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The John Crown Affair
Read more about: Health, Media
Strange how the mind works. I saw this item on RTE’s website yesterday in which Dr. John Crown was quoted providing a detailed critique of the management of cancer services. It all seemed sensible and corresponded closely to what he said in the same day’s Irish Times (subs. req’d) but I did think: why are they giving such prominence to what was said on one radio show? Well now we know. There was a row (via the Sindo).
He was supposed to be on The Late Late Show the night before. In what seems like a seepage of American style “objectivity” into the scheduling, RTE dropped Crown from the panel on grounds of balance, despite the fact that he’s an actual expert in his field. The rest of the panel was Eamon Dunphy, Mary Raftery, Gerry Robinson — fine blatherers to be sure, but symptomatic of the reliance on usual suspect talking heads for all these shows (to be fair, Crown was replaced by Professor Maccon Keane from UCG).
So it looks the Saturday slot was the “make-up” call. The question is whether there’s a backstory in terms of government interference in the decision. RTE says No, but attention has now swung back to remarks of Bertie in the Dail last Wednesday. This is as good a time as any to mention that Bertie should be careful for what he wishes for with a digital TV Oireachtas channel because then more people might see an uglier side of his character that emerges when he’s on the defensive. Anyway, it was Eamon Gilmore who got to Bertie on this occasion:
Deputy Eamon Gilmore: … While we were discussing the issue in this House yesterday, Professor John Crown was speaking on the radio, where he described the Government’s approach to health services as insane.
He said the Government is presiding over an apartheid system and that its policy appears to be to make public health care as unattractive as possible. He added that the Government has an attitude to public health care which is like its attitude to the dole - it despises it - and that the Government is being hypocritical in closing public facilities on the grounds that they are too small while opening private facilities that are even smaller.
Professor Maurice Nelligan yesterday at a conference said it is immoral and wrong to run down small hospitals without having in place the promised centres of excellence … He went on to say that the plan to build private hospitals has more to do with suiting the construction industry than suiting the needs of the patient. He said the Minister and the HSE are in cloud cuckoo land if they believe that patients are not suffering as a result of the Government’s health policies. He also said the Minister for Health and Children would have resigned or been sacked from her position if she was in any other country.
In this morning’s Irish Examiner, Professor Ray Kinsella argues that responsibility rests squarely with the Government and that the policies now being pursued, whatever about the Ministers who are pursuing them, were rejected by the electorate in June. Professor Niall Higgins, who drew up the cancer strategy, has described what happened in the hospital in Portlaoise as “a systems failure”, something the Taoiseach said yesterday it was not and which he repeated again here this morning.
These people are respected experts in the field of medicine and health economics. They are not Opposition politicians nor leaders of political parties. They do not have a political axe to grind … Hold on one second, these are people who cure people. These are people who do their job responsibly and if this Government was doing as good a job in managing and running the health service as these people are in curing their patients, we would not have the problems in the health service that we have today.
…
The Taoiseach: The vast majority earn far in excess of what I do in terms of salary.
Deputy Brian Hayes: The Taoiseach must be joking.
The Taoiseach: One of the individuals the Deputy mentioned, to the best of my knowledge, has a huge private practice along with his public practice and the best of luck to him. … As I said yesterday and numerous times in the last week, our work must be to try to help the people who are affected by this and not to get lost in all of the other details. Obviously, for those seven people and some other cases mentioned here over the last few years, the services did not work, for one reason or another. I am not the expert to write the reports. There is a person appointed to do that, who has all the qualifications to write an independent report and I will accept that report, whatever it says. I have been very careful not to cast aspersions on the people involved. I have not even used the briefing notes I have had.
Deputy Brian Hayes: The Taoiseach has briefing notes on everything.
The implication was that Bertie’s notes include not just policy information but information for use in attacking his critics, all prepared at taxpayer expense. Crown seems to be targeted for having expressed the opinion 5 years ago that the best way to improve the health service was to vote Labour. Five years later it certainly doesn’t seem that the best way to improve it was to vote Fianna Fail.
One final media ethics note: while the Sindo has the goods on this story, it’s dubious of them to allow a government source to maintain anonymity for a personal attack on Crown (”arrogant”, “nasty”). Anonymity should be used for leaks or insights, not as a shield for insults.
Ah now, come on.
I am sure you have all figured it out by now.
Berite is copying what USA did some years ago.
Nothing new at all.
Anyway, this is the way the elite like it.
The more sick people there are- the better it is for business for various professionals and pharmaceutical companies.
Any eejit who believes this government cares about anyone else except themselves is deluded.
Crown was melely stating truth and boy does Truth hurt sometimes.
You always know one has spoken truth when Bertie reacts.
However we are paying Beries salary for doing very little indeed.
I agree that the HSE is living in cloud cuckoo land and many of the professionals in it are a danger to children and adults alike.
They would label Joe Public as a child abuser if he/she did what they do and get away with.
But their secrecy keeps it all hidden from the public.
What a can of worms we have now - just opened up, and waiting for them to crawl right out into the light of truth.
I have been waiting for this time for years and it looks like my patience is going to pay off.
Like Portia above, I have been waiting for this time for years too and I only hope it finally shakes the Irish masses out of their deeply-conditioned coma, induced by their long (seriously repressed) experience of ROME! Its about time we stopped beating OURSELVES up and by the way, John Crown is no different, in essence, from Bertie and Mary and the rest of the Irish mafiosa. They’re all like vultures devouring a dying corpse and that dying corpse is the Irish people themselves. About time we (the Irish people) woke up to what our “Heroes” are actually doing to us!
PS. Who in their right mind would want to follow the American Dream…. which is RAPIDLY turning into the Nightmare is really is!!!
John Crown and many others, including the Labour party, are proposing the social insurance model used in Germany, France and Canada among other countries. There is no doubt that this seems to be one of the fairest and most efficient health funding systems in use worldwide. It certainly seems better than the unwanted love-child of the NHS and the US-insurance model that is currently used in Ireland.
However, it seems to me that the logical extension of this policy is privatization of the existing system, at least at the level of service-provision. Attempting this will make curing cancer look easy.
I disagree with you KeV. John Crown is most definitely not proposing the social insurance aka Universal model that exists in France, whereby every citizen has access to decent health care/medical treatment irrespective of their wealth or lack of it, because the collective social insurance (Public Taxes) finances it all. Crown harps on about the “Bismarckian” model of Health Care, never mentioning France. One wonders why? Could it be that he is real keen, i.e., zealously trying to hang onto his Irish (Catholic) model of Health Care, whereby his lucrative PRIVATE practice remains well-camouflaged by his purported concern for “public” patients? You know how it goes with religious zealots - they SAY one thing and DO the complete opposite. Sit up and pay attention to what’s actually going on in Celtic-Tiger Ireland today. Let’s not repeat the mistakes of our fear-ridden Catholic parents before us, namely: sit back and DO NOTHING about the tyranny of the Ruling Irish Catholic Elite (thugs)!!! We owe it to our children, and their future, and their childrens’ future (our grandchildren) to stand up to these RC thugs, who have been running the show for far too long! DO we REALLY want to go the American way? And being obese is the least of their problems!
I think the most telling thing about the make-up of the Late Late Show panel was not the dropping of John Crown but the fact that they couldn’t find anyone to defend the HSE or the state of the Health Service.
How can you try to be objective when the other side won’t even turn up to defend themselves?
Reg. Martha’s comment “Crown harps on about the “Bismarckian” model of Health Care, never mentioning France. One wonders why?” Prof. John Crown could keep quiet like most of the other consultants in this country, but he is the only one with the courage and the knowledge to criticize and more importantly suggest solutions. So the real question is why is Mary Harney not listening? Regarding consultant contracts where did Mary Harney get the ratio 80% public patients to 20% private, when 53% of the population has private health cover???
In the interest of clarity I went back to look at Crown’s article from 17th October this year, which is actually just before the latest row blew up and so deals with the more general issue of healthcare provision and not just cancer — here are the key bits (can’t tell whether it needs a subscription or not) –
Truly informed students of health economics (poorly represented among our ad-hoc health commentariat and even less well in government) will have found the results of the recent Euro Consumer Health Index striking, if predictable.
Ireland ranked 16th out of 29 nations surveyed across a set of consumer parameters, but in the area of waiting lists, the index that matters most to patients, we ranked dead last …
Strikingly, every one of the top five countries - Austria, Germany, Switzerland, France, the Netherlands - finance their hospitals through a single-tier, social insurance-based “money follows the patient”, or Bismarckian model …
If the current Harney reforms are implemented, the system will be replaced by a rigidly apartheid two-tier system. The poor, whom the right regard as uninsured parasites, will rely on fixed-budget and highly rationed care. Those who can afford it (including virtually all politicians, health bureaucrats and commentators) will use an insurance-based parallel private system … A true reform, and not the patch job currently in offer, based on universal insurance and single-tier care (similar to Germany, Austria or Canada) deserves support from right and left.
The left should love the total equity of access, with the poorest person in the land seeing the same doctors in the same offices and hospitals as does the Taoiseach. They should worship a system where care is delivered on need and not on ability to pay.
The right should love a system which at the stroke of a pen cuts taxes (replacing them with something much more efficient - a non-progressive health insurance contribution), fires thousands of bureaucrats and links hospital funding to activity and efficiency, a system where the patient on the waiting list represents lost revenue, not an inactivity bonus.
As I understand it, this is the “money follows the patient” model i.e. healthcare is not free at the point of delivery, as in the NHS or Irish public, but everyone pays and then gets reimbursement either from insurance or the state. Thus there is private insurance but they are heavily regulated (e.g. community rating, pre-existing conditions) and the state is backstopping the whole thing, but there is single tier provision — from the perspective of the hospital, everyone is a paying customer.
Banging drums P?
The blogosphere drums are beating with the so-called John Crown Affair and the idea that RTÉ, our national broadcaster, capitulated to its political masters and “banned” a troublesome voice of dissent. To some it appears to make sense that the head of TV, or even the director general, would quietly pull guests because it might disturb the TV licence fee review. And because a Minister told them to do it.
@Mark that is another great point and it suggests this whole bunker mentality going on inside gov/HSE is gonna stay for a while.
Crown may well have been dropped with no government interference but it isn’t blogs spreading red herrings, he was in two sunday newspapers that I talking about Bertie’s briefings. As well as this it is plausible that someone pulled the plug due to either expected pressure or in anticipation of a decision up the line (it was well covered on Eamon Keane yesterday)
The reporters and opposition politicians did the “affair” a disservice by doorstepping the Taoiseach and Harney demanding to know if they rang Noel Curran (RTE TV MD) to have Crown dropped. Of course that didn’t happen. Instead, as Mark pointed out, the HSE and Department of Health simply refuse to provide a spokesperson. Then there is no “balance” and underlings, can demand of RTE that there is “balance” and this is best achieved by dropping the one qualified person on the panel instead of journalists and commentators. Harney should’ve been asked, not if she demanded that Crown be dropped, but why she didn’t provide a spokesperson for the other side. And when on earth did Eamon Dunphy become an expert on the health system? As for Mary Raftery, I though the Catholic Church was her forte. Shouldn’t one of them been dropped?
The other point is that when you have one party in government for nearly 20 years and its the same week that the licence fee increase is being decided, you realise why effective one party rule is on occasion sinister. The phone call doesn’t even have to be made. The RTE executives meet socially and officially the ministers all the time, the flow of employees between RTE and government buildings and PR firms is steady, and when Fianna Fail is a prospective employer, maybe no one needs to phone to make you think very hard about how best to achieve “balance” when the Dept. won’t provide a spokesperson…It’s a culture, not a conspiracy.
I’ve found myself, as I increasingly meet the members of the establishment, it can take the sting out of your attacks on them - they become human instead of agents for the Dark Side
Both governments and broadcasters need regular fresh injections of personnel to keep everyone on their toes…
well what do you know, for once I’m right! In his column today, Noel Whelan spends most of his 1200 words debunking the “Harney didn’t phone Cathal Goan” story and then three quarters way down admits “It did emerge that during contact with the Late Late Show about the possibility of Harney participating in the programme, her press officer had also observed that the line-up looked unbalanced but that is a very far cry from the suggestion that she had put direct pressure on the director general of RTÉ.”
There ya go…don’t provide a spokesperson, then claim there’s no balance…