Three Thousand Versts of Loneliness

In a News Letter column I argue that health can't be treated in the same way as other products and services if it is provided for free. Whichever way you spin it, choosing a treatment from a hospital is not the same as choosing a product from a shop. If healthcare is just another part of the market, it is one sphere where the customer is not always right. No-one wants a return to the days of overbearing, uncommunicative doctors, but the philosophy of patient choice can be taken too far, particularly when the taxpayer picks up the tab.  A patient led service, where GPs are under pressure to provide the treatments people want, rather than those that they need, has its pitfalls. Thanks to the internet, we already have a whole generation prepared to second guess the advice of doctors, on the basis of their own spurious researches.  The NHS currently has some protection against the pressure of unscientific opinion and popular campaigning. The National Institute of Health and Cli...

McGimpsey - did the business with Harney Northern Ireland's politicians have a great propensity for boasting about their readiness to "do the business".  Gerry Adams likes to claim he's up for "doing the business", Peter Robinson likewise, but no more so than the Health Minister, Michael McGimpsey ( just not too often ). "I have done the business with (ROI health minister) Mary Harney four weeks ago in our meeting in Armagh.  And as far as I'm concerned until the next meeting comes along, that's it." Quite so minister.

More to follow on Iris Robinson's departure. However it is worth quoting a snippet from Clive Aslet at the Daily Telegraph. I don't know whether to accept that the Northern Irish MP Iris Robinson's stated reason for quitting politics – depression – is the whole story. A row about the fact that she and her First Minister husband employ four family members on their staff may have also been a contributory factor. But I welcome the attention she has drawn to the issue of mental health, which remains too little understood. Stigma surrounding mental illness has certainly dissipated, but it is still a very real issue. Whether one accepts that Iris Robinson's decision to give up her public role is an uncomplicated health matter, or not, she has performed a useful service by owning up to her condition. Assessing her contribution to Northern Ireland's politics is, of course, an entirely different matter.

I must confess, the ‘we love the NHS’ campaign, organised to respond to American criticism of the institution, makes me vaguely queasy. Gordon Brown has joined the Twitter group, of course, in another ill advised foray into internet campaigning. Iain Dale has posted rather effectively on the topic, arguing that it is ‘puerile’ to claim ‘love’ for a public service. Don’t misunderstand me. Reactionary voices in the US, which contend that the NHS is ‘evil’ and resist any move towards state funded health provision, make me even more bilious. I understand the reflex to defend our health service. But there’s more than a little impulsive nationalism to this popular response to American criticism and there's a distinct whiff of populist opportunism where politicians seek to clamber on board the band wagon. Everyone has experiences of the NHS, and many of them are good, but few would contend that the service is perfect. We have reason to be proud that health care is available, free ...

Northern Ireland’s new Finance Minister, Sammy Wilson, has been showing off the grasp of economics which he acquired teaching the subject at Grosvenor High School. Let’s not forget that he was head of department and helped to set some exams. The East Antrim MP has repeated the DUP’s occasional mantra of ‘Tory cuts’ which, whilst it is echoes a theme developed by Labour leader Gordon Brown, does not quite share the Prime Minister’s intellectual disingenuousness. He is simply lying about his intentions for the economy but the DUP neither knows nor cares about the national picture, as long as Northern Ireland retains the same sized slice of a diminishing pie. None of which is new or particularly surprising, but Sammy has accompanied his pre-empting of Conservative policy with some ludicrous claims, wonky sums and awe-inspiring ignorance. Wilson demonstrates his wobbly grasp of Tory pledges by claiming that George Osborne has promised to ‘ring fence’ spending on health and education....

I notice that a couple of the big Conservative blogs, Dizzy and Iain Dale , have clambered aboard a campaign to amend the smoking ban. The argument is that current legislation is too inflexible and provision should be made for certain exemptions. There is an implication that pubs and clubs especially might choose to operate outside the ban, in order to lure back lost customers. This type of thinking is obviously attractive to the libertarian strand of Conservatism. Personally I oppose the campaign. I suspect that the smoking ban’s uncompromising nature has provided the impetus for its success. Without producing hard evidence (although I’m quite prepared to do some research if anyone thinks my contentions are questionable) I’d imagine there are fewer smokers today than there were before the legislation came into force and those who do smoke certainly smoke fewer cigarettes when they are out at bars and restaurants. I am told that medical professionals are already satisfied that t...

Accompanying the hysteria surrounding swine flu, I have noticed a particularly insidious piece of jargon, which, if it is does not yet constitute an epidemic amongst health professionals, is certainly rapidly becoming endemic. Rather than refer to the risk of death which the disease might pose, experts keep discussing the possibility of it precipitating a ‘mortality event’. A more obfuscating piece of doublespeak it is difficult to imagine. Could any phrase more neatly epitomise a living example of the type of English which George Orwell excoriated in his essays and satirised in his fiction? Doctors are already notorious for dancing around the truth. For many years it was established procedure to refer to all manner of ‘growths’ rather than tell a patient he or she had cancer. Sometimes, I imagine, it is beneficial to speak in language which only the initiated can interpret. But in a public debate about the possible effects of a disease, in which any sense of proportion has long ...

Michael McGimpsey’s performance as Health Minister has been one of the rare success stories of the Northern Ireland Executive. Despite acquiring one of the most challenging departments, and facing a constant fight to retain funding, the South Belfast MLA has delivered free prescriptions and targeted investment where it is badly needed. Tackling the most pressing health issues and seeking to modernise the ambulance service’s elderly fleet, McGimpsey is a minister with an understanding of his brief. With this in mind, I am all the more puzzled at the Department of Health’s f rosty reception to the Ireland Air Ambulance initiative, which is currently undergoing trials . Largely it is accepted that a degree of centralisation and specialisation is inevitable within the modern NHS and Northern Ireland, which has a small, dispersed rural population, is obviously no exception. The ability rapidly to transport patients from areas where local hospital provision is either not available, or...

Les Reid of the Belfast Humanist Group has endorsed Diane Abbot MP’s campaign to extend the 1967 Abortion Act to Northern Ireland. It is a troubling anomaly that women in Northern Ireland are not afforded the same rights in this regard as women in the rest of the United Kingdom. It is still more troubling that many so-called unionists seek to retain this anomaly, rather than insisting that women in Northern Ireland enjoy the same rights as their counterparts across the water. "Since Northern Ireland is part of the UK, the same rights and facilities should be available here as elsewhere in the country."

BBC 2 last night aired a programme on addiction entitled Am I Normal , presented by clinical psychologist Tanya Byron. The documentary itself did not arrive at any startling conclusions, finding that addiction could be attributed to a combination of biological, psychological and social factors. What it did expose however, was the tendency to use the description ‘addiction’ as a means to absolve people of personal responsibility for a whole range of excessive, compulsive and damaging behaviours. I have no particular medical knowledge and I would be reluctant to dismiss a gamut of research adduced to support the theory that behaviours as well as substances can be addictive. I am in no position to dispute these findings, which amount to brain scans proving that people seek to replicate experiences which release endorphins (if I have understood correctly), but there are various social implications which arise if we decide to take this broader approach to the definition of addiction. In ...

I was somewhat dubious about spending my Saturday night watching a film about a man who emerged from a coma to find himself completely paralysed barring an ability to blink his left eye. Strange then that The Diving Bell and the Butterfly proved to be as uplifting a piece of cinema as it was sad and that Julian Schnabel’s movie actually justifies using the much misapplied superlative ‘life-affirming’. The film is an adaptation of Jean Dominique Bauby’s book. It charts the author’s emergence from a coma after suffering a massive stroke which left him with “locked-in syndrome”. Impressionistic camerawork with cloudy and sporadic images recreate the impression of Bauby coming out of the coma. Indeed for the majority of the film the camera remains behind the protagonist’s good eye, evoking the claustrophobia of Bauby’s ‘diving bell’. A sense exacerbated by the audience sharing an inner monologue of the ill man’s thoughts and perceiving the rest of the dialogue through his hearing, ini...

Although my preferences are not hidden, I have tried as far as possible to prevent this blog becoming too party political. When I disagree with something emanating from the Ulster Unionist Party, I do not hesitate in raising my objection. I do not apologise however for highlighting the political courage being demonstrated by Michael McGimpsey as he merges four health boards into one and slims down the bloated bureaucracy that afflicts the NHS in this country. Mr McGimpsey is translating words into action, the quality which is conspicuously lacking in other parties (see below). His initiative will cost 1,700 jobs which are not needed, but will allow services to be delivered on the front line.

Roy Beggs Junior has pointed out the disparity between the proposed increase in spending for the Office of the First Minister and Deputy First Minister and that designated to health . " It is staggering to think that the DUP-Sinn Fein Office of the First Minister and Deputy First Minister is receiving greater priority than our National Health Service. That this is occurring at a time when health expenditure in the rest of the UK is rising at a significantly greater level will only increase the unacceptable disparity between health care in Northern Ireland and elsewhere in the UK. " Incredibly spending on the OFMDFM has increased from £32m in the previous devolved administration to £73.9m in the current dispensaton. It takes a lot of money to keep the rictus grins of the Chuckle Brothers in place.

Pathologically steer clear of populist wisdom, is a maxim to which adherence would normally be advisable, but occasionally there arises an issue in the media where common sense is apparently so palpably subverted that it is simply not possible to resist manifesting an attack of the “Jeremy Clarksons”. Initially I was tempted to respond to the news that a study had declared individuals no longer responsible for their own obesity, in just such a fashion. Having ruminated briefly on the issue and simultaneously on a full fat buttered slice of toast, I came to the more measured conclusion that although this was the angle the BBC were taking on the story , the experts behind the research were simply highlighting the scale of the problem and concluding that it was simply not enough to submit the issue to individual responsibility ALONE any longer. The damning statistics detailing decreased productivity and spiralling costs of care for obesity related conditions for the NHS, does compel the ...

This summer I became vicariously acquainted with the important and responsible work carried out by medical secretaries in the NHS. I have also come to understand that there is a shortage of candidates to fill these positions in Northern Ireland, due to the derisory wages offered. The result is a large backlog of work, inefficiency in delivery of services and public money being wasted by plugging the gap with agency staff. The SDLP’s Thomas Burns raises this issue today in the NI Assembly’s written questions and outlines the disparity between medical secretaries in Northern Ireland and in the other devolved regions: Questions to the Minister of Health, Social Services and Public Safety 1. Mr Thomas Burns ( South Antrim): To ask the Minister of Health, Social Services and Public Safety to provide an explanation of why all medical secretaries in Northern Ireland were matched to Band 3 pay levels, regardless of experience, compared to 70% of medical secretaries in Wales and 80% of medi...

Health Minister Michael McGimpsey has addressed wasteful madness whereby all press releases and advertisements for his department were automatically translated into Irish. It is precisely this type of profligate nonsense (predictably introduced by Bairbre de Bruin), of no benefit to anyone, which undermines goodwill toward the Irish Language lobby. Hopefully this rare instance of common sense will not soon be overturned.