JM Thorn 

31 March 2008 

Last Saturday (29th March) five thousand marched through the streets of Dublin to protest at the state of the of the health system.  Organised by the Dublin Council of Trade Unions, the youth committee of ICTU and Patients Together, the march took as its slogan:  “Enough:  A Decent Public Health Service”.  It was made up of a wide number of activists drawn from the trade union movement, community health campaigns and political parties.  There were significant contingents from Labour and Sinn Fein, as well as socialist and anarchist groups. 

Lead by the husband of cancer victim Susie Long, protesters made their way from the Remembrance Garden to Leinster House. Here they were addressed by a number of speakers.  Des Derwin of the Dublin Trades Council made a few introductory remarks, saying that it was time to end the cutbacks and stop the handover of resources to private medicine. He called for the creation of a fully funded public health service. Des said that the demonstration had come about because people had put aside their political differences, and that it would not be a one-off event.  There would be a special delegate conference held of the 26 April to decide the future direction of the campaign.  Des also claimed that ICTU would make the health service a key issue in the upcoming national pay talks.  He concluded by saying that the demonstration represented the best form of social partnership – that between trade unions, patients’ organisations and community groups. 

The next speaker was Louise O’Reilly of the nursing section of SIPTU.   Louise called for patients to be put before profit, vowing that trade unions would “not stand idly by” while the health service was under attack. 

The next speaker was Conor MacLiam, the husband of cancer victim Susie Long.  He said that he was at the demonstration to honour the legacy of his wife. Conor recounted Susie’s story, blaming her death from bowel cancer on the seven-month wait for a colonoscopy that delayed a diagnosis.  He called on Bertie Ahern and Mary Harney to resign, claiming that his wife was dead because of their Government’s policies.  But he also made the point that Susie was just one of many who had been failed, citing figures from the Health Research Board, which estimated that inequality and health disadvantage in Ireland, was killing 5,000 people every year.  In the conclusion to his address Conor appealed to people to “fight to end the two-tier apartheid system in health.”  Susie had called before her death for unions to pull out of a social partnership that delivered such a health service.

Conor was followed by Paeder McMahon of the Monaghan Community Alliance.  Paeder said that he hoped that 29th March would go down in history as the day when patients finally said enough is enough.  He highlighted the situation in Monaghan that had seen a reduction in acute hospital beds from 166 to 50 over the last ten years.   With the withdrawal of acute services patients were forced to travel for emergency services.  This had undoubtedly resulted in deaths but no one was prepared to take responsibility.    Paeder revealed that in a meeting with the HSE, representatives of his group were told that the cuts that had taken place in the North East would happen across the country.   He finished by calling for the Government listen to the people and to sit down and negotiate how a better health service would be created. 

Kevin Callinan of IMPACT attacked the record of the HSE.  He said that it had promised better services but instead there were patients on trolleys; better conditions for health staff but instead there was a jobs freeze; value for money but instead there was “mismanagement and dictat”.  Kevin said he hoped that the rally “could be a catalyst” for the creation of a movement that would be able to confront the Government over health. 

The next speaker was Dr Orla Hardy-Batton of Doctors for a Better Health Service.  She said that doctors cared about the health service and were the allies of patients. They did not want to see rationing.  Orla also cautioned people not to be too negative about the Irish heath system as there were parts of it that were worth defending.  The problem was that it was disorganised and underfunded. 

Brenda Power, a presenter of the Your Call programme on Newstalk, which has dealt extensively with the issue of health (including the case of Susie Long), said the public-private health system was "immoral" and shamed a wealthy country.  In this system the public patients was treated as a charity cases. 

Janette Byrne of Patients Together claimed that the rally represented the “first time that patients, staff and unions have come together to demand a better health service.”  She said it reflected the disgust that people had for a Government which left them without mental health services, without home care packages, cancelled operations and made rape victims wait for vital assessments.  Janette said that in Ireland animals were treated better than people. 

Madeleine Spears of the Irish Nurses Organisation contended that health was a political issue. She called for the end of co-location and the removal of the private for profit element within the health service. Madeleine also highighted the loss of nurses and midwives and the cut backs in training.  She concluded by claiming that the Government had lost public confidence, and called on the Greens and PDs to withdraw from government. 

Dr Teresa Graham said she was proud to be addressing the rally, but she was ashamed when she told doctors from other countries of Ireland’s high death rate due to hospital infections.  This was a problem the Government knew about and could have dealt with but didn’t.  She cited the example of Holland where the problem of infections had been tackled twenty years ago.  Teresa said she had no confidence in the HSE, Harney or Ahern.  Her hope lay with the people.  She urged protesters not to let their anger dissipate or to allow the politicians get away with what they were doing. 

Walter Cullen of UNITE said that the rally reminded him of the tax marches that were held in Ireland over twenty-five years ago.  He claimed that the HSE had torn up partnership agreements, and that the Government had overseen the dismantling of the health service.  They had created a system that was market driven and based on maximising profits.  Walter concluded by calling for a special confidence of health service unions to plan the future of the campaign. 

The final speaker was consultant oncologist Prof John Crown, who has been one of the fiercest critics of the health system from within the medical profession.  He attacked the two-tier system that had developed in Ireland, branding it as not only unfair and inequitable but “totally insane”.  He claimed that no rational person sitting down and planning a health system at a time when patients are living longer and treatment is getting better, would take every hospital in the country and divide it straight down the middle into public and private.  Co-location would take this separation of public and private patients to a new level.   John also attacked the proposed centres of excellence, ridiculing the idea that something can be deemed excellent before it has even come into existence.  He concluded by calling for the creation of a health service financed through a form of mutual health insurance.

While not matching the inflated predictions of its organisers, one of whom claimed it would bring out 70,000 people, the health rally had a number of positive aspects.  The first was the number of activists it attracted beyond the ranks of the far left.  It is this layer of trade union, political and community activists that has the potential to become backbone of a national campaign.  The second positive aspect was the speeches from a number of the speakers, particularly the husband of Susie Long and a couple of the medical professionals, who made clear their opposition to privatisation and the two tier system.  This went beyond the minimalist approach of the organisers, which was summed up, in the official theme of the rally:  “Enough.  A Decent Public Health Service”.  This was really just moralism and was reflected in a number of TU speeches that concentrated on horror stories about hospital conditions and indignation. 

This all reflected the real difficulties behind this initiative.  It really is hard to take seriously the protestations of a trade union leadership with such a poor record, as it is Des Derwin’s assertion that the health service will be a key issue in the upcoming national pay talks.  How did things get this way in the first place? Why so few endorsements of the campaign by ICTU directly or individual trade unions?   The proposals for taking the campaign forward centred around a special delegate conference on 26 April.  As this appears to be a conference made up of representatives of trade councils it immediately excludes political and community activists and lay union members.  It is also a fact that trade councils are the most moribund element of the of the trade union structure.   A conference based upon them will inevitably be under the tight control of trade union officials who haven’t the slightest intention of presenting a challenge to the Government. Despite the calls for unity the upcoming conference, organised by the Socialist Party, hardily got a mention from the platform.  But it is the unity of trade unionists with other forces that offers the best direction for building a real campaign.

A successful campaign will unite trade unionists with all the other opposition forces in society.  The trade union march did not send militants on to the Dublin conference.  The Dublin conference must send delegates back to the trade unions and demand unity of workers and patients, the building of a campaigning mass organisation.