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November 24, 2014

Crown’s jewels of wisdom

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Prof John Crown: An ‘early public whistle-blower’ in the cancer arena

Gary Culliton profiles the plans and policies of Prof John Crown, who is seeking election to Seanad Éireann on the National University of Ireland panel.

One of the country’s most vocal health commentators, Prof John Crown — who is seeking a seat in the Seanad on the National University of Ireland (NUI) panel — is known all over Ireland for his blunt speaking on radio, television (invited on The Late Late Show or not!), and in the Sunday Independent.

There are 27 applicants for three positions in the NUI election. Prof Crown, a consultant oncologist at St Vincent’s University Hospital and St Luke’s Hospital, argues that the people responsible for running the public health system — the Government — should use that system.

“By and large, politicians have private health insurance. Air China required that its executives be in the air at the critical moment when the Y2K computer bug was due to strike, to reassure clients,” said Prof Crown. “The same principle should apply to those running our health system.”

Like his fellow candidates, Prof Crown has to canvass 120,000 NUI electors in his search to win election to the Seanad.

Although not a member of any political party, he has opposed Fianna Fáil government-led policy over recent years and is a supporter of universal healthcare.

Internationally recognised for his research into improving the effects of chemotherapy dosage on cancer patients, Prof Crown has received a merit award from the European Society for Medical Oncology for his work in breast cancer research — the first Irish oncologist to have received such recognition. He is convinced that he can make a difference.

He regards Fine Gael’s Dr James Reilly as an “advocate for change”, but believes it is “unfortunate” that such a potentially reforming Minister for Health has been appointed to Hawkins House at a time of “national financial disaster”.

The consultant has long expressed a distaste for Ireland’s two-tier health system and he backs the ‘money follows the patient’ model — versions of which both Labour and FG espouse. While there is a place for private insurance, an element of social insurance should be present in any system, Prof Crown argues. He advocates a ‘Bismarckian’ healthcare system: one based on social insurance, where there is a multitude of insurance organisations that are organisationally independent of healthcare providers. “The best health systems exist in Germany and Israel,” he said. “The Canadian model is good and the Dutch system is excellent.”

‘Perverse incentives’
In contrast, he is not keen on for-profit private health insurance, as he believes this creates “perverse incentives” for hospitals.

In his preferred health system, most hospitals would be ‘not for profit’ — he himself has worked in a number of philanthropic institutions. He favours the Fine Gael proposal to scrap the HSE, as he believes any system based on national command and control will fail. However, oversight of the health sector should return to the Department of Health.

“The new government have committed to introduce universal single-tier healthcare, funded by a mixture of public and private insurance. I support these plans, but worry that they might be shelved for economic reasons. As a totally independent Senator, I will maintain pressure to see that reform is implemented.”

Prof Crown is one of the most high-profile cancer researchers in Ireland. A graduate of UCD, he received his medical training at the State University of New York. His postdoctoral training included posts at Guy’s Hospital in London and St James’s Hospital in Dublin.

He completed his fellowship training in oncology at Mount Sinai Medical Centre and the Sloan-Kettering Cancer Centre, both in New York. He also served as Assistant Professor at Cornell University Medical College before returning to Ireland in 1993 to take up his consultant post at St Vincent’s and St Luke’s Hospitals.

Chairman of Molecular Therapeutics for Cancer Ireland, he has lectured in more than 40 countries and holds degrees in medicine, science and business administration. He has been awarded Professorships in cancer research from Dublin City University and University College Dublin.

He founded Ireland’s first national cancer treatment research group — the All Ireland Co-operative Oncology Research Group (ICORG) — in 1997. ICORG now has 100 employees nationally and brings in millions of euro worth of free cancer drugs to our health service.

A long-term advocate and agitator for improvement in cancer care (he describes himself as an “early public whistle-blower” concerning the terrible deficiencies in our cancer services), Prof Crown believes, however, that there have only been “superficial changes” in the cancer area in Ireland.

Smart economy
Another area in which he is keenly interested is that of innovation and research. “Biopharmaceuticals is an €18 billion industry in Ireland. That needs to be protected,” he stressed, adding that he was “very committed” to third-level education generally. “It is good for us as a species to be smart.”

However, one impediment to this growth was the fact that the number of full-time consultants engaged in academic research was low in Ireland compared with international standards, he said.

On the question of electoral reform, he does not believe that an upper house that is not based on universal suffrage should continue.

If elected, he has also pledged to give his entire Seanad salary to cancer research.

Visit www.johncrown.ie.