22nd May 2003
"Include me out" is one of those graphic American expressions like the use of the word "closure" which tells one a lot. The athletes from some countries are to be included out of the Special Olympics games. I'm not an expert in public health and I have already expressed my concern at such a major international event as the Special Olympics going ahead with the public health doctors on strike but those involved in the games have a point when they ask why they have been singled out for such treatment. One person said, if this was a major trade delegation would the delegates have been excluded? Are all those nurses from the Philippines who are coming here to shore up our health service to be told to stay at home? I have a strong suspicion that the public health doctors strike and our lack of confidence in our public health system is the main reason for the athletes' exclusion. Wouldn't it be far better to settle the strike now and not have very disappointed young people being told that Ireland excluded them?
Economics have become increasingly important in this country as to whether we include people in or out. United States of America forces, some in uniform which was definitely unconstitutional, were allowed to traverse Shannon because, we were warned, American companies would pull out of Ireland if we did other than allow this. The United States Chamber of Commerce in Ireland met here recently. Not once did I hear their gratitude for our hospitality to U.S. forces expressed. Instead, they threatened to pull out their companies due to our lack of competitiveness, poor road infrastructure and old fashioned internet systems. Not that I have the heart to totally blame our government for allowing planes to refuel on the way to the invasion of Iraq because the present U.S. government is so vindictive I'm sure we would have suffered with taxation penalties or something like that. But big business is interested in the bottom line rather than political policy and we should remember that.
If the government had had the courage some six months ago to use that favoured Irish phrase "Now looka" to our American friends we might have prevented a huge section of the world becoming a "no go area". Iraq is in turmoil and I do commend our medical colleagues there for coming out and saying that the proposed new Minister for Health was corrupt (include him out!). They succeeded in having another candidate more to their liking installed - imagine if that sort of thing caught on internationally!
Where will we go for the sun in winter now that more and more places are out? No planes to Kenya, the Gulf states in doubt before I got a chance to see more of them than Abu Dabai airport. The war on terrorism has certainly made us draw the wagons into a circle.
Economics are including out more and more in the health service. In view of the fact that we are constantly told to be more productive I was rather surprised that those who work in the A & E Department in Tallaght Hospital weren't commended for their initiative in using the mortuary there to treat patients when it was unoccupied by b.i.d.s. It is sometimes impossible to please. I doubt very much if anyone was unsubtle enough as to say "please come and lie on a trolley in the mortuary". I'm sure all was very tastefully done but as I know, it can be hard to be praised for innovation and incentive.
In case they don't get praise from other quarters let me say how glad I was to see Dr. Joe Fernandez and Amnesty praised for highlighting how included out are the homeless and how hopeless their position. Some of the homeless have minor mental illness because of being homeless but many are homeless because of their illness. My sympathy for the mentally ill who are homeless is almost exceeded by my concern for the staff who have to deal with these patients with totally inadequate resources. I regret to say they are included out, too.
Recently, I organised a debate in Private Members time in Seanad Eireann on the need to build a new hospital for the patients in the Central Mental Hospital. I've gone on and on about conditions there for ten years with no effect but I should not complain because the Inspector of Mental Hospitals has done the same for over twenty. How the staff attempt to treat these seriously ill people in such circumstances is beyond comprehension. I suggested that the first monies from the proposed sale of state property should be used to establish the long promised modern building where something approaching a therapeutic regime for the patients could be put in place.
Well, Senator Brendan Ryan got it about right - he said if the Government did as I requested they would get no praise and if they did not they would get no blame. Naturally at the end of the debate I was told that the Office of Public Works did not build hospitals so that was that. Would that we had someone who gave a Mrs. Thatcher like response and admitted that the mentally ill are "Out, out, out".
Because the mentally ill homeless are sleeping rough and not taking medication I suppose they aren't costing too much. But have we no shame to see people going from psychiatric institution to the streets to prison to psychiatric hospital in an inevitable cycle? Or will it do because we have "included them out"?
Senator Mary Henry, MD
