Reilly File 2

James Reilly is a politician and minister for health. I am primarily a
medical doctor interested in medical science and the proper
organisation of the health services based on the principles set out by
Arnold Relman when he was editor of the New England Journal of
Medicine.

For many years before he was elected I hear various statements from
James Reilly in his time as an IMO leader. Militancy from the IMO is
in my view one of the reasons that medical professionalism has
suffered here. Medical vocationalism was partly sacrificed on the
alter of overtimeism. The income levels in many areas are
unsustainable and are incentives to have cheaper nurse practitioners
and medical technicians operate in areas where doctors only operated
before. James was a good union leader getting well paid deals for his
members and colleagues from government departments.

In his time as an opposition health spokesman for Fine Gael, he
opposed many things in a very definitive and emphatic way. He
certainly knows how to do opposition. Many of the comments he made
would be outside the range of what I thought on various issues. I
certainly would be incapable of carrying on in such a manner because I
though some things that Harney did were correct ( Keane on cancer) but
the trust of her gagging policies and other control measures were
certainly not. An expensive folly is how I would rate the consultants
contract.

I attended health services political meetings on his insurance scheme
and was and am extremely skeptical. The Dutch system has been
criticised in the Lancet and elsewhere and is not the panacea. We
cannot afford it at the moment. The necessity for a good nation wide
information technology system to run the payments and diagnostic
groups is someway in the future. Just look at the screw up in the NHS
from computer companies – £300 million and counting.

How can an insurance system of payment address the supply side problem
of out-patient waits?

How can the NHS doctor employed to do an NI on the long queues make
the changes stick when you look at the revertion in Northern Ireland?

Openness and transparency and clear English is the only way forward in
the health service.

Enda Kenny should get some advisers who will supply him with another
view. Awkward situation but there you are! C’est la vie.

How Fine Gael came up with this policy, I am not certain. Was it a
flash of brilliance from Alan Dukes? Why were neither John Barton in
Ballinasloe nor myself in Beaumont consulted?

A little more humility and a little less hubris might be in order.

Have a nice day!