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35 years ago today July 3, 2016

Posted by Tomboktu in Health, LGBT.

Is health insurance a scam? August 14, 2014

Posted by Tomboktu in Business, Health, Medical Issues.
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Is health insurance a scam?

I discovered today VHI has been including home-birth cover in my plan for some years. Gay male, late 40s, and I will so need that! More fundamentally, I’ve been paying for healh insurance for over 15 years, but as I have been approaching 50 in the last few years, the cost has been rocketing. Is it a case of reasonable rates when you’re young(er) and healthy (healthier), but push them up when you get to the age you’ll begin to need insurance, not matter how long you’ve been paying without drawing down?

This year, the price has to the point where I looked at it and wondered “why pay this?”

This morning, as I was discussing the options on the phone with the rep, I kept coming back to “If I’m so ill that I need insurance, my concern is to get the treatment, not to be in a first class hotel-standard room.”

Sex education in Irish schools March 5, 2014

Posted by Tomboktu in Education, Health, Human Rights.

In yesterday’s Irish Times, Jacky Jones uses her column to attack the advocacy of sexual abstinence until marriage as part of Relationships and Sexuality Education in Irish second-level schools. She reminds her readers that “Anyone over 17 years of age, married or single, gay or straight, can choose to have, or not have, consensual sex at any time.”

One of the interesting nuggets she draws attention to is that the Department of Education and Skills cites European human rights law in its 2010 circular to schools reminding them of their obligations (pdf of circular here).

1.5. Access to sexual and health education is an important right for students under the terms of the Article 11.2 of the European Social Charter. The Council of Europe European Committee of Social Rights, which examines complaints regarding breaches of the Charter, has indicated it regards this Article as requiring that health education “be provided throughout the entire period of schooling” and that sexual and reproductive health education is “objective, based on contemporary scientific evidence and does not involve censoring, withholding or intentionally misrepresenting information, for example as regards contraception or different means on maintaining sexual and reproductive health.

Jones asserts in her article that Catholic schools are not entitled to promote Catholic views on sexuality. I don’t know enough about the rights of a Catholic school to know if that is correct, but there is a further aspect Jones did not mention. The Department of Education circular she quotes from also cites the Education Act:

1.4. Regard must also be had to Section 30 (2) (e) under which a child may not be required to attend instruction in any subject which is contrary to the conscience of the parent of the student, or in the case of a student who has reached 18, the student.

At some stage in the mid 1990s I attended the launch, in the city’s museum, of the Derry Pride Festival. A few of us were amused when some Free Presbyterians showed up outside to protest, singing hymns: a handful of zealots were not a threat. But we were mistaken to see it only as amusing. One of the people at the launch inside the museum was the teenage son of one of the singing protesters outside.

Jones points out in her article that we have no information on whether restrictions on young people’s rights to objective relationships and sexuality education are practised, although I would bet that the Opus Dei school in Dublin does not teach objectively about the role of contraception.

The Education Act was passed in 1998, before the European Committee of Social Rights was asked to rule on the Croatian case that the Department quotes in its 2010 circular. It is time to re-visit Section 30(2)(e) to ensure that it cannot be used by parents to restrict their children’s rights to full RSE education.

Constitutional Convention February 24, 2014

Posted by Tomboktu in Bunreacht na hÉireann, Health, Housing, Human Rights, Judiciary, Religion.

It would not be correct ot say that the Convention on the Constitution has been radical, but it has wrapped up its work with its most radical recommendation.

In Ireland, economic, social and cultural (ESC) rights are included in the Constitution merely as “directive principles” for the guidance of the Oireachtas. (The exception is the right to a primary education.) The Constitution states that these rights “shall not be cognisable by any Court under any of the provisions of this Constitution”. [An aside: doesn’t the word ‘cognisable’ sound like street slang for ‘recognisable’? The image of Dev getting down with the lads doesn’t seem right. At all.]

The principles listed under this provision are

  • an adequate means of livelihood
  • ownership and control of the material resources distributed to best subserve the common good
  • the operation of free competition not being allowed so todevelop to the common detriment
  • the aim of the control of credit shall be the welfare of the people as a whole
  • there may be established on the land in economic security as many families as practicable
  • the State whall favour and, where necessary, supplement private initiative in industry and commerce
  • private enterprise shall be conducted to ensure reasonable efficiency in the production and distribution of goods and to protect the public against unjust exploitation
  • the State safeguarding with especial care the economic interests of the weaker sections of the community
  • ensure that the strength and health of workers, men and women, and the tender age of children shall not be abused

Those of us on the Left would hardly think it radical that any of these would move to legal requirements that can be invoked before the courts, and would not be thrilled to see the status of private industry — already sheltered with property rights — re-inforced by being made something judges must take account of in legal decisions.

An overwhelming majority — 85 percent — of the members of the convention voted in favour of the broad proposition that the Constitution should be amended to strengthen the protection of economic, social and cultural rights. A smaller majority — 59 percent — recommended that the Constitution be amended by the insertion of a provision that the State shall progressively realise ESC rights, subject to maximum available resources and that this duty is cognisable by the Courts. This was the strongest of three options the Convention considered for strangthening the status of ESC rights in the Constitution.

However, progressive realisation subject to maximum available resources is not a very strong standard.

It also voted on five possible specific new rights to be named in the Constitution:

  • housing
  • social security
  • essential health care
  • rights of people with disabilities
  • linguistic and cultural rights

In each case, it voted overwhelmlingly in favour of each of these — the least popular was linguistic and cultural rights, with 75 percent support.

It also voted for the “rights covered in the International Covenant on ESC Rights” to be named in the Constitution — this received support from 80 percent of the members of the Convention.

I do not expect this recommendation to go far. The idea that citizens could go to the courts to invoke rights on these matters is simply too alien to our governments, politcal and permanent. Indeed, when an alliance of NGOs first met last year to discuss the idea of asking the Convention to consider the issue, they held a seminar at which the political parties sent representatives to give their views. It was disappointing to hear the party representatives say that constituional protection of ESC rights is not something they support. I hope some them reconsider in lgiht of the numbers from Sunday’s vote.

Dr Noël Browne resigns April 12, 2013

Posted by Oireachtas Retort in Health, History.
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..today 1951.

The health of Irish women & children is free from undue influence 62 years on thankfully.

An Leas-Cheann Comhairle: Deputy Dr. Browne has given notice of intention to ask the permission of the House to make a personal statement.

Dr. Browne: It is fitting and, I am informed, in accordance with usage, that I should explain to the Dáil very briefly the reasons which led me to resign my position in the Government. I am deeply grieved that I have found myself compelled to take this step.

Since becoming Minister for Health I have striven within the limits of my ability to improve the health services of the country. Some progress has been made but much remains to be done. It is perhaps only human that I should wish to have the honour of continuing the work. However that is not to be. To me the provision of a health scheme for the benefit of the mothers and children of our nation seems to be the very foundation stone of any progressive health service without which much of our efforts in other directions would prove fruitless. It seemed equally important to me that any such scheme to be effective and indeed just should be made available free to all our people who choose of their own free will to use it without the imposition of any form of means test. On this point did I stand firm in my negotiations with the medical profession. On other matters I was willing and, indeed, eager that the profession should from their knowledge and experience play their full part in improving the scheme.

I had been led to believe that my insistence on the exclusion of a means test had the full support of my colleagues in the Government. I now know that it had not. Furthermore, the Hierarchy has informed the Government that they must regard the mother and child scheme proposed by me as opposed to Catholic social teaching. This decision I, as a Catholic, immediately accepted without hesitation. At the same time I do not feel that I could be instrumental in introducing a scheme which would be subject to a means test. Apart from my personal views about a means test I feel that in taking the decision which I have had to take, as a man privileged to hold my high office, there is another principle to which I had to have regard. I have pledged myself  to the public and to the Clann na Poblachta Party to introduce a mother and child health scheme which would not embody a means test. Since I could not succeed in fulfilling my promise in this regard I consider it my duty to vacate my office.

While, as I have said, I as a Catholic accept unequivocally and unreservedly the views of the Hierarchy on this matter, I have not been able to accept the manner in which this matter has been dealt with by my former colleagues in the Government.

In June, 1948, the Government, in Cabinet, authorised me to introduce a mother and child health scheme to provide free maternity treatment for mothers and free treatment for their children up to the age of 16 years. At the meeting of the Government at which this decision was taken the question of whether the scheme should be free to all those anxious to use it was discussed. The decision of the Government was, in effect, that there should be no means test. I, accordingly, on the authority of the Government, wrote in August, 1948, to the Irish Medical Association to inform them that the Government had considered their representations on the question of a means test in the proposed mother and child health scheme and had rejected their proposal for its imposition.

Following discussions with the Department of Finance, agreement was reached on the financial aspects of the scheme, which was thereupon drafted. The Estimate for the Department of Health for 1950-51, with the consent of the Government, included almost £400,000 for a scheme without a means test, but as it had not been introduced, this money was not expended. Nearly 12 months ago direct negotiations on the scheme were entered into with the Irish Medical Association. A copy of the draft scheme, based on these principles, was also transmitted to each member of the Government for his information. In the course of negotiations with the Medical Association, counter-proposals were made by them. These proposals were rejected by me as being in conflict with the policy in relation to a means test which the Government had already made, and which has only formally been rescinded by them as late as Friday last.

On the 10th October, 1950, I was informed that His Grace the Archbishop of Dublin, wished to see me in connection with the proposed scheme. I attended at the Archbishop’s House on the following day where I met His Grace and Their Lordships, the Bishops of Ferns and Galway. I was informed that at a meeting of the Hierarchy on the previous day at Maynooth, His Grace and Their Lordships had been appointed to put before the Government certain objections which the Hierarchy saw in the scheme; that I was being informed of these objections as a matter of courtesy before transmission to the Taoiseach as head of the Government.

His Grace read to me from a letter which had been prepared for transmission to the Taoiseach. A general discussion followed. At the conclusion of this interview I was under the impression, erroneously as it now appears, that His Grace and Their Lordships were satisfied with my explanation of the scheme and with my answers and undertakings given in regard to the objections made by them. On that day I was also informed by His Grace the Archbishop of Dublin, that he was meeting the Taoiseach on the following morning, 12th October. On the following day the Taoiseach spoke to me of his interview with His Grace the Archbishop of Dublin, and he informed me he had been told by His Grace that he and Their Lordships were satisfied following their interview with me. The Taoiseach has since denied that he made this statement. What is certain. however, is that he did not give me to understand that His Grace and Their Lordships remained unsatisfied.

About the 9th or 10th November I learned that the Taoiseach had received a letter, dated 10th October, 1950, from the Bishop of Ferns, as secretary to the Hierarchy. The Taoiseach gave me this letter for my observations with a view to a reply. The objections in the letter appeared to be those read to me by His Grace the Archbishop of Dublin, during my interview on 11th October, and, in the light of the later events, I concluded that it had been transmitted solely for the purpose of record and formal reply. I, therefore, acting on this assumption, prepared a draft letter for transmission by the Taoiseach to His Lordship of Ferns, as secretary to the Hierarchy, in reply to the various points raised in their letter. In this answer I substantially recapitulated the case I had made when I met His Grace and Their Lordships at Drumcondra on 11th October. I would like to emphasise that, as I still believed that His Grace and Their Lordships had been reassured by the case made by me on the 11th October, I merely regarded this reply also as being for purposes of record by the Hierarchy. I sent this draft to the Taoiseach shortly after mid-November to be forwarded by him to the Hierarchy. As I heard nothing further about the matter from either the Hierarchy or the Taoiseach until a couple of weeks ago I had no reason to believe that the Hierarchy were not fully satisfied, and the work of preparing for the introduction of the mother and child scheme continued.

From October onwards discussions were continued with the Irish Medical Association in an effort to reach agreement. The association was also interviewed by the Taoiseach and the Tánaiste. An account of that interview (which, I understand, was submitted to the Taoiseach) is contained in a circular letter issued by the Irish Medical Association on 12th December, 1950, to their members, in the course of which it was stated that it was the Taoiseach’s considered opinion that neither the Dáil nor the Seanad would approve any amendment of the Act or regulations which would envisage the omission of a free service for all in connection with the scheme. Preparations for the introduction of the scheme progressed and on 6th March its early implementation was widely publicised by me.

In the meanwhile the Book of Estimates for the financial year 1951/52 had been published in which provision was made (page 403) for an expenditure [671] of £661,000 on mother and child services, and it was explained in a footnote on that page that further expenditure of about £300,000 in the year was probable, and that a Supplementary Estimate would be introduced.

On the 9th March I received a letter from His Grace the Archbishop of Dublin. From this letter I was surprised to learn that His Grace might not approve of the scheme, and declared that the objections which had been raised by him in October had not been resolved. I was surprised for the simple reason that I had heard nothing further, either from His Grace the Archbishop of Dublin, acting on behalf of the Hierarchy, or from the Taoiseach, acting for the Government, in the four months that had intervened since I had handed to the Taoiseach in November my reply to Their Lordships’ letter. Following receipt of His Grace’s letter, a copy of which was sent by His Grace to the Taoiseach, the latter suggested to me on the 15th March that I should take steps at once to consult the Hierarchy regarding their objections to the scheme. I then learned to my distress and amazement that the reply to Their Lordships’ letter which I had prepared and sent to the Taoiseach in the previous November had, in fact, never been sent by him. The Taoiseach has given three explanations—two to me and one to the Hierarchy and all differing—as to why he did not forward my letter to the Hierarchy. One reason to me was that he considered the reply ineffective; another was that no covering letter from me was received with it and he did not realise that. I wanted it sent to the Hierarchy. In his letter of March 22nd the Taoiseach says that he explained to His Grace the Archbishop of Dublin, his reasons for not replying to the Hierarchy, and that His Grace conveyed these reasons to the Hierarchy. The third reason for not replying, which appears in the Taoiseach’s letter of March 27th to the Hierarchy, was that he and His Grace the Archbishop of Dublin, believed it to be more advantageous in the [672] special circumstances of the case to await developments.

I told the Taoiseach orally that his failure to forward this reply had placed me in a very embarrassing position and might easily give Their Lordships the impression that I had omitted to give any consideration to their objections and that further I had been guilty of extreme discourtesy in failing to ensure that a reply had been sent to them. I also pointed out that his failure to send this letter had the effect that I remained under the erroneous impression that the objections of the Hierarchy had been fully resolved and that I could proceed with the scheme. I was surprised also to learn from the Taoiseach that he had been in constant communication with His Grace the Archbishop of Dublin, on this matter since the receipt of the letter of 10th October from the Hierarchy, so presumably he was fully aware that Their Lordships’ objections were still unresolved. He offered no explanation as to why, in the light of this knowledge, he had failed to keep me informed of the position; had allowed me continuously to refer in public speeches to the scheme as decided and unchanged Government policy, and finally had allowed the scheme to go ahead to the point where it had been advertised at considerable public expense and had been announced to the public, both in these advertisements and by my radio talk. He, furthermore, offered no explanation as to why, being aware of the Hierarchy’s objections to the scheme, he continued to allow the Tánaiste, Dr. O’Higgins and myself to negotiate with the Medical Association, and why, in the light of this knowledge to which he now confesses, he himself informed the Medical Association that the Government would not agree to the inclusion of a means test.

This conduct on the part of the Taoiseach is open, it seems to me, to only two possible explanations—either that he would not oppose the scheme if agreement were reached with the Medical Association on the means test or that. in the light of his knowledge of the objections still being made by the Hierarchy and withheld from me, [673] he intended that the scheme without a means test must never in fact be implemented.

At this time medical opposition became very intense, however. Yet I, acting on the Government decision of 1948 and my own convictions in the matter, remained constant in my determination to exclude a means test from the mother and child scheme. On the 14th March the Taoiseach spoke to me in Leinster House concerning the growing opposition of the Medical Association and informed me that he now believed that there should be a means test and that he was in favour of the Medical Association’s views on that matter. I challenged him, as I challenged the other Ministers—Mr. Dillon, Dr. O’Higgins, Mr. Norton and Mr. MacBride—who made similar representations, that they should consider this matter not as individuals but as a Cabinet and if they so wished reverse their decision of 1948 to exclude a means test. I would then take whatever action I considered fit in regard to my personal position. They all refused to take this course. On the 14th March I received a letter from the Minister for Finance pointing out that a change I had proposed that private general practitioners should be admitted to the scheme would involve a further expenditure of public moneys and that, consequently, the matter would require to be placed before the Government. As the amount involved was very small in relation to the total cost of the scheme and as he had allowed the larger financial issues in the main scheme to be settled without formal reference to the Government, this attitude surprised me.

Evidently at this time my former colleagues finally realised that I was adamant—that nothing short of a Government decision to the contrary would alter my determination to implement a scheme without a means test. They now revealed the final objection to my programme—the objection of the Hierarchy.

Despite the representations of the Taoiseach on the 14th March concerning his fears of the repercussions from the opposition of the Medical Association and concerning his wish and [674] anxiety to retain a means test in the proposed scheme, and despite also the letter which I received from the Minister for Finance on the same day, which pointed out the importance of the economic implications in my proposed extension to include private practitioners, is it not strange that in the long and carefully worded letter of the 15th written by the Taoiseach on the very day following these various objections of money, means test, necessity for further Cabinet consideration on the scheme, the danger of opposition from the Medical Association—that none of these politically dangerous objections was mentioned, but the objection which, in his then view, was the only outstanding one—the views of the Catholic Hierarchy? My fears at this stage that the Government were unwilling to ratify their decision of 1948 to initiate a scheme with no means test have been confirmed by the contents of this letter.

The letter sent by the Taoiseach on the 27th March, 1951, to the Bishop of Ferns, in his capacity as secretary to the Hierarchy, enclosing my observations, refers to the scheme “advocated by the Minister for Health”, thereby implying that the scheme was not advocated or supported by himself or other members of the Government. In a letter of the 5th April from His Grace the Archbishop of Dublin, written on behalf of the Hierarchy, it is stated that they were pleased to note that no evidence had been supplied in the Taoiseach’s letter of the 27th March that the proposed mother and child scheme advocated by the Minister for Health enjoys the support of the Government. I have, accordingly, regretfully come to the conclusion that, notwithstanding the Government decision of June, 1948, against the inclusion of a means test, the Taoiseach and the other members of the Government had, in fact, changed their minds about the scheme.

It is a fact noted by many people that in no public speeches did Ministers of the Government other than myself speak in favour of this measure. I regret that for the want of courage on their part they should have allowed the [675] scheme to progress so very far—that they should have failed to keep me informed of the true position in regard to their own attitude and the attitude of others. I have, consequently, been allowed by their silence to commit myself to the country to implement a scheme which certain members of the Government at least did not want, on their own admission, to see implemented and which they were in fact aware could not be implemented.

I trust that the standards manifested in these dealings are not customary in the public life of this or any other democratic nation and I hope that my experience has been exceptional.

I have not, lightly, decided to take the course I have taken. I know the consequences which may follow my action. The honesty of my motives will be attacked by able men; my aims will be called in question; ridicule and doubt will be cast upon the wisdom of my insistence in striving to realise the declared objectives of the Party to which I belonged.

As Minister for Health I was enabled to make some progress in improving the health services of the nation only because I received the generous cooperation of members of all political Parties and of all sections of the community.

I lay down my seal of office content that you—members of this House—and the people who are our masters here, shall judge whether I have striven to honour the trust placed on me.

The Taoiseach: It is obvious that the statement made by the former Minister for Health requires an answer at the earliest possible moment. I, therefore, with your permission, propose to move the Adjournment of the House at 7.30 in order that I may have an opportunity of replying. In the meantime, may I say that I have seldom listened to a statement in which there were so many—let me say it as charitably as possible—inaccuracies, misstatements and misrepresentations?

Mr. Morrissey: Hear, hear!

Mr. Flanagan: May I ask the Taoiseach whether, when the Adjournment [676] of the House is moved at 7.30 for a discussion of this matter, an opportunity will be given for the purpose of discussing the allegations made by Deputy Dr. Browne against the Minister for External Affairs for participating in corrupt practices?

Mr. Kitt: The lawyers will make another Locke’s Distillery out of this.

Mr. O’Rourke: Will we be allowed to examine the correspondence?

Mr. Flanagan: I believe that this statement that has been made by one Minister against another will have to be cleared up and I hope the Government will realise their responsibility in clearing it up, and if Deputy MacBride is guilty of any irregularities, he will be required to answer to this House.

Mr. C. Lehane: The Minister for External Affairs does not need any defence against attacks from any little whipper-snapper like Deputy Flanagan, who was never heard of until a few years ago.

Mr. Flanagan: There has been a charge made, Sir——

An Leas-Cheann Comhairle: I must ask Deputy Flanagan to resume his seat.

Mr. Flanagan: I merely rose to say——

An Leas-Cheann Comhairle: Not now. The Taoiseach will move the Adjournment at 7.30 and there will be a discussion then on the statement made by Deputy Dr. Browne.

Mr. Flanagan: Will we be allowed to discuss the correspondence that appeared in to-day’s papers?

An Leas-Cheann Comhairle: The discussion will be on the statement made by Deputy Dr. Browne.

Mr. Flanagan: That is good enough; we will have the correspondence, then.

Minister for External Affairs (Mr. MacBride): The last Deputy who spoke, Deputy Oliver Flanagan, has availed of this occasion to make a dirty and slanderous insinuation against me. I shall welcome any [677] inquiry that this House may decide upon on a free vote.

Mr. Smith: Pontius Pilate!

Mr. MacBride: That comes very well from Deputy Smith.

Mr. Smith: Pontius Pilate!

Mr. Murphy: There is a lot of honesty over there!

An Leas-Cheann Comhairle: We cannot have discussion now. The discussion will be on the motion for the Adjournment, to be moved by the Taoiseach at 7.30, and the subject will be the statement made by Deputy Dr. Browne.

Captain Cowan: May I ask if sufficient time will be given for Deputies who desire to participate in this discussion to take part? I think it is vital and I certainly ask for time to discuss it.

Mr. Kitt: The lawyers will make another Locke’s Distillery out of it.

The Taoiseach: Up to 10.30 or 11.

Captain Cowan: I hope an opportunity will be given to Deputies such as I to speak on this.

The Taoiseach: That is a matter for the Chair but I am bound to warn Deputies that I will take some considerable time to deal with the misrepresentations and inaccuracies of the former Minister for Health.

Dr. Maguire: I would like to give notice that I will raise on the Adjournment the question of the protest by provincial newspapers concerning difficulty in obtaining newsprint.


The State’s position on the rights in the kind of situation before Savita Halappanava’s death November 17, 2012

Posted by Tomboktu in Bunreacht na hÉireann, Ethics, Feminism, Health, Human Rights, Ireland, Medical Issues.
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Here is what the government says is the official procedure to be followed in the kind of situation that preceeded Savita Halappanava’s death, as explained by the Government to the European Court of Human Rights in 2009, and summarised by that Court in September 2010. [I have added the emphasis. Here they are dicussing the case of “C”.]

189. As regards the third applicant specifically, the Government made the following submissions.

In the first place, they maintained in response to a question from the Court, that the procedure for obtaining a lawful abortion in Ireland was clear. The decision was made, like any other major medical matter, by a patient in consultation with her doctor. On the rare occasion there was a possibility of a risk to the life of a woman, there was “a very clear and bright line rule provided by Irish law which is neither difficult to understand or to apply because it is the same law that has been applied under Section 58 of the 1861 Act, under Article 40.3.3 of the Irish Constitution and under the legislative provisions of every country which permits a pregnancy to be terminated on that ground”. As to the precise procedures to be followed by a pregnant woman and her doctor where an issue arose as to such a possible risk, it was the responsibility of the doctor and a termination could occur when the risk was real and substantial. If the patient did not agree with that advice, she was free to seek another medical opinion and, in the last resort, she could make an emergency application to the High Court (as outlined above). The grounds for lawful abortion in Ireland were well known and applied. Referring to the Medical Council Guidelines, the CPA Guidelines and the evidence of practitioners to the Committee on the Constitution, the Government considered it clear that, while there were issues regarding the characterisation of medical treatment essential to protect the life of the mother, medical intervention occurred when a mother’s life was threatened, the refusal of treatment on grounds of moral disapproval was prohibited and a patient was entitled to a second opinion. While the Irish Institute of Obstetricians and Gynaecologists had no published guidelines concerning a pregnant woman presenting with life threatening conditions, that Institute would be in agreement with the Guidelines of the United Kingdom Royal College of Obstetricians and Gynaecologists concerning the management of ectopic pregnancies and it was probable that Irish gynaecologists would “by and large” follow the latter Guidelines with or without minor amendments or additions. This clear process of how a decision to terminate a pregnancy was taken in Ireland by the patient in consultation with the doctor was regularly followed in the case of ectopic pregnancies./blockquote>

[You may wish to know that Ireland was found by the European Court of Human Rights to have breached the human rights of “C”.]

The 90-page PDF is available here.

IMPACT Channel October 27, 2009

Posted by Tomboktu in Education, Health, Internet, Ireland, Irish Politics, Justice, Labour relations, Social Policy, Society, Trade Unions, Uncategorized, Unions.

I thought regulars (and, indeed, visitors) in the Cedar Lounge Revolution might be interested in the IMPACT channel at Youtube.

At the moment it contains four films: Labels, The Nerve, They’re Everywhere and Monster.

The first two are straightforward.

Which of your wasteful public services would you cut?:

A concerned mother shares her son’s experience with his public servant speech therapist:

The second two engage in parody.

News ‘report’ on public servants:

A backroom Irish public servant comes clean:

HPV Vaccine Programme. Candlelit Vigil tomorrow outside Dáil Eireann. December 9, 2008

Posted by WorldbyStorm in Health, Irish Politics, Social Policy.
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hat tip to Red Mum…

Meanwhile in Northern Ireland – the Cervical Cancer Vaccine programme is rolled out… November 8, 2008

Posted by WorldbyStorm in Economics, Economy, Health, Irish Politics.

Watching the ad breaks between Channel 4 News I was struck by a short advert which depicted a young woman talking about the HPV Vaccine programme. She had a northern (Irish) accent and spoke about how the vaccine would be available to all girls. You can imagine that in view of the events of the past number of days in relation to cervical cancer vaccination programme cuts in the South I took note. There’s a website she was promoting, it’s called Help Protect Yourself and you’ll find it here.

It’s a swish campaign. Informative, transparent, clearly directed and without any hint of apology or a sense that this is ‘too expensive’, or to put it in the language Turlough O’Sullivan treated to us yesterday in the Irish Times ‘Ireland simply can’t afford the luxury of our public service’. Well, he can because he comes from an income bracket which will cushion the slings and arrows of an economy – which he lauds – that essentially is shifting towards insuring the better off and financial sectors from their mistakes and removing social protections for those who had few enough to begin with. The reality of the social and welfare networks that surround and support the better off in this society, as in others, is entirely striking. The way in which they fight tooth and nail to preserve such networks through tax relief, low taxation on their interests and so forth while preaching to the rest of us is becoming ever more apparent. And, as an aside, his continual use of the term ‘productive sector’ for the private sector as if the public sector, health, education etc are not a motor for generating precisely that productivity and social outcomes that support the private sector in areas which the latter will not touch (ever seen a national comprehensive private education system accessible to all irregardless of income? No? What a surprise) is symptomatic of the new supposedly ‘realist’ language of business media and the political class.

But to return to the central topic, pardon me for finding this utterly ironic. As Mary Harney puts the vaccine on hold in the South women in one portion of this island have the benefits of living in a state which understands the necessity for preventative interventions by the state on health issues. One could point, futilely, to the penny pinching of a government meaning that girls literally living within feet of each other will be faced with radically divergent health outcomes in their lives.

And this will, as ever come back to social class. Those from middle class background and higher income brackets will – entirely naturally – see their parents shell out the €600 for the vaccines, privately. Those not will not. Predictable. Iniquitous. Devoid of any moral or ethical conscience.

What a bunch. And how very telling. I don’t want to go on about this in relation to partition… it’s a gloomy probability that if this were a unitary island state the situation would more closely mirror the Republic of Ireland/Harney stance, but the fact that we don’t (and I write as one living in the southern jurisdiction) often enough look North to see what is happening there in terms of best practice is a terrible failing and indicative of a terrible narrowness of vision. And in this instance at least we have an object lesson as to how to do this right.

It’s difficult for me to express how angry I am about this and what it tells us about our government. But at least I’m not the only one

And here’s a question, does anyone know is any group or formation pushing for some sort of medical economies of scale on an all-island basis or even a strategic partnership between the UK NHS and our own embattled health services, or indeed an all-Europe approach?

Harney Chooses to Bail Out Private Hospitals While Savaging the Elderly October 19, 2008

Posted by guestposter in Health, Irish Politics, Social Policy, The Left.
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This is a very timely cross-post from the Irish Left Review. On a regular basis we hope to bring the best of the ILR to showcase the breadth of material available there…

This week, indignant old men and women have led a wave of unprecedented social protest in the national media. Next week, the same old men and women will take their protest to the streets. The government may fall.

The primary issue may be medical cards but the core value at the heart of the matter is the entire concept of the universality of welfare entitlements. Universality has become the battle-ground. Joe Behan has powerfully articulated the core Irish values long since jettisoned by Fianna Fáil. We may be witnessing the death throes of the Progressive Democrats, but the cancer of their neo-liberal ideology has spread.

Ms Harney, in particular, seems hell bent on ensuring that Ireland will not have the opportunity to transform itself into any form of egalitarian state, operating a Nordic-type social model, before she departs the scene. She wishes to dismantle the last remnants of the Irish welfare state.

What has been particularly striking about the budget debate in general is the absence of any protest about increased taxation by the wealthier members in society – as noted in the recent TASC survey, there has been a shift to the left among ABC1’s. There is an acceptance that the wealthier must pay more tax – this is simply no longer in dispute. No one is protesting about the cut in the ceiling for tax relief on private pensions or the 2% levy for higher earners. Higher earners themselves would probably support even more progressive taxation if it was clear that good public services and universal education and health care would be maintained. And the entire population seems to be unified in its outrage by, not just the threat to the universality of the medical card for the over 70’s, but also the application of the 1% levy to even the lowest earners.

Health care is the key battle ground in the universality war. For over a decade now, universality has been losing ground to ‘market justice’ and privatisation, despite growing evidence that the market system has failed in health care provision. For example, it is common knowledge in medical circles that many of the country’s private hospitals would not survive at all without the National Treatment Purchasing Fund (NTPF). And it is also well known that the NTPF is a gravy train for private hospitals. Ms Harney has a displayed a particular fondness for the NTPF, which has managed to escape any real scrutiny despite its massive budget.

The 2008 budget for NTPF is €100 million – the same amount of money that was to be saved by taking the medical card off the ‘ineligible’ over-70’s.

Reducing expenditure on the NTPF would have been one of several health care ‘cuts’ considered by the government, but cutting the medical card for over-70’s is what it chose. Above all else, bail out the boys. Maintain the illusion that the private hospital sector is efficient and cost effective, rather than invest in the public hospitals so that they can deal, in a timely manner, with the patients that were referred to them. And spin it so that it looks like the medical card money was only going to doctors for doing nothing anyway. In this analysis, spending money on GP’s is the same as wasting money. (On the contrary, the evidence in the medical literature is that expenditure on primary care offers the best value for money in health care – much more so than expenditure in the acute services). But do not, under any circumstances, dare to mention or to threaten the extravagant profligacy of NTPF money (€100 million) being doled out to the beloved private hospitals and investors.

It’s not as if all of the cases being dealt with by NTPF are exactly high priority – only 44% of those offered outpatient consultations on the NTPF bothered to take up the offer and only 17% required any surgery. The annual reports of the €100 million endowed NTPF are a complete disgrace, thick with unctuous self-congratulation but exceedingly thin on meaningful data. They make no attempt whatsoever to provide any information on value for money or any comparison with the cost of the same treatments if they had been carried out in the public hospitals. The sum of money involved in 2007 was €92 million and the number of in-patients treated was 22,000.

This year, the Regional Maternity Hospital, Limerick, will provide comprehensive maternity care to some 6,000 mothers of all levels of clinical complexity on a budget of a mere €18.5 million (and this includes the neonatal intensive care of many extremely preterm babies, some born as early as 24 weeks and the cost of whose care can amount to over €0.5 million per baby).

The maternity hospitals in this country continue to struggle to provide a decent level of care on very miserable budgets. And for the second year running, despite huge increases in the number of births (44% in a decade), not an extra red cent has been provided in the budget to improve them.

Will pregnant women will have to descend on the Dáil, along with the pensioners, to pelt eggs at the ministers responsible before anything will be done? And pelt them they should. We have indulged and put up with this type of messing for far too long.

“This Budget serves no vested interest. Rather, it provides an opportunity for us all to pull together and play our part according to our means so that we can secure the gains which have been the achievement of the men and women of this country. It is, a Cheann Comhairle, no less than a call to patriotic action.”

This was Brian Lenihan, ending his budget speech on Tuesday and apparently trying to sound like Franklin D Roosevelt. What unmitigated blather. No vested interest served? Patriotic action? Please, give us a break.

Here’s Roosevelt himself, proclaiming his New Deal in his 1932 election campaign – “Throughout the nation men and women, forgotten in the political philosophy of the Government, look to us here for guidance and for more equitable opportunity to share in the distribution of national wealth… I pledge you, I pledge myself to a new deal for the American people… This is more than a political campaign. It is a call to arms.”

There are no FDR’s in this government.

Dr Gerry Burke, FRCOG, is a consultant obstetrician & gynaecologist in Limerick’s Regional and Maternity Hospitals. He is also a member of the Labour Party.

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