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Professor Crown talks Lisbon, his "penniless" father and his daughters 15.07.08

OUTSPOKEN cancer specialist Professor John Crown believes Ireland's health service is "bureacratised to death".
He said it was laughable that the Health Service Executive (HSE) was now returning to the health board system it abolished several years ago.
He told the audience at the 'Up Here We're Dying to Live' conference at the Mount Errigal Hotel on Saturday:
"Anybody would have laughed if they didn't feel saddened by the announcement over the last week that the HSE is going back to a devolved partly-regionalised model having nine years ago told us about the wonders of the centralised model and how it was going to fix all of the adminstrative problems in the health service."
And he feared that things would only get worse now that the Irish economy was in the grip of an economic downturn. But he said the policy makers had to shed the "erroneous notion" that spending on the health service was bad for the economy.
Professor Crown, who is medical oncologist at St. Vincent's Hospital in Dublin and a leading cancer researcher, said he deliberately did not take a public position on Lisbon.
"I very deliberately did not take a public position on the Lisbon Treaty because I did not understand it but I can say now that the vote is over, that I would have voted 'No'... because of my real worries about the democratic deficit and the bureacratisation which we're seeing in Europe and culturally which we're seeing in politics across
Professor John Crown
Europe and in this country."
He said the people who suggested that the people should not have had a say on the Lisbon Treaty were the same people who believe that patients should not have any right in deciding what healthcare they should get and that the only people who should decide are health administrators and civil servants.
"In Ireland, in general, we have a subsistence health service. In all kinds of indices for every single speciality you care to mention, we have the lowest number per head of population.
"In some cases we have one-tenth or one-twentieth the European average. There are more oncologists in Latvia - a poor country like Latvia - than there are in Ireland.
He said the core of the problem was that Ireland had a very unfair, inequitable and inefficient health system.
"Unfairness, inefficiency and poor quality are the big three and I believe that the reforms that are currently being propagated will address none of those."
He showed pictures of his late father Jack Crown who left Manorhamilton in north County Leitrim in his late 20s and went as a "poor penniless emigrant" to New York where worked a number of jobs including taxi driver, bread truck driver, green keeper on a golf course etc.
He said his father "prospered modestly" and came back to Ireland and "thankfully lived long enough to see his son go to medical school".
Prof Crown recounted the story about his father coming back from the US. He had private health insurance and when he went to a heart specialist in Dublin, the specialist advised him to have surgery.
By chance, he was admitted shortly afterwards with another complaint to the same hospital. The same surgeon saw him this time as a public patient and advised him to keep taking the pills, for his heart.
"I remember thinking there is something very odd about the system we have here. It is hugely odd, because it is unbelievably unfair. The treatment that public and private patients get is vastly different," he said. He urged the HSE to take bureacracy out of the health service and urged it to do away with its plan to send around 200 health service inspectors around the country to judge the nation's hospitals.
He said he could save the HSE the money it would spend on the inspectorate by telling them the services are "all poor quality".
Rather than spending tens of thousands of euro in sending a team out to inspect what is known to be poor quality, he said the HSE should be concentrating its efforts on fixing the problems and improving the quality. Meanwhile, during a questions and answers session with the audience at the DACC conference, Prof Crown was asked about the cervical cancer vaccine. He revealed that his daughters "the Crown girls" had all received the vaccine privately and he urged people to go private and get the vaccine. However, he believed the vaccine would eventually become available on the medical card.
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