Insider writes under the shadow of the tragedy of the Grenfell Tower fire in London, where, for £5,000 more in investment in better quality fireproof outer cladding, an as yet uncounted number of lost souls might have been saved.
As far back as 1984, in the documentary, The Great British Housing Disaster, the the fire dangers of external cladding was highlighted by an engineer. Can the fans of austerity among us justify such a saving where Kensington council has £270 million in reserve funds, and where, in contrast to such a massive reserve, £200,000 more might have bought a sprinkler system?
Indeed, under the modern version of the right-wing outlook, public services and infrastructure are onerous costs in pursuit of the almighty economy; where the Laffer Curve - discredited among modern economists - rules supreme; and the view that only by reducing taxes can we achieve that American great dream where only the individually rich might (maybe, possibly… ) be able to afford health insurance. And now we have it with Trump and May, both being the perfect embodiment of this ideology.
Insider sometimes wonders how much our right leaning friends actually understand markets and market economics, as most failures under right leaning governments seem to indicate the converse. Bertie Ahern may have said he was a socialist, yet he let rampant property speculation distort the Irish market to a point where it nearly destroyed the State. Fine Gael seem to think it is economically intelligent to reduce recruitment and restrict an entire generation’s access to the nation’s largest employer: The State.
And so we come to our own corner of the world. As a famous Irish YouTuber asked: “How does austerity affect you?” Let’s start with our local city and county councils, both living under the cloud of a politically impossible merger over their heads. Galway County Council is suffering from an inability to instate many of its staff as anything other than 'acting' status, meaning staff move on. Vital human resources go lacking and cannot be allocated where needed, in areas such as planning and roads. Discretionary services remain under threat year after year as the council scrambles to merely maintain its day to day budget - all this during the much mooted 'recovery'.
Which brings us back to the ongoing tower fire happening daily amongst our midst: Our rural ambulance service. Despite the dedication and professionalism of our ambulance operators and staff, as the service is run, tragedies accumulate daily in rural Ireland due to an inability to provide the support necessary to ensure rural citizens have decent access to emergency services.
Insider knows of two cases where elderly women with broken hips were left lying on cold floors for hours while ambulances were either delayed or dispatched from a neighbouring county. He is also aware of a case of a women, who had a post natal haemorrhage, was left in a pool of her own blood waiting for an ambulance. An hour and 20 minutes after it finally arrived, it brought her to Westport only to be made wait for another ambulance from Castlebar for a transfer.
Another case involved an elderly man who was forced to wait in a doctor’s surgery for an hour and 40 minutes while waiting for an ambulance, all just to travel 10 minutes to where the air ambulance helicopter service was already waiting for 30 minutes. Imagine. We live in a country where, although the air ambulance may be dispatched, you must wait for another ambulance to be dispatched possibly from a neighbouring county to carry you for just a 10 minute drive. Kafka lives on in modern Ireland!
All the while, the HSE conflates urban and rural response times to claim an 18 minute response time but when the actual figures are investigated further this does not hold up. Naturally it took a freedom of information request and years of effort to get to the truth of the matter.
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In other cases where people experience critical medical emergencies such as stroke and heart attack, the minutes where life may be saved within the medically critical Golden Hour tick down. As the ambulance dispatched winds its way from Mayo or elsewhere because a local crew is not available, the lifesaving minutes of the Golden Hour are wasted. By the time the ambulance arrives, there is the hour, or longer, return journey back to medical treatment. Overall it might take four hours to reach the critical hospital facilities to keep you or your loved ones alive.
Worst still is that Minister Harris is aware of these and other cases as they were presented to him by a group of campaigners in Connemara. Harris and other Fine Gael representatives were happy for the photo opportunity and there were smiles a plenty on the day….but after the dust settled and Minister Harris was gently reminded of his commitments by means of a Parliamentary Question, this was his reply: “As this is a service matter, I have asked the HSE to respond to you directly.”
It is questionable that the Sir Humphreys' of Hawkins House can empathise with the misery and pain of rural people. Another issue lies in that the HSE is not totally responsible for the national ambulance service either as this is now is its own department within the HSE and what does not warm the cockles of a bureaucrat like a game of interdepartmental correspondence tennis.
There is a cruel irony in that there was more accountability when ambulances were run under the regional health boards. There were more rural ambulance staff, and with more than just two Galway councillors on the board, as there are now with the regional health forum there was more local accountability in providing this vital service.
Under a single ambulance service, all accountability mechanisms are self-contained within that department's management, and while the people who operate the national response centre are dedicated and competent professionals, Insider doubts they have the hands-on experience of what it takes to cover an area as vast as County Galway, where road quality varies greatly.
And so we return to the ongoing question we must face, are ongoing savings made in cut services worth it in the larger picture? Was a £5,000 saving out of £270 million in Grenfell worth it? Is the cost to employ extra ambulance crews to serve rural areas worth it? Surely it is, when either our family or we individually ourselves come face to face with that inevitable medical emergency that all people face, rich or poor, young and old, left wing or right wing…money saved on lower taxes, the Laffer Curve, and promises of the almighty economy mean little to the person dying on the roadside.
