Wednesday, February 28, 2007

Bertie's brand of english.

Bertie Ahern is famous for the facility with which he can mangle the English language.

So it came as no surprise that, at Leader’s Questions today, in response to a question from Enda Kenny about the level of drug sampling among teenagers, Bertie defended his government’s record in the fight against drugs, listing the various measures to educate young people and provide rehab facilities for addicts, including significant investment in “detoxication” programmes.

No, I can't find it in the dictionary either.

The New Stickies

In today’s Irish Independent, Senan Molony reports that Sinn Féin's Mary Lou McDonald has rejected the suggestion that she was constantly seen 'doughnutting' Gerry Adams to the detriment of her role and attendance as an MEP. "I am not a doughnut," she said.

The joke is that Mary Lou and Caitriona Ruane have become the "New Stickies“, as they seem to be physically attached to the great man whenever the cameras are present.

Footnote: Published as a letter in the Irish Independent

Tuesday, February 27, 2007

Chick Lit reviewed

Ryan Tubridy was having a discussion about Chick Lit on RTE this morning, so I felt obliged to offer a view, which he aired, including my full name. I'm not just in trouble with the wife!

"Chick-Lit is popular because it's perfectly in tune with many modern women - a self-obsessed, self-indulgent, "because I'm worth it", retail therapy group.

Generally as intellectually shallow as a car-park puddle.

Jade Goody is a timely warning for where it can all end up."

Sunday, February 25, 2007

Ireland 43 England 13

It was great to beat England so well, particularly as they only managed to get 13. One less than the last time they played in Croker when they got 14.

Thursday, February 22, 2007

Public Service - 36% overstaffed?

It is difficult to form any coherent picture of relative efficiency or appropriate staffing levels within the public service, but perhaps a look into some of the semi-state companies would be a reasonable proxy, given that they share, with the wider public service, the same ultimate owner representing "the public interest" and the same unions representing the staff. Information on these is more readily available, both from published annual accounts and from media analysis of the privatisation prospectus issued in the case of some such as Eircom and Aer Lingus.

Based on the three "case studies" below, it is possible to surmise that the wider Public Service may be overmanned by approximately 36%. This average will cover a variety of outcomes - from functions which are understaffed to those which might be 100% overstaffed, or whose function might even be redundant.

Eircom in 1994 had approx. 13,000 employees and you waited for a couple of years to get a home phone installed. Through very generous early retirement and voluntary redundancy deals, couple with giving 14.9% of the company to the employees via the ESOT (Employee Share Ownership Trust), this number had reduced to 8,000 by the end of 2004 and your home phone would be installed within days of your request being received. That’s a 38% reduction in staff numbers coupled with a massive increase in efficiency.

ESB in 1997 had 11,500 employees which reduced to 8,300 by end 2005, a reduction of 28% in staffing levels without any noticeable reduction in service levels. This was again achieved through very generous early retirement and voluntary redundancy deals, coupled with significant salary increases for employees who remained behind. A recent survey estimated that average ESB salaries were 40% higher than their UK peers, with some power station operatives grossing up to €140k per annum when overtime and shift allowances are factored in. (According to 2005 annual accounts, the average salary across all 8,300 employees was €65k). ESB staff numbers will have reduced even further since 2005, including 400 staff in their retail network of 54 shops which was sold to Halifax.

Aer Lingus in 2002 had approx. 6,500 employees which reduced to approx. 3,500 by end-2006, a massive 46% reduction in staffing levels in a period when it has greatly expanded its European route network and increased the number of passengers carried. Achievement of this reduction was greatly assisted by an industry background where long-established national carriers such as Sabena and Swissair (both much larger than Aer Lingus) went into liquidation and ceased operations, and through the use of generous early retirement and voluntary redundancy deals, coupled with significant salary increases for employees who remained behind and a 14.9% ESOT stake in the airline at the time of privatisation. Unfortunately for Aer Lingus employees, Ryanair’s dawn raid on the stock, acquiring over 25% and launching a takeover bid, has forced Aer Lingus management to revisit the staffing/efficiency cupboard again. This threatens to be a year of industrial unrest in Aer Lingus.

If any or all of these three semi-states are indicative of the manning and efficiency levels being achieved within the public services generally, then we really are wasting billions, perhaps tens of billions, of euros every year. Whatever opportunity existed to use the bench-marking process to achieve changes in structures and work practices, in order to deliver value for money, has been well and truly wasted. Bench-marking has been, as correctly predicted by the INTO’s Senator Joe O’Toole, “a stroll to the ATM”.

McDowell's Word of Honour

Minister for Justice Michael McDowell gave his word of honour to the Dáil that he had “no hand, act or part” in the arrest of journalist Mick McCaffrey over the leaking of a report into the Dean Lyons case.

Then under questioning it emerged that (a) the complaint to the gardai was made by the Secretary of the Dept of Justice and (b) McDowell was aware that this action was being taken.

Clearly he could have stopped this complaint being lodged if he so wished.

He must have no understanding of the meaning of “sins of omission”, and his initial denial “on his word of honour” has been exposed as weasel words that might be technically correct but are morally bankrupt.

Rats find new ships

Having established that BUPA was a just bunch of buccaneers, bent on screwing super-profits out of the medical health insurance market in Ireland, you’d be forgiven for thinking that their top people would be pariahs in business, at least until a reasonable period of time had elapsed.

Not so, for the chief of the pirates, ex-BUPA Chairman Maurice Keane was, on 15th February 2007, appointed as a member of the National Pensions Reserve Fund Commission by Minister for Finance Brian Cowen.

I suppose he had time on his hands.

Wednesday, February 21, 2007

Lenten sacrifice

I've decided to give up all types of sweets, chocolate bars etc for Lent, but mainly for width.

Clarifying when life begins, or doesn't!

When a sperm fertilizes an egg, the result is a cell called a Zygote and has all the DNA of both parents. The Zygote then begins to divide by mitosis to produce a multi-cellular organism which becomes an Embryo.

The debate about the “right to life” involves many groups who believe that life begins at the moment of fertilisation of the egg. This appears to be the official position of the Catholic Church.
However, Church practice today, Ash Wednesday, appears to contradict its own interpretation of when life begins.

Let me explain.

Ash Wednesday (and Good Friday) is a Fast Day for Catholics, when they are forbidden to eat meat. This prohibition includes chicken and other poultry.

However, Catholics are permitted to eat fish and eggs on Fast Days. There is no distinction made between whether the eggs are fertilised and unfertilised. But if the egg was fertilised, and the Church believes that life begins at fertilisation, then such a fertilised egg would, if fact, have become a chicken in the eyes of the Church and its consumption would consequently be prohibited on a Fast Day.


Should I send this to the Pope?

Drug smugglers avoid check-in & baggage reclaim delays

Today’s Irish Times reports that Weston Airport, owned by Jim Mansfield of Citywest fame, has been facilitating foreign flights illegally. The report states that between 600 and 800 such flights have used the airport over the past three years. There is no permanent Immigration, Police or Customs & Excise presence at the airport.

Mr Mansfield is quoted as saying that, before gardai contacted him, he was unaware that he should not be facilitating some planes and passengers.

Last September, Belgian police seized €6m worth of cocaine and heroin as it was about to be loaded onto Jim Mansfield’s private jet for transportation to Ireland via Weston. Mansfield denied all knowledge of the affair, claiming that he didn’t even know that his plane had
been taken out of the country. You’d have to wonder just how many of those 600-800 flights were involved in drug-smuggling?

A reasonable man on the 46A bus would say that it was Mansfield’s plane, his airport and a huge haul of illegal drugs and could only conclude that Jim Mansfield and his associates should be the subject of a thorough investigation by the Garda Drug Squad.

In addition, the gardai should throw the book at him for multiple and serious breaches of Aviation, Immigration and Customs & Excise regulations. Ignorance of the law is no defence.

In any event, Mr Mansfield has already demonstrated his complete contempt for planning regulations with regard to Citywest, so why would anyone believe that he would adopt a different attitude to irksome Government regulations with regard to the running of his
private airport. A lengthy jail sentence might be the appropriate outcome.

Fianna Fáil will hold their pre-election Ard-Fheis in Citywest Hotel in March 2007, the party's 2006 Ard-Fheis was also held there last November. Jim Mansfield was a guest at Bertie Ahern’s Dublin Central Constituency annual Christmas party, held in the Clontarf Castle on December 2nd last.

But this will not inhibit investigation and prosecution of Mr Mansfield, will it? Am I holding my breath?

Bertie's Ashes

Bertie Ahern may be one of the few true socialists in the Dáil, but now it looks like he might be the only real Catholic too.

At Leaders Questions today, he sported the only visible smudge of ashes on his forehead in the Dáil Chamber.

In the gallery was a deputation of about 6 representatives of various State Legislatures from the USA, there to watch proceedings.

Hopefully someone had explained the relevance of the smudge and they didn’t go away thinking that he had a very perfunctory wash this morning and is without access to a mirror.

Monday, February 19, 2007

Thanking the Government

As the election approaches, the electorate is constantly reminded of the debt of gratitude we owe to the current Coalition Government for the success of the Irish economy.

That economic success has been largely built on the growth in commercial activity in Ireland, which has been fueled by two main factors; the lowest Corporation Tax rate (12.5%) in the industrialised world, introduced by Ruairi Quinn as Finance Minister in the last Rainbow Coalition Government, and historically low interest rates which are determined by the European Central Bank.

The latter has also helped to maintain the frenetic activity in the residential housing market, sustaining high levels of employment in that sector and hugely boosting revenue receipts of VAT & Stamp Duty. It is widely acknowledged that our economy has become over-dependent on the Construction sector, both for employment and also for revenue receipts. Any setback in this area would have major knock-on consequences for the whole economy.

While the main drivers of economic success have had little to do with the current Government, things which are their direct responsibility e.g. the Health Service, Transport, Gang/Gun Crime, meeting Kyoto targets etc are all in a chaotic state. Major initiatives undertaken by this Government such as Decentralisation, Bench-marking, eVoting, PPARS etc have all demonstrated a breath-taking level of incompetence.

The Government has been awash with money, which it has thrown at every problem area where it perceives there might be votes. It has bought industrial peace in the public service at enormous current and future cost, but has failed miserably to achieve any meaningful reform in associated structures and work practices, which is badly needed to improve delivery of services and extract value for money. It has even managed, every year, to miscalculate the state of the public finances. Luckily these miscalculation, by billions of euros, have been on the positive side of the accounts - to date.

Whatever about lacking experience in Government, any alternative administration could hardly be more lacking in competence than the current lot.

Footnote: Published as a letter in the Irish Times, the Irish Independent & the Irish Examiner.

W(h)ither the PDs?

Take McDowell’s word for it - it can’t be auction politics if it’s the PDs who are doing it, but there’s no doubting the desperation of their pre-election promises, spurred by that recent 1% opinion poll result.

Even if the PDs don’t achieve melt-down in the upcoming election, there seems to be a growing consensus that Fianna Fail are likely to lose seats and will need a larger coalition partner if it’s to form part of the next Government, hence the constant wooing of Labour.

So even if McDowell returns with the same number of seats - or even a modest increase - the PDs are likely to find themselves sitting on the opposition benches.

It’s hard to see what relevance or influence they’ll have from that particular perch. McDowell has discarded any remaining shreds of the moral authority which was long the hallmark of the party, though which had been rapidly fading as the party made compromise after compromise in order to stay in Government. The PDs have progressed from supposedly being a watchdog to prevent Fianna Fail excesses to being their poodle and political mudguard.

McDowell’s not a consensus player and had managed to insult just about every existing opposition party on an ongoing basis for the past several years, so he’s hardly going to be welcomed into the “opposition club”.

Without any input to Government decisions or influence on public opinion, the PDs will undoubtedly wither and their membership drift away to apathy or other political parties. Even if they don’t implode at the upcoming election, it’s hard to see them survive the following Dail term as a coherent political force.

Our Eurovision Entry

I heard Ireland’s entry for this year's Eurovision Song Contest on the radio today.

Frankly it’s crap - a "70's-style liberal sentiments" song performed by a band (Dervish) whose singing style is several decades earlier.

I expect this John Waters effort to get about the same final score as he got in The Restaurant, screened on RTE earlier last week - Deux Points!

Sunday, February 18, 2007

Radio Mooney

It comes as no surprise to me that Matt Cooper’s Last Word on Today FM has overtaken RTE’s Drivetime in the listenership ratings war.

There’s two hours of drivel on RTE before Drivetime, under the stewardship of Derek Mooney, aided and abetted by Brenda O’Donoghue.

I rarely turn off the radio but am all to frequently inspired to do so by this irksome duet. Mooney has a habit of offering strong but gormless opinions on serious topics about which he clearly knows nothing, while O’Donoghue seems to have been drafted in to take the pressure off Mooney by saying and doing stupid things.

The latest whiz to keep listeners happy is a “best bag of chips in Ireland” competition which will be conducted by Brenda and her great friend “Paulio Tullo”. Since his name is Paulo Tullio and pronounced that way, it’s clear she never met the man before in her life. When he laughed at her effort to say his name, she made a couple of extra pathetic efforts, each one confirming that she didn‘t know the man at all.

This really is crap radio and must have listeners switching stations or switching off in their droves.

The family reared in hell

It reads like the storyline for a horror movie of unrelenting awfulness, but the Murphy household in Dalkey was no work of fiction.

The clear inference of the testimony, presented to this weeks inquest into the death of a new-born baby in 1973, is that the children were sexually abused by their father and brother, and also pimped to other local men who included at least one member of the gardai.

Peter & Josephine Murphy raised 10 children, including a granddaughter who subsequently committed suicide leaving a 35-page suicide note, which documented claims of being sexually abused in her grandparents house. Two sons are also dead, one by suicide and the other found dead in dense bushes near Killiney DART station , three years after he went missing.

There is one redeeming feature to this story of the family reared in hell: 30+ years after the event, the truth is finally out and hopefully some sense of delayed justice and closure has been given to the surviving victims of the abuse. It will be interesting to see if any charges are brought against the father and brother who have been accused of molesting the surviving girls. Both men deny that they ever raped their family members.

There now remains the need to investigate the role of the local gardai, both in the actual abuse itself and in the failure to act on earlier complaints by Cynthia Owens. Given the time that has elapsed it’s unlikely that anything can be proven against the non-family abusers, but the victims are entitled to have the effort made on their behalf.

Wednesday, February 14, 2007

The end of the road?

An ominous email received yesterday.

Dear Mr Molloy, -- Is it right to assume that any letters from you which do not refer specifically to items in The Irish Times will also have been sent to the Irish Independent? -- Yours, Liam McAuley, Letters Editor, The Irish Times

I've sent the following reply, which hasn't produced any response:

Dear Liam,
In recent months that has regularly, though not universally, been the case. I read several papers daily, including the IT & Indo, and noticed that many letters page contributors had adopted this approach. Do you have a problem with this?
Regards, Peter

On 20th February I emailed this follow-up:

Dear Liam,
Caitriona Walsh has a letter on PDs/Tribunals in today’s IT & Indo. Ciaran MacAonghusa has his “Culture of Contentment” letter in today’s Indo - you published it on Saturday. David Sowby has a letter on nuclear power in today’s Indo, you had a one from him on The Red Cow last Saturday.
Yesterday, your Opinion page carried a piece on “God Save the Queen” by Gerald Morgan, a man whose letters I often see replicated in all three national broadsheets.
This is just a small sample from a couple of days to illustrate the point that letter writing is a fairly promiscuous activity - the writers want to be published and, if they can’t be confident of having their way with “madam“, they’ll also try some other ladies.
What I find interesting is the reactions I get from family, friends, acquaintances - it’s quite distinct audiences for the Times & the Indo - very few “ordinary” people seem to read both.
Regards, Peter

Footnote: On 21st Feb, the Irish Times published a letter - essentially my blog of 19th Feb "Thanking the Govt"

Spending on the Dáil

Just watched Taoiseach's Questions on RTE 1 - the Dáil chamber was no more than 50% full.

When RTE coverage finished, I switched to Dáil Beo on TG4, where the Taoiseach continued to take questions - from Trevor Sargent and Arthur Morgan.

Trevor was the only Green TD left in the chamber, ditto Arthur for SF. Enda Kenny remained with one FG sidekick, while Bertie's benches were empty apart from Tom Parlon.

There have been media reports in recent months of plans to spend millions upgrading the Dáil chamber in order to accomodate a larger number of TDs required by our increasing population.

Another waste of public money, which seems to flow like water when funding is required for politicians' vanity projects. Let any TD who can't find a seat stand in the chamber or sit on the steps - just as they do in Westminster.

Monday, February 12, 2007

Dunphy Mellow, not a pretty sight

Eamon Dunphy has a one-hour programme on RTE radio every Saturday morning where he interviews one subject and plays 3 or 4 pieces of music selected by his guest.

This is the mellow Dunphy, fully in touch with his feminine side, who never gets aggressive or even asks an awkward question. Many of these interviews sound like a meeting of a small mutual admiration society.

Last Saturday’s guest was Ryanair’s Michael O’Leary, another man noted for his robust and acerbic treatment of anyone who annoys or disagrees with him.

There wasn’t a raised voice or uncomfortable moment in the entire hour for the two boys. Here was a pair of chilled-out, laid-back, mellow lads just shooting the breeze. You couldn’t imagine butter melting in the mouth of either man.

It was hard to marry those images with earlier ones of Dunphy, the poisonous toad at the time of Saipan and his subsequent vilification of all things McCarthy, or O’Leary who has a well earned reputation as a mean-spirited and vindictive employer rather than just a PR motor-mouth on behalf of Ryanair.

Dunphy on football is a somewhat different animal, though he does seem to have calmed down a lot on his regular RTE football panel appearances. He’s calling for the departure of Steve Staunton, though that’s hardly a unique or surprising view. At the outset he was prepared to give Stan the benefit of the doubt, but that’s all changed now. He was previously a big fan of Brian Kerr‘s appointment until he too proved incapable of getting Ireland to any major championship.

Isn’t it gas to remember that the two managers he really hated all the time were Jack Charlton and Mick McCarthy. Yet Jack got us to World Cups in Italy (1990) and USA (1994), while Mick got us to Korea & Japan (2002). Perhaps we should ask Eamon to draw up a shortlist of definite non-runners for Irish manager and then pick one of those.

Sunday, February 11, 2007

Hospital fraud?

Last Wednesday’s Irish Times reported Health Minister Mary Harney as saying in a Dail debate that if a private patient arrived in a public hospital, the consultant received a fee, irrespective of what bed the patient was in.

This seems to indicate that anyone with private health insurance is charged for their stay in a public hospital, regardless of how they got there or what treatment they received.

If you arrive in a public ward bed in hospital via their A&E Department or via a public waiting list, surely your PRSI payments have covered you for this service? Why should your health insurer be asked to pay on the double?

What are the implications if hospitals are charging VHI, BUPA & Vivas for routine admissions to public beds and associated procedures?
1. People who pay both PRSI & Health Insurance are deprived of their entitlements under PRSI.
2. Costs for Health Insurers are inflated with the knock-on effect on annual premiums for members.
3. The hospital is incentivised to extend your stay as a revenue generating measure, when there is clearly a shortage of beds.

Are we in a situation that, in those circumstances, you should refuse to provide information about having health insurance, unless you are being provided with a bed in a private or semi-private ward?

If this is how the system operates, could this be a fraud perpetrated against the health insurers by the hospitals?

The unmanageable in pursuit of the unbiddable

According to the HSE website:
“The establishment (in 2004) of the HSE represents the beginning of the largest programme of change ever undertaken in the Irish public service.
Prior to this, services were delivered through a complex structure of ten regional Health Boards, the Eastern Regional Health Authority and a number of other different agencies and organisations. The HSE replaces all of these organisations.
It is now the single body responsible for ensuring that everybody can access cost effective and consistently high quality health and personal social services. The service will be delivered making best use of resources allocated by Government. The largest employer in the State, the HSE employs more than 65,000 staff in direct employment and a further 35,000 staff are funded by the HSE. The budget of almost €12 billion is the largest of any public sector organisation.”

Oscar Wilde described fox-hunting as “the unspeakable in pursuit of the uneatable”. To paraphrase Wilde, the current HSE/Hospital Consultants dispute is “the unmanageable in pursuit of the unbiddable”.

When the HSE was formed and the multiple regional health boards abolished, there should have been multiple redeployments, early retirements and redundancies among staff of those bodies. In any real business this would have been the inevitable consequence of the merger.

Instead, in the interests of industrial peace, the Government conceded that there would be no redundancies and no forced relocations. The end result must be an organisation with multiple duplications and overlaps, sections with no real function to perform, disgruntled employees who have lost status and career prospects.

The result is that there is probably a substantial “fifth column”, some of it at quite senior level, working within the HSE to undermine the organisation and prove that the new structure is unworkable. This “fifth column” is undoubtedly welcomed and abetted by representatives of the various interest groups who are at odds with the HSE - not just employee groups such as consultants and nurses, but also local hospital support groups.

The Government replicated this flawed approach in its efforts to cover up the complete nonsense that is their 2003 Decentralisation Strategy, happy to waste public service employees and public money to disguise its own incompetence.

The danger now is that, with the next election in sight, the Government will simply try to buy industrial peace in the Health Service by conceding on all fronts, wasting even more public money. If this approach is adopted, it simply digs an even deeper hole into which more money is poured and increases the risk of the whole health service becoming even more dysfunctional.

Footnote: Excluding sections in italics, published as a letter in the Irish Independent. An edited version also appeared in the Irish Examiner on 26th Feb.

Friday, February 09, 2007

A good start to the weekend!

Just as I heard the bad news that O'Driscoll (and Stringer) won't play against France on Sunday, my doorbell rang.

A courier delivery contained a pleasant surprise. It was from Cooley Distillery and contained 3 bottles of The Tyrconnell Single Malt Whiskey. The delivery note was from Cooley and the only clue was a cryptic "letter of the week" annotation.

I can only assume it's from the Independent Group - though whether it relates to daily or Sunday, or which letter it's for, I have no idea.

However, it's a first tangible reward for all the letter writing and a bloody good start to the weekend. Cheers, Sir Anthony.

Wednesday, February 07, 2007

For Whom the Bell Tolls?

Under the headline “It is time we found out for whom the RTE Angelus bell tolls”, Bruce Arnold (Sunday Independent 4th Feb) has serious points to make regarding the potential clash between religion and medical ethics, and concerns about the influence of the catholic church on our politicians, but uses the Angelus on RTE to first alienate a sizeable portion of his readership.

The Angelus oppresses no-one, even if it seems to offend Mr Arnold. There is a world of difference between being offended and being oppressed.

The Angelus represents part of the tradition and culture of a sizeable majority of the native population of the Republic to which RTE broadcasts.

The political correctness which seeks to dictate that the majority should abandon non-oppressive traditions in order to show respect to minorities is surely a flawed approach. If the majority show such scant regard for its own traditions, what does that say for its likely respect for minority traditions in future years?

Footnote: Published as a letter in the Sunday Independent.

Mayday call for the PDs?

Is it all hands to the pumps on the sinking PD ship?

Today’s Irish Times reports the resignation of PD Director of Policy Seamus Mulconry (my old sparring partner), while in the past 7-10 days the spouses of prominent PD Ministers have been engaging in media outings.

Brian Geoghegan a.k.a. “Mr Harney” has had letters published in both the Irish Times & Irish Independent attacking the opposition. Meanwhile, Dr Niamh Brennan a.k.a. “Mrs McDowell” appeared last Sunday on Marian Finucane’s RTE magazine programme. Although she attacked Pat Rabbitte, Labour Party leader, for seeming to keep his post-election options open, she was never identified as the wife of the PD leader. Is Marian a closet PD supporter or just a desperate housewife who still loves FF?

Hopefully the next election will see the demise of the PDs. If they fail to form a part of the next Government it’s not too hard to see them withering away quietly. A May election could really become a MAYDAY (distress) signal from the PDs.

Monday, February 05, 2007

Hospital Consultants again

My 26/1/07 blog "Breaking the Consultants Stranglehold", published in the Indo (and Examiner) produced three published responses, including one from the IHCA (who also sent a hard copy to my home address). My riposte, below, was published in the Independent on Friday 2nd Feb 07.

Dear Sir - My attack on hospital consultants (Letters, January 30) has resulted in several hostile responses from the profession, doubtless a very small sample of those you received. A common theme of those responses is that hospital consultants are much maligned and made the scapegoats for all the problems in the health service.

I think they have only themselves and their IHCA to blame if their own PR has failed to convince the public. However, the public does recognise that problems within the health service are multifactorial, as stated by Brendan O'Hare, medical director of paediatric intensive care at Our Lady's Hospital, and that consultants are only part of the problem.

Hospital consultants are the most highly educated, highly skilled and highly paid group in the Health service. Their salaries equate to those enjoyed by very senior executives in business, probably far more than those paid to the much-maligned hospital administrators, and they should be providing active leadership at local level to help sort out the variety of operational issues which plague their hospitals.

Instead, the most powerful of the many vested interest groups working within the health service are perceived, rightly or wrongly, to be standing back from those local operational issues.

Rather than waiting for the "big strategy" which will solve all problems, they must adopt the maxim "think globally, act locally." In other words, each individual consultant and group of consultants must be seen to tackle those problems within their own span of control, accepting that some of their solutions will be temporary and/or sub-optimal.

The Government (and the taxpayer) is rightly reluctant to simply pour more money into a dysfunctional Health system when far too much of it seems to end up in enhanced salaries rather than enhanced services.

If hospital consultants took a visible leadership role in achieving change, they would greatly influence the other vested interest groups, including HSE and Government, to actively participate in the process.

In such a changed environment, the Government would also be prepared to invest more money in the health system. I am sure that taxpayers would support that investment. Yours etc

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