December 2013        

Health worsens as mandarins thrive

As Christmas approaches it has become apparent that Santa Claus comes early and often to the mandarins of the Health Service Executive and their appointees in various hospitals and centres. Even some consultants have become enmeshed in the seasonal cheer and have been caught in the act.
      The most scandalous instance of the top-up culture comes from Our Lady’s Hospital for Sick Children in Crumlin, Dublin, where senior executives robbed the kiddies’ sweet-shop to give themselves extra bonuses.
      Then there is the case of the Central Remedial Clinic, where fund-raising for the centre was diverted to provide top-ups for the chosen few. And almost daily come revelations of more scandals, as those without any scruples or sense of shame continue to wage war on the poor, sick, disabled, and defenceless.
      Our Lady’s Hospital for Sick Children has also confirmed that its chief executive, Lorcan Birthistle, is getting a private allowance of €30,000, generated from the profits of the hospital shop. This brings his salary to €140,808.
      At the Central Remedial Clinic it has emerged that its chief executive, Paul Kiely, trousered more than €135,000 in top-up and allowances from its own funds, on top of his salary of €106,900 provided by the HSE. The breakdown was: salary provided by HSE, €106,900; allowance (CRC), €19,000; top-up from CRC, €116,965; total, €242,865.
      Others at the CRC also benefited from top-ups. These include officials working in client services and network administration. In addition to salaries of €79,000, three blazers got top-ups of €32,000. The IT manager had a salary of €79,000 but also grabbed a top-up of €37,000.
      From the National Maternity Hospital in Holles Street, Dublin, came the revelation that its master, Dr Rhona Mahony, is getting a privately funded top-up of €45,000 in addition to her salary and allowances of more than €236,000.
      Daily we are reminded that this top-up culture, based on greed and bolstered by the ideology of the free market, is not new but permeates Irish society like a rotten abscess.
      The Adelaide and Meath Hospital at Tallaght, outside Dublin, said it ceased top-up payments to senior staff members in 2010, after it was revealed that approximately €700,000 was paid out from public funds to five senior staff members there between 2005 and 2010. But a report by the Heath Information and Quality Authority into governance issues at Tallaght, published eighteen months ago, revealed that senior managers were receiving top-ups, in one case to the tune of €150,000.
      And in May 2012 the Sunday Business Post published a comprehensive story under the heading “Mater says top-up payments made to 17 consultants and executives.”
      While these senior executives and consultants are making hay, the plight of public patients worsens. Wards are closed and staffing levels reduced. Those at the front line, such as nurses and junior doctors, are stretched to breaking point as they try to maintain some level of civilised care. A&E departments are packed. Instead of waiting on trolleys as a step to a bed, patients queue on chairs for hours in the hope of getting a trolley. In the areas of step-down facilities, the situation is dire.
      Home help and care services are slashed, and waiting-lists are lengthening. Enda Egan of the Carers’ Association has been quoted as stating that “carers who had asked for more incontinence pads were asked to bring in used ‘nappies’ to be weighed so the HSE could determine if they actually needed more than the permitted quota!”
      And patients and their families can expect even more hardship next year. A letter from the director-general of the HSE, Tony O’Brien, to the minister for health, James Reilly, leaked to the media reveals that the plan to cut spending on medical cards will now run to €133 million—up from the planned €113 million. And the HSE has been asked to make a total saving of €666 million next year.
      Meanwhile there is no shortage of resources for those at the top. Top-ups funded by pocketing the charges from car parks and robbing patients’ sweet-shops are always an option. There seems to be no shortage of these top-ups. There is little concern that these extra payments are being made at a time when more than €3 billion has been cut from the health budget over the past five years. And next year up to €1 billion more is due to be slashed.
      The rich and powerful flourish while we, the poor, teeter on the brink of the abyss. For us it is the daily grind for survival in the face of unemployment, illness, disability, cut-backs in health, pay, and welfare, social charges, stealth taxes, and threatened evictions. Meanwhile the rich, powerful, well-connected minority live the life of Reilly. Their policy is the neo-liberal Tory mantra, “Greed is good!”
      All this is just the latest manifestation of class war in Ireland and the class nature of the state. What is usually hidden is suddenly revealed as the contradictions inherent at this specific moment of capitalist and imperialist crisis intensify.
      This can be fought, but only through the united action of anti-capitalist and anti-imperialist forces. Unity and co-operation on a principled basis is the key!

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