiatric ward, what does that say about the morals of the country you are in?

For help or support contact Samaritans call 1850 609090 or email jo@samaritans.org