Letters to the Editor: Suzanne Crowe spoke up for Ireland's voiceless
In response to the article about 'talking back' or 'speaking up' by Suzanne Crowe (Patients are failed by medical culture of ignoring those who speak up — Irish Examiner, April 23): I agree with her.
There's a culture in Ireland where speaking up is frowned upon.
That's why we have such an awful past, and even present, with horrific abuse scandals and more — the Grace case being the one at the forefront of my mind.
As a parent of a disabled teenager who has been under the care of 14 medical teams for his life so far, I have seen how people working in medicine are afraid to speak up, and parents are the same. We are often afraid of the consequences of relaying our concerns to a nursing manager or a doctor, we are afraid that our child's care will be compromised. It is not an irrational fear, as it has happened to me and my son.
My son is extremely medically complex and requires 24-hour care.
He has severe/profound intellectual disability, Down syndrome, and an ultra-rare disease. He is non-verbal and a full-time wheelchair user. He is tube fed into his jejunum. He is on a tonne of medication, many of which are pain meds to keep him as free from pain as possible.
Having a disability definitely means that he is very often the subject of passive discrimination. This is very obvious in a hospital setting. There are so many little ways that he is discriminated against. He is not alone, I believe that everyone with a disability is discriminated against in some way or another.
Parents of children like my son often find ourselves having to 'speak up', also known as advocating. Our children are often forgotten about as they have no voice of their own, so parents like me have no choice but to be their voice.
We are sometimes made to feel as if we are being awkward or troublesome. But, in fact, most of us who care 24/7 for our kids at home are experts in their care, and good doctors and nurses know and appreciate that.
We appreciate that understanding and empathy more than they know. It's about having compassion. These are important traits to have for anyone working in healthcare. But also — as Suzanne outlines — is bravery.
We need medics to speak up and make a stand if something isn't safe.
Not after the damage is done, but before. Whistleblowers shouldn't even exist because people should be listened to.
The new national children's hospital is a good example where many doctors 'spoke up' but were ignored, as it is not in the correct location and it's not open yet, and the most important co-location of all, a maternity hospital, is absent. So ill newborns are still going to be at risk of disability or death. Having to be transported from a maternity hospital to a children's hospital is so risky for many newborns. Many doctors and other workers in healthcare spoke up and were ignored. Then it became obvious that if they did speak up, their jobs could be at risk.
Parents 'spoke up' too, but were also ignored. What would we know?
I think Suzanne's daughter will go far, she did nothing wrong in school. 'Talking back', 'speaking up' or 'advocating' is something that our children are doing better than we did. I was afraid to 'speak up' in school, as to risk the wrath of the nuns was not worth it. My daughter is 21 and in college doing journalism and she is well able to stand up for what she believes in and to form her own opinions. I'm very proud of her.
My son will never speak, so I will have to continue 'speaking up' on his behalf. I appreciate those doctors, nurses, and allied healthcare professionals who advocate for him alongside me.
Aisling McNiffe, Ardclough, Co Kildare
Public hearings shine a spotlight
I read with admiration and some relief the article on whistleblowers by Medical Council president, Suzanne Crowe. I would like to ask her to take appropriate steps to ensure Medical Council inquiries revert to public hearings.
Public hearings were introduced as a direct result of the Caesarean hysterectomy scandal in Our Lady of Lourdes Hospital Drogheda, which came to light in 1998. I had the honour of working with the women and families concerned for several years, and understand how vital the change was for them and how hard they worked for it.
Public hearings for professional misconduct were suspended during covid, for obvious reasons. Online hearings are now held where neither doctor nor complainant attend in person. This is unsatisfactory for injured patients and families.
It reinforces the unhealthy secrecy surrounding bad doctoring and, in so doing, indirectly encourages it.
Public hearings help to normalise the raising of concerns and accountability in a way that is necessary to encourage whistleblowing. They need to return.
Sheila O'Connor, via email
What's your view on this issue?
You can tell us here
Finger off the pulse
As a taxpayer contributing over 40% of my income to the State, I am compelled to ask: At what point does this Government acknowledge its systemic failures and commit to meaningful reform? While Ireland's public services and infrastructure crumble, and families grapple with exorbitant mortgages, the self-congratulatory rhetoric of our leaders feels increasingly detached from reality.
Decades of mismanagement have left us with a healthcare system in perpetual crisis and a housing market that prices generations out of home ownership. Infrastructure projects like the National Children's Hospital (€1.4bn or more over budget) and the delayed MetroLink exemplify fiscal recklessness. Yet the Government's solution, selling off public assets and privatising essential services, prioritises short-term cash injections over long-term public good.
Natural resources, from offshore wind to minerals, are increasingly outsourced to private interests, eroding public ownership and energy security. Similarly, the privatisation of critical services has left households paying more for utilities and waste collection, while corporations profit and avoid taxes. Public-private partnerships, touted as efficient, often saddle taxpayers with hidden long-term costs and reduced accountability.
This short-termism has consequences. Households today require two incomes to afford what a single wage could secure in the 1970s, sacrificing family time and quality of life in the process. Meanwhile, our elderly population, many of whom built this State, face neglect, with inadequate homecare supports and nursing home scandals exposing systemic failures in their welfare. Our children, too, bear the brunt: Under-resourced mental health services and endless waiting lists for Camhs betray a generation in crisis.
Taxpayers deserve answers. Why must we pay world-class taxes for subpar services? Why are public assets and resources sold off for fleeting gains? When will those responsible for repeated failures be held to account?
Ireland's social contract is fraying. It's time our leaders govern for citizens, not private interests.
Michael Reynolds, Kilgarvan, Co Kerry
Banking on war
Humanity has never witnessed such atrocities before perpetrated on children; over 50% of the Gazan population is under 14 years of age.
Every day and night we see images of powerful missiles dropped on tents on purpose, with the deliberate intention of burning and shredding people alive. The Israeli government is intent on eradicating the Palestinian population. No food, water, or medical supplies have entered Gaza since March 2.
I find it disgusting that the Central Bank of Ireland (CBI) continues to allow Israel to market its sovereign war bonds in Ireland, and acts as the gateway for their sale throughout the EU. It is absolute nonsense that our Government cannot direct the CBI to stop this. This could be stopped in the morning under existing legislation if they had the will and stopped pandering to the US and the EU who have too much skin in the game, selling arms to Israel.
As an aside, the CBI's code of ethics states the bank is an apolitical institution and staff should protect its apolitical position at all times. The code states that staff must not engage in any activity which could call into question this apolitical status or risk the bank being drawn into any political or public controversy.
Facilitating the sale of war bonds would surely be classed as political, and their absence of cop-on and continuing sale of bonds has and continues to draw the CBI into political and public controversy.
Sheila O'Riordan, Charleville, Co Cork
What's your view on this issue?
You can tell us here
Séamas O'Reilly's support for trans rights
Thank you for publishing Séamas O'Reilly's wonderful piece on the moral panic fomented around trans rights in Britain.
He cuts cleanly through the disingenuous rhetoric used to disguise the intentions of the transphobic few who deliberately whipped up and led a mob to protest the very right to exist of a tiny and vulnerable minority.
I echo his call to resist this 'very British bigotry'.
It is time for us all to stand in defence of our transgender brothers, sisters, and children. Love wins.
Bernie Linnane, Dromahair, Co Leitrim
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Irish Examiner
4 days ago
- Irish Examiner
Psychiatry cannot be allowed to dominate debate on Mental Health Act
Recent public debate around long-awaited reform of the Mental Health Act, 2001 has predominantly consisted of doctors and commentators creating moral panic over legal changes they claim will erode doctors 'right' to force treat people. Let's be clear: the Mental Health Act, 2001 will continue to allow people to be involuntarily confined and force treated. Let's also have some clarity that under the current system, mental health outcomes are very far from satisfactory. Indeed, despite the now accepted deconstruction of 'mental illness' as simply a diagnostic construct, this system is now largely upheld because of legislative frameworks. It begs the question, should those within the system and seeking to uphold it be allowed to constantly dominate the discourse around reform? Let's get to the heart of the real issue here — psychiatry and its wish to retain its legal powers. Psychiatrists use a legal defence of medical necessity for forced treatment but this is increasingly untenable. As Dr Pat Bracken, the highly respected independent consultant psychiatrist, has written: If psychiatry is going to take away people's liberty and use invasive methods of treatment, then it needs to be 'confident that we can predict outcomes, and happy that we understand how our treatments work and for whom.' His conclusion – and the now widely accepted scientific reality, is that psychiatry cannot reach this efficacy standard. The treatment on offer for people who are severely unwell and distressed is not, as some may erroneously believe, intensive therapy that seeks to get to the root cause of the issue. Rather it is drugs and sometimes electricity. There may be psychological interventions but these are few and far between. Of course there are situations where people need acute care and medication to stabilise them, but traumatising environments that use powerful psychotropic drugs should not be the only answer when someone is in distress. People in this system are guinea pigs, labelled treatment resistant if drugs don't work, lacking insight and branded non-compliant if they don't agree with doctors and do what they are told. Debate in Ireland is regressing as is our move towards a rights-based system. Just this week it has been reported that the Cabinet has signed off on an amendment brought to Cabinet that someone who is involuntarily admitted to an acute psychiatric unit can be detained for up to 42 days, an increase on the 21 days previously proposed under the bill. This is a flagrant move in the wrong direction with no debate and no rationale given. In this paper recently Dr Suzanne Crowe argued that people experiencing psychosis do not know they are ill and have no insight into their psychiatric condition. This contention assumes that viewing people through a psychiatric lens is the legitimate view, ergo if a person does not subscribe to this view 'psychiatric illness', then this means they have no insight and therefore must have their liberty taken away to be sufficiently chemically restrained. People who are struggling, who are different, who are living in a chaotic family or community, who have extraordinary experiences, who are in deep emotional distress may not have 'insight' into the limitations of psychiatric diagnosis but the way to help them and those around them is not to lock them up as second-class citizens, take away their liberty and assault their personhood. Insight is so very important, but it is a two-way concept. In order for these 'psychotic people' to receive the help and human engagement they may need for healing, it is important that those tasked with providing care also develop insight. Insight into the multiple perspectives, experiences and circumstances that cause people to warrant support; insight into the need to provide choices that might be more conducive to people wanting to engage, and insight into the damage the 'medical model' paradigm of care causes. This is about a fundamental right to health. Moving towards a rights-based legal system, as outlined in the UN Convention on the Rights of Persons with Disabilities, to which Ireland is a signatory, means treating people as rights holders, not as mere subjects of legal or state control. Consent Unquestionably, evidence-based care should be at the core of cancer or heart, or any other type of health treatment. Therefore, it cannot be the purview of just one highly contested profession (psychiatry) to impose what is increasingly seen as a dogmatic ideology onto people who are already in a vulnerable state. This is not to say psychiatry should not be part of a suite of measures available to people, but mental health care should be based around consent and choice — a right to choice should be enshrined in legislation, and requisite funding must be put into things like family work, peer support, peer-run grassroots organisations, community development, non-medical crisis houses and open dialogue. Choices should not be viewed through the sole lens of a psychiatric classification system that prescribes meaning to people's struggles, distress, environmental outcomes and extraordinary experiences. These choices have long been mandated as part of the post-psychiatry paradigm for mental health service provision, and the new paradigm is awash with international examples of best practice. In other words, there are examples of how we can do things better. Certainly, things cannot get much worse for people in distress. In 2013, the UN Special Rapporteur on Torture explicitly stated that forced psychiatric treatment may amount to torture or ill-treatment, especially when not evidence-based. Doctors may be offended that their well-intentioned treatment is causing harm, but advocates cannot dampen the quest for change and justice to appease psychiatrists. Because the harsh truth is that while some coercive practices might not always meet the legal threshold for torture, they do often qualify as inhuman or degrading treatment. Surely if there is even a question that 'care' could be considered as something akin to torture, this requires radical debate and reform. Jennifer Hough is a human rights and social justice advocate Dr Líam Mac Gabhann is Associate Professor in Mental Health Practice at Dublin City University Read More Watchdog to create code of practice for using surveillance in mental health services
Irish Examiner
6 days ago
- Irish Examiner
CHI failure to deliver international best practice 'harmed' children, among findings of report
The unpublished report, seen by the Irish Examiner, into concerns at Children's Health Ireland hospital identified: • An unknown number of children — between five and 80 — with the same health condition receive 'suboptimal' care at this hospital compared to how patients with the same condition are treated in another CHI hospital. They were known as 'orphans' internally, with one staff member interviewed saying: 'How can you have patients that aren't someone's responsibility?' • Some of the children may develop cancer or be infertile due to delays related to a procedure which should be done by 18 months old. • The review quotes another unpublished report from 2017, which warned of similar problems for these patients. It says by 2021 they found 'lack of clarity' about actions taken on that older report. • National Treatment Purchase Fund monies given for 'insourcing' to run extra clinics for 179 children is questioned. Some 95% of children seen could have been seen in another service during regular hours without extra funding. Some could have been seen sooner. Some of the children were referred to an inpatient waiting list which was longer than at another service which could have treated them. The review found this was 'potentially negligent'. • Risk assessment in 2021 for one national service said children being treated 'have a poor experience or are harmed due to the inability of CHI to deliver international best practice standards of [this care]'. It was given a risk score of 20 out of 25 • A 'toxic culture' was identified, with three specialist nurses leaving one service between 2013 and 2021. Comments show one person had panic attacks at work. Trainee doctors faced a 'psychologically unsafe environment' in one department reviewed. • Some 89% of people interviewed described 'a culture where change was slow, which lacked governance and robust processes' across CHI as a whole, while 43% said 'they wanted to see real change across CHI'. • A defamation case is on-going between two consultants, which the report linked to 'fraught relationships' between two services in which they work.
Irish Examiner
6 days ago
- Irish Examiner
Watchdog to create code of practice for using surveillance in mental health services
A code of practice is to be drawn up for the use of CCTV, GPS trackers and other surveillance technologies in Ireland's mental health services. A public consultation process is currently underway by the Mental Health Commission, to seek the views of people who use mental health services about how the use of surveillance equipment impacts on them. The views of family members, carers and friends are also being sought, as well as those of people working in the sector. The Director of Regulation at the Mental Health Commission, Gary Kiernan, says surveillance technologies have advanced considerably in recent years, and their use has become 'a complex area' in mental health services. He said: 'The Mental Health Commission wants to develop a code of practice that takes account of these technological advancements while encouraging and promoting good practices and high standards in relation to their use. "This consultation is particularly concerned with how Ireland's mental health services should protect the rights of people who use mental health services, especially their rights to privacy and dignity. I would encourage all interested parties to engage and ensure their voices are heard.' According to the commission, such technology is used to observe or monitor service users to 'inform their care and treatment'. While CCTV is currently the most commonly used form of surveillance, other technologies being used include bodyworn cameras, infrared cameras, sensors, alarms, and GPS trackers. The use of such equipment falls under regulation 25 of the Mental Health Act 2001 (Approved Centres) Regulations 2006. The Mental Health Commission says the purpose of the consultation is to identify key areas that the new code of practice should address. It said: 'The Code of Practice will apply initially to inpatient mental health services. Its scope may be widened in the future to include community mental health services and community residences once the MHC's regulatory remit expands to include these services.' The survey can be accessed online here. PDF versions of the survey may also be requested from standards@ and returned via email or by post. Focus groups and interviews with interested stakeholders will also take place, with interested parties invited to email standards@ The public consultation will close at 5pm on July 16. Read More Suzanne Crowe: People with severe mental illness will be failed by proposed new law
