Some notes on Irish health care and abortion

What follow are two comments I posted on two recent Irish Times opinion pieces by Ann Marie Hourihane yesterday and Monday previous. The first was titled ‘A medical conspiracy against the public‘, and the second was titled ‘Hospital patients’ relatives are also victims of our shoddy health system.’

Both pieces were published accompanied by a picture of Praveen Halappanavar. Both used Praveen Halappanavar’s experience in University Hospital Galway as a starting point for a discussion of the general problems of the Irish hospital system, but without discussing the crucial matter in the Halappanavar case, the fact that Savita Halappanavar was refused an abortion because of the law.

As I note in the second comment, this approach uses precisely the same framing of the issue as the Catholic Right.

Considering both these articles – and the publicity generated by the first article, with discussion on Liveline among other things- I think there are a couple of other things, beyond the avoidance of the key issue of the refusal of an abortion, worth highlighting. There is no mention of rights in either article.  There is no mention of how the Irish health system divides patients up in terms of their ability to pay, in terms of private and public.

What there is instead is reference to ‘conspiracies against the public’, and ‘faceless managers (making) darn sure they remain faceless’: a kind of discourse regularly used to justify attacks on public sector pay and conditions and collective bargaining.

More suspicious minds than I might read such things and conclude that public services, which are presently being dismantled under the Troika-backed austerity drive, are being conflated with the bureaucratic despotism of the State, and that the effect is both to shield certain constituencies from scrutiny and/or blame for Savita Halappanavar’s death, and to mobilise animosity against the very idea of public services owned by the public.

First comment (on the piece titled ‘A medical conspiracy against the public’)

It’s beyond doubt that the Irish hospital system is deeply deficient. It’s beyond doubt that every day patients who ought to expect quality care delivered with warmth endure pain, isolation and humiliation and bewilderment instead.

However it’s wrong to claim identification with Praveen Halappanavar, as this piece does, without addressing the specific, central issue in his case: the fact that Savita Halappanavar was denied a termination because of Irish law, and, according to the expert witness in the inquest, would still be alive had her request been granted.

The central issue in the Savita Halappanavar case is not that the hospital system is a ‘conspiracy against the public’, but that the Ireland’s abortion laws are the expression of a conspiracy against women and an attack on women’s rights. Her request for an abortion was denied because ‘the public’ considers women’s bodies as property of the State.

It is wrong to draw a veil over this specific violation of rights whilst using Praveen Halappanavar’s ordeal to make observations about a situation characterised by the absence of health rights in general (in fact the author does not make mention of rights of any kind).

Second comment (on the piece titled ‘Hospital patients’ relatives are also victims of our shoddy health system.’ This piece included the following: ‘(Savita Halappanavar’s) death was not just about Ireland’s abortion law; it was about an abysmal standard of hospital care. Why is it in poor taste – as implied by several correspondents to this newspaper – to associate Praveen Halappanavar’s suffering with that of the relatives of other patients in the same hospital system? It is only logical to do so.’

I found the author’s previous column associating Praveen Halappanavar with the general problem of the quality of care in Irish hospitals objectionable. Not on account of taste, however, but because it did not address the central fact of the matter in Savita Halappanavar’s death: she was denied an abortion when she requested it on account of this country’s laws. Her death was a consequence of this, as concluded by the expert witness to the inquest. Therefore it did not treat the fact that a patient was denied the treatment she requested, on account of legal restrictions that do not exist in most other jurisdictions, as in any way significant to a discussion of general health system concerns. This, by the way, is precisely how the Catholic Right is framing Savita Halappanavar’s death: there was no violation of women’s rights, merely inadequate care.

In presenting the Savita Halappanavar case as a simple example of deficient care, that article, and this one, pass over in silence the basic political question of how the State and the social relations that underpin it determine the nature of health care in Ireland.

To wit, if a State considers a women’s bodies as primarily the State’s property, and not her own, shouldn’t that tell you something about the kind of society you live in, and what you might expect from its health system in terms of rights?

Look at the way ruling politicians have sought to instrumentalise psychiatrists -as “social police”, as the president of the College of Psychiatry in Ireland put it- so as to maintain this inhuman order that maintains women as property of the State. Doesn’t that tell you something important about the interests governing the health system in Ireland?

Elsewhere in the papers today, a former Taoiseach, and present chairman of an influential financial lobby group dedicated to preserving the interests of a centre enabling corporations to avoid paying tax that would sustain things such as public health systems, writes of his opposition not only to abortion but also to allowing women to travel for an abortion [the reference is to a John Bruton article in the Irish Independent]. Doesn’t tell you something about how the political and media establishments view the question of public health, and the fundamental -political- matter of health rights – a matter both of the author’s articles have ignored?

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