A year of dashed hopes

The passing of the chain of office from consultant Dr Christine O’Malley to public health doc Dr Paula Gilvarry was the feature event of the first day of the IMO AGM. The news, according to the outgoing president, was not good.
A crowd of about 30 people – the real IMO diehards who arrive on the Thursday – heard Dr O’Malley offer her perspective on what makes this year different from the previous: which was no difference at all, except that things were possibly worse.
The theme for this year’s IMO AGM is “Realism not rhetoric”. Nevermind that little witty slogans like “realism not rhetoric” are the very definition of rhetoric – the message got through: Doctors feel beat up this year more than ever. They feel outspun by Mary Harney, by the Department of Health, by the HSE. They feel like the media is against them. They feel like the public doesn’t understand.
Dr O’Malley seemed so fed up with all the forces working against doctors that she addressed her speech directly to patients, even though no patient was in attendance (people who are exclusively patients, rather than also doctors and journalists and a few PR types, I suppose).
She went so far as to apologise directly to them: “I would like to apologise to you, the patients of Ireland, that we did not speak out to contradict the HSE. You see, we thought we were on the same team. We thought we shared a vision for patients.”

That’s a nice bit of rhetoric, but I’m suspicious about the fact that any doctor, in 2006, felt like the HSE was on his or her side. My opinion is that doctors knew very well they were in for a battle, and have known since the honeymoon ended (the marriage of a consultant – Brendan Drumm – with health service management).
As the always outspoken Dr O’Malley (so outspoken that she has learned to speak twice as fast as anyone else in order to fit it all in) passed the chain of office to Dr Gilvarry, the dashed hope was palpable in the room – the feeling of banging your head against a wall for twelve months to no avail.
Dr O’Malley said it all in her speech: nobody seems to want to hear what is so self-evident to doctors – that the HSE is hell-bent on running medicine like a business, turning patients into clients, turning quality into targets, as well as building infrastructure on the cheap (nevermind that inequality will be institutionalized as a result).
The A&Es aren’t crowded anymore, except that they are. Cancelled elective procedures aren’t linked to A&E crowd ceiling, except that they are. Mental health tribunals are running smoothly, except that they aren’t. Consultants don’t want to work flexible schedules, except that they do, if they get paid for it. There are enough beds, except that there aren’t. Nurses are respected and are better off with benchmarking, except that they aren’t. The HSE does not employ creative accounting or spin, but they do.
Still, how in the world do you fight spin, except with relentless and daily honesty (as opposed to an annual outburst of honesty every April in Killarney)?
The IMO is always a little slow on the Thursday. There was a fascinating scientific session about HIQA, nursing homes, and care of the elderly in the afternoon (and I’m not even into that kind of stuff). Dr Cillian Twomey, Dr Martin Daly, Dr Brian Meade, Dr Shaun O’Keeffe, and some professor from England showed the following undeniably: doctors care about the health service, and they have solutions.
That doesn’t mean anyone’s going to listen.