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Chapter 1: What is the main issue surrounding the Rotunda consultants?
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0818 715 815. This is LiveLine on RTÉ Radio 1.
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So like I say, you can call on it, you can text on it, you can send a voice note, whatever is handiest for you. And Anna Moore is on the line, the so-called mammy of Irish boxing. Anna, how excited are you at the announcement that we're all expecting in about 13 and a half minutes time, I think, to be precise, that Katie Taylor's going to be fighting in Croke Park.
I'm over the moon. I am just so elated over it. Because do you know what? She is a good ambassador for boxing. She lived in Ireland all her life. She's Irish. She's a world athlete at the top of athletes that are world class. Katie will be one of them. And through professional boxing... when the women's boxing weren't getting horses.
When Katie came in, Katie started getting the big horses and everybody wanted a boxer. And she never, ever refused. I am so proud to hear that she's going to be in Croke Park. You know, it's just amazing.
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Chapter 2: How are private patients treated in public hospitals?
You know, we only get a glimpse of her, the rest of us. But it always felt like she remained unbelievably well grounded despite all of the success. I mean, anyone else, they'd let it run away with them a little bit.
No, she was well-grounded. She was well-grounded. There was no, I'm Katie Taylor, I'm the best in the world, which she was. But there was nothing like that. Nothing like that. And everybody from the Chinese to the Indians, any country throughout the world wanted a photograph with Katie Taylor.
And were there times over the last few years, you know, as she was... you know, in that kind of, those three fights, those three, you know, bouts with Amanda Serrano or the couple of Chantel Cameron fights as well, where you were nervous for her at all, Anna?
The only one I was nervous with was the first time that she boxed Chantel. And I was there inside. Oh my God, my heart was pounding. It was too close to call. But I really thought that that fight, even though Katie didn't get the decision, I thought it should have been a draw. I felt it should have been a draw. A lot of people won't agree with me, but me watching it, I thought it would be a draw.
It should have been a draw, you know. But Katie, I mean, you look at her. I mean, the Americans. Katie Taylor is this. She's getting, the judges are only giving it because of it. All of this sugar. That's a load of. I won't say the word. It is a lot. It's nothing to do with what she'd done. Any fight that she fought, people that don't know boxing and don't know how bouts are scored would know.
My own son now, Ken, I was asking him, I said, what did you think? He said, I would have given to her by two rounds. These would have been her others with Serrana and with Chantel, you know. But, I mean, the first time she boxed, Serana. I remember after it, the girl admitted and then, what was her name again? Serana, we just called her Serana.
She admitted Katie beat her and she was looking forward to going away and spending the money she got, the purse she got for fighting Katie. And then the next day she was on, oh, I should have got it, I was robbed. The Americans seem to think they don't ever think much of Katie.
Yeah. I wonder how much of that was just trying to ramp up a bit of excitement for a rematch. I think possibly that's what was going on there.
I'd say you couldn't be wrong there because, as I said, the purchase they got for just fighting Katie would have been nearly 10 times what they'd get before Katie came into professional boxing.
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Chapter 3: What are the implications of the public-only contract for consultants?
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LiveLine with Kieran Cudahy on RTE Radio 1.
51551 the number for your texts or you can get in touch as I said on WhatsApp 087 484 888 and indeed lots of people did get in touch yesterday when we were talking about this row between the Department of Health and the Minister for Health and the Rotunda Hospital in the Rotunda consultants who are on the public only contract are treating private patients in the hospital in the public hospital they're not meant to be doing it anymore the Rotunda say they've taken legal advice and they think this is
The minister, for what it's worth, absolutely disagrees. She was pretty unequivocal about that when she spoke to David McCullough this morning. When she spoke to David McCullough as well, she directly responded to some people who spoke to us here on Liveline yesterday, Jessica amongst them. People remember the argument that was made that the only way that you can have
consultant-led continuity of care with maternity services in Ireland is by going private. And so by removing the private option, which is in effect what is happening, you are removing that choice. That was the argument made by some callers. Some disagreed, but that was certainly what was put forward. And that was the argument David McCullough put to the minister.
And here is what the minister said.
Women going into the rotunda should expect continuity of care, consultant-led care, if that's what they want, or if they want a more midwife-led system, that's fine. But if they want a consultant, that's what they should be able to get. But it is all women, and not just women who can afford it, but all women. All women have risky pregnancies. All women are capable of having twins.
All women can have gestational diabetes. There are risks with all pregnancies, and all women deserve and need the support that expert-led care can provide.
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Chapter 4: How does the Minister respond to concerns about maternity care?
I don't know. I don't have a clue. I don't know. But they certainly have skin in the game financially in making their arguments about women having choice. And, you know, they're not arguing for all women to have the choice. They're only arguing for the women who are going to pay them the extra bucks for their mixers. You know, so I wouldn't really have any truck with that.
Now, the irony of it is that a number of years ago, I had a baby in the rotunda and I had the choice of I had the choice of going private or semi-private, and I opted to go semi-private. And I do believe in public health care, and I remember at the time thinking it was wrong that I had that choice, but I was presented with that choice.
And I chose semi-private because the choice that I wanted, I mean, I didn't really, consultants are not neither here nor there, because I think if you are at risk and you need a consultant, you're going to get that within the public system. But I wanted to have a woman as my obstetrician and I wanted continuity of care. I wanted to see the same person through the pregnancy.
I was nervous, first baby, a number of issues and I had, you know, I had, I saw the same, every second visit was to the GP and the ones in the hospital. I saw a registrar who was a young woman about my age, specialist in obstetrics and she was Yeah, she was great. Like I had a great service, but it was wrong that I could afford to pay for that.
And I did that. Imagine you were back there today and you went into the hospital and for all those reasons you wanted to go private or semi-private and the hospital said, no, you can't. And they'd say, listen, ideally, we all want to live in a world where you can come in as a public patient and get the service you just described. But that doesn't exist in Ireland.
And we're weeding out the private and semi-private. So sorry, you're not getting any of that. How would you feel?
I would accept it. And I would also be agitating for everybody to have a continuity of care, to basically have the same doctor that you're seeing over the course of your pregnancy. It does not seem like a big ask. It doesn't have to be a consultant unless a consultant is warranted because it's high risk. I mean, I thought it was a perfectly reasonable thing to not want a male obstetrician.
And, you know, I would still feel like that. But I think that everybody should have that. And I would be agitating and I'd be roaring the house down for them to actually provide to me as a public patient. And if they said you can't go private, you can't go semi-private, it's no longer available, that's fine because I actually morally agree with that. You know, I think...
I think they need to up their game in terms of what they're providing to everyone and not be giving all their attention to trying to accommodate those who want to go private. If they want to go private, the private consultants and the private hospitals and the private insurance companies need to sort that out and provide the service. It's a business. It's commercial operations.
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Chapter 5: What choices do women have regarding maternity care in Ireland?
They wrote to all the hospitals at the start of the year and said, because of the terms of that contract, we're not reimbursing. We will only reimburse if you're treated by a doctor who's on the old contract. Doctors on the new contract, that's gone. So actually, they're not. It is the taxpayer footing the bill.
Yeah, but the taxpayer is the patient as well.
I know, but the taxpayer... They actually are entitled to be in that hospital. I know, and they're entitled as a public patient to go into it. But in this situation, they go into the rotunda. They're treated as a private patient in a public hospital by a doctor who signed a public-only contract.
And because they signed it, they can't even reimburse, get the money back from the health insurance anymore.
I actually highlighted this two years ago when this came up. I wrote to the minister at the time. I have written a lot about this. because I saw it coming. I'm not of a childbearing age, but my children, some of them will be, and my grandchildren. I am so worried about women in this country. And a lot of the time it's men.
And people like Fintan O'Toole, who I generally support his views, writing like that about women.
And I just say, we'll just make it slightly less personal because we did talk about Fintan yesterday and we gave him a right to reply. He knows what was being said about him and doesn't have an issue with people commenting on his commentary. But anyway, go on.
No, but all I'm saying is, It's taking away a right. I don't know how the minister is going to manage this with smoke and mirrors, but it is unacceptable. Now, the other situation is that these consultants are put under pressure to sign these contracts. And that lady before me was right in saying eventually it will die out. But it's the only discipline that will die out.
There's no other discipline that will die out. Now, this is a dilemma. for society. But it is actually saying, as if we're in a communist country, that somehow or other you've no choice. And we give everybody else a choice. And it is a dilemma.
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Chapter 6: How has the perception of private healthcare changed over time?
You know, nobody is stopping them. It's a free country. You know, that can absolutely be provided. What they're actually saying, and if you look on the website, what they're actually saying is we'll do the best of both worlds. That's the phrase that they use, which is they will use the public facilities and top it up with kind of extra private facilities.
And, you know, the continuity of care, care for every single woman, every single woman, you know, who goes into Sunderland or any other hospital should be determined by her medical needs, right? So the care program for every woman should be determined. And it should be, what does this woman need?
Many women do not need, you know, in particular, you know, a continuity of care provided by a specific consultancy. Remember, sometimes, again, if you look on the Rotunda website, it'll tell you, even if you book this private care, you may not get it because the consultant may not be available.
I know lots of women don't need it, but some women do need it. My experience is like yours. It was in Hollis Street and we went through the public system and I couldn't say a bad word about either of our experiences. It was a brilliant midwife-led and my wife would echo that as well.
But some women, and we've spoken to them over the last couple of days, it's not being pushed by the consultant necessarily. They want that consultant-led continuity of care. Despite the great services provided by midwives, it's not just consultants pushing it.
But can we just remind ourselves what we're talking about here? We're not talking about a supermarket. We're not talking about a consumer service. We're talking about a publicly funded healthcare system. And in a publicly funded democratic healthcare system, the nature of the care that every single woman is entitled to is the care that her particular condition requires. For a lot of women...
Absolutely the best option is, you know, the midwife-led service for a lot of women, and a lot of women still do this, you know, it's what we did, is kind of shared care between their GP and the hospital.
You know, there's lots of different kinds of needs, but for the master of a publicly funded hospital to come out before the Ructus Committee and say effectively what he was saying, and Chris Fitzpatrick, who's the former master of the Coombe, has been very... good about pointing this out.
What they're basically saying is that there will be different levels of safety applied to women in relation to whether they can pay or not. And that is, to me, astounding, and nobody can stand over it. I don't believe that there's a single midwife working in our healthcare system.
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Chapter 7: What are the financial implications of the current healthcare model?
Thanks, Cathy. Finn, I'm sorry, you were suggesting it was being distorted, the nature of the phrase you used.
Yes, it is. And also, this is typical distraction stuff, isn't it? I've been around long enough to know this is what, you know, you just take a phrase or something, rather than dealing with the fundamental issue. It's very striking, right, that actually... what your callers have been saying, the ones who are criticizing this, is itself a mark of a scandal.
Because what they're saying is they're afraid. They're afraid. I mean, what sort of republic do we live in where significant numbers of women have been taught to think that if they are treated by consultants who have signed a public-only contract, Voluntarily, right? Nobody put a gun to their heads to do this. They're very well paid to do it. That they will not get safe service.
I mean, first of all, I think that's completely untrue. I see no evidence whatsoever that the consultants, the midwives, the people who are working in our hospitals are not there to provide a safe service for women based on their needs. That's their profession. That's what they're there to do.
You know, and it's terrible that women have been terrorised into this idea that somehow if you don't come up with a big chunk of money, you should be scared.
Do you think that implication that the public system is less safe, that that's... It's almost the sales point when it comes to private maternity care. Because when it comes to everything else, because Cathy's not with us, but she kept asking, why do people have private health insurance?
Now, what I would have said to her if she was still here is, in most other cases, it's actually just to skip a queue. It's so that you can see a cardiologist quicker or you can see and get your ankle injected in sanitary quicker or whatever it happens to be. And you don't have to wait around. But there's no waiting around element to maternity care because the baby is coming on...
D-Day and there's nothing you can do about it. So you have to come up, you have to come up with some other sales point, is that it?
You do, you do. And, you know, some of those sales points might be to do with private rooms, with better food, whatever. You know, let me just be clear. I have absolutely no problem if consultants who wish to continue to provide private only care establish private hospitals. We have loads of private hospitals in Ireland. You know, we have a whole system of private care. It's thriving.
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Chapter 8: What is the significance of Katie Taylor's upcoming fight in Croke Park?
Where are they going to sit? Where are the beds? They don't exist.
I mean, already at the moment... Is that a slaunch of care versus private? Is that just the issue that the health system...
Well, nobody has answered the question. Yeah, nobody has answered the question. Where is all the money going to come from that is already generated or that is being generated by the private patients attending public hospitals? Where is all that money going to come from?
Yeah.
Nobody's answered the question. I don't think anybody's actually even asked the question, not to mind getting answered the question.
Sorry, Catherine, just because on your point, you know, you criticised Fintan for suggesting that, you know, doctors didn't have to sign the contract. You said if they didn't sign it, they'd be out of a job. If you were already on the old contract, you could stay on it, and that's still true.
Oh, yes, yes, yes, of course.
And Fintan as well, and sorry not to put words in your mouth, Fintan, made the point that, you know, there's nothing to stop an obs and gynae consultant working privately in the future if they want to go off and set up their own hospital or set up a maternity ward in one of the private hospitals.
Well, I think that's a little bit disingenuous to say that. Obviously, one doctor... is not going to open a hospital.
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