They say that the definition of madness is doing the same thing over and over again and expecting a different result. There are exceptions to every rule of course and because of such exceptions a long time ago I stopped using birthdays and other significant numbers to determine a standing line of lottery numbers. I tried it for a while and then realised that more often than not I forget to play lotto and it would be absolutely tragic if my numbers came out and I hadn’t bought a ticket. Apart from having set lottery numbers though, the madness definition applies to almost everything and maybe someone should stick it on a banner in the largest letters they can find and deliver it to Mary Harney and the Department of Health.

Before the Mary Harney supporters throw the paper down in disgust let me say that I don’t believe the appalling state of the health service is entirely her fault. Calling for her head on a stick seems pretty pointless as she will just be replaced with another politician who will then have the miserable excuse that he or she is getting to know the job/looking into the difficulties/setting up another costly committee to re-examine the situation. Whatever way you look at it, it will take another lifetime and meantime the crisis on the ground continues. It is difficult to know where to start in this totally untenable, lumbering, behemoth that is the HSE, but someone has to start somewhere and pretty quickly.

It is a sad day indeed when you have a fear of hospitals and that fear isn’t driven by some poor association from childhood or mental illness. If in a relatively successful, first world nation fear of hospitals and the health service is driven by the reality that you are at greater risk inside these supposed beacons of health than on the outside, there is a huge problem. There is also the other situation where if you have no choice but to go to a hospital, unless you literally have a limb falling off, you risk being put on a waiting list for a number of months, if not years unless you can afford to pay privately.

The truly awful cases will always make headlines. The person that dies on a hospital trolley 63 hours after being admitted, the unbelievable mistakes in mass misdiagnosis, MRSA and other super bug outbreaks (that are often down to plain dirt and unhygienic practices), most recently the child who had the wrong kidney removed or the person who is on a two year waiting list (or pain list) for an operation. Mistakes will happen, human error is inescapable, but the staggering statistics of gross bumbling and delay are nothing short of outrageous. The rate and speed of these disasters and revelations seems to be heralding the very obvious fact that the health system is way out of control. It’s very easy to say this dispassionately when you are well and relatively healthy, but we must constantly remind ourselves that these statistics represent real people. Even if your life isn’t in immediate danger, waiting lists are still detrimental to the human psyche. You may be living with pain and daily discomfort for months. Even if you successfully manage your pain, it is having a negative effect on your quality of life. If you are in pain and the source of that pain is unknown, the images conjured in your brain while you wait for diagnoses can often cause as much, if not more, damage than the actual illness or problem.

I know of one person recently who had a suspect lump which required investigation. They were lucky to undergo the tests pretty quickly (about two weeks from lump discovery) but then had to wait three weeks for the results. (Not to mention the fear of other infections that they went through while actually in the hospital.) Those three weeks not only affected and impacted the individual but also stressed out an entire family. For three weeks they barely functioned while a very dark cloud hovered overhead. Fortunately the results, when they did eventually come, were clear – but it took a further two months for the patient to fully accept that they were healthy. Any psychologist will tell you that this is not unusual. If you spend five weeks convincing yourself of the worst even when good news comes your brain has to adapt to it. The general lack of confidence in the system made the acceptance part even more difficult.

It is easy to complain and we all have stories of neglect, lack of compassion, poor treatment or waiting for hours. Relaying these anecdotal situations just seems to provide column inches for papers and subject matter for radio talk shows; the answers seem much harder to come by. However a rare light shone on The Late Late Show last Friday night in the form of consultant John Crown. For the first time I actually heard someone talking about solutions. He was frank in stating the case and was adamant that there is tremendous folly in the current two tier system. He made the very valid point that while you continue to build private and public hospitals and maintain the two camps, there will be mediocrity in both rather than bringing the knowledge and expertise together for the benefit of the patient and greater good.

I am not a medical person or a politician and would never even claim to be half as smart as those supposedly in charge, but his arguments made perfect sense. So what is preventing this from happening? Why is the Government not willing to listen to people that seem to know what they are talking about? “A wise man will listen to a fool, but a fool will listen to no one”. It would appear that common sense isn’t that common after all.

Even if John Crown is wrong in his summation and solutions for the health service, which I don’t believe he is, at least it is a different approach. If nothing else a one tier system seems more just. The general perception appears to be that if you have money you stand a better chance of being well and receiving the care you need; this is unacceptable. Let’s stop doing the same thing over and over again and try something new. Maybe the results won’t be the perfect ones that we were looking for, but at they will be different and it may lead to something else. If Thomas Edison had adopted the approach of the Health Service when he was inventing the light bulb, you might just be reading this by candlelight!