I left this comment on the article in today’s Irish Times by James Sheehan, which is titled ‘Radical reform and renewal needed in our obsolete hospital system’.
-“What’s the diagnosis, doctor?”
Elsewhere in today’s Irish Times, John Waters reviews a recent study by Julien Mercille of UCD, and concludes that economic debate in Ireland’s main newspapers was characterised by “an overwhelming degree of uncritical acceptance of fiscal consolidation/austerity”. This study also revealed the predominance of figures from elite institutions among outside writers. We might speculate, mutatis mutandis, if the same thing happens in other areas of public debate, such as health and social affairs.
The study cited by John Waters grounded the media coverage in successive Irish governments’ addressing of the crisis by following neoliberal principles – austerity, ‘structural reforms’, privatisation of public assets, and the protection of the financial sector against the interests of the population at large.
In this particular article by James Sheehan, the founder of the private Blackrock Clinic and someone who can get the Minister for Health to speak at his book launch, there is a great deal that conforms to the same neoliberal principles. Let me focus on one aspect in particular: the idea that healthcare planning -as with so many other aspects of public policy under neoliberalism- must be “removed from political interference”.
On the surface, this, under the guise of blandishments about “radical reform”, may appear an attractive idea: why should self-serving politicians stick their oar in and wreck attempts by experts to improve public health? But politicians -even if they often act in Ireland as the enemies of people who elected them- are supposed to represent the interests of the public at large.
What James Sheahan calls “political interference” is, in fact, supposed to be someone articulating concerns on behalf of the public. And rightly so, since the health of the public, the quality of services they are able to access, the question of who owns hospitals and who pays for them, are fundamental political issues.
So even as Sheahan talks up the “shame” of “concerned citizens” due to the parlous state of Irish hospitals, he advocates that such citizens should hand over the decision making process to the experts. Trust us, we’re doctors.
Well, it’s one thing to trust in medical practitioners who are treating you for a condition. But as we have seen in recent days with payment scandals in publicly-funded bodies, it’s another thing entirely to entrust the running of the health system to unaccountable private interests, however much Ireland’s media might try, on behalf of elite interests, to shape our disposition in this direction.
And it’s worth dwelling on the particular elite interests getting expressed in this article. James Sheehan is also a patron of the Iona Institute, which has one columnist writing weekly in the Irish Times, and another writing weekly in the Irish Independent. The Institute also has regular access for its contributors to RTÉ and other media channels, where it often appears as a representative voice for committed Catholics.
It has, in other words, a powerful media presence, conferring it the power to shape public perceptions about what is possible (private health, private education) and what is not (universal healthcare, an end to government funding for private schools) what is acceptable (heteronormative families where the mother works unpaid to maintain the home and raise children) and what is not (gay marriage, abortion).
Perhaps John Waters could examine the influence of these elite interests in his next article? I am sure there would be a great deal more to discuss, particularly in terms of how private actors can exercise decisive control over institutions that many people assume to be public.
ADDS: A recent feature in Legatus Magazine, the journal of the ‘organisation for top-ranking Catholic business leaders’ -‘and their spouses’-, Legatus’ 2013 Ambassador of the Year, outlines how “Jimmy and Rosemary faced a lot of opposition from political parties and various people trying to put obstacles in the way of their setting up the (private) hospitals.” Political interference, how are you.
Sheehan is reported in the article as saying “with the religious orders largely withdrawing from health care due to lack of numbers, I felt it was important that those of us in the laity took up that role, to propagate the culture of Catholic hospitals.”
The article also says that “a prominent chapel is at the heart of the Galway Clinic, right off the main lobby, with wards surrounding it named for Our Lady of Knock, Blessed John Paul II, and Blessed Mother Teresa.”