The gaps in Keeping Ireland Alive

I held my fire after the opening episode of Keeping Ireland Alive- RTE’s reality TV series in the prime time slot right after the 9pm news on RTE One Television over the past four weeks.

Well, kind of held my fire… I did tweet last week about the absence of General Practitioners i.e. GPs or family doctors – throughout the series. The first week was very heavily concentrated on the hospitals and the drama of childbirth and high tech surgery. I’d held my fire then as I thought by week 2 or even 3 we’d have begun to see inside at least one family doctor’s surgery… But no.

So now as the series heads into another week it is a good time to assess it. It has been well filmed with dozens of cameras at dozens of locations around the country on a single day. That is the series’ unique selling point but also its weakness. While it has gathered a myriad of stories – many heartwarming and many heart wrenching – it cannot be said to be a comprehensive look at the Irish health service on a particular day.

There are significant gaps in this narrative – and I think that is mainly due to the demands of prime time TV – drama sells and keeps audiences watching . And the drama is to be found mainly in the major hospitals and the insights like brain surgery and complex childbirth. Will he patient survive? What does the doctor have to do? Wow isn’t that an amazing form of surgery they can do these days?

Furthermore this format demands that the stories it finds can mainly be told in one day with maybe a sentence or two of voiceover at the end by the narrator to tell us how the story ended.

Just like in health politics – which is dominated by hospital beds and hospital services (cue the John Halligan/ Waterford hospital saga) – hospitals are good at getting media attention and political attention. And tons and tons of funding.
The far less dramatic and more mundane parts of the health service are effectively ignored in this series.

GAP: the family doctors.

Ireland’s nearly 5000 family doctors are the backbone of the health service. No matter what we might say about hospitals it is the day to day ordinariness and efficiency of the thousands of family practices around the country that keep the health service going. It is the family doctors who treat the chronic illnesses from asthma to cardiac disease; who treat thousands of people in their own homes and keep the out of hospital; who diagnose the muscle sprains, the influenzas and the high temperatures.
These are the gatekeepers of the Irish health service who have effectively been ignored in this series.

GAP: the private hospitals.
Whatever you might say about the public-private mix the private hospitals play a big role in the health service, by reducing the high demand on the public hospitals. While it is fair to say that the most complex and demanding treatments are carried out in the public hospitals the privately run hospitals and clinics are playing a growing role in the ecosystem. Surely it would have been possible to include at least one of them or was the HSE calling the shots on where the cameras could go?

GAP: the managers.
In last week’s episode I saw – very briefly – a stressed Bed Manager in one of the major hospitals struggling with a crowded whiteboard and a losing battle to get patients discharged to ensure that the overcrowded Emergency Department was cleared. We didn’t learn how she got on in the end but it would have been a surprise if she achieved her target for that day! And what also surprised me about that little vignette of her in action was the table full of clerical staff around her – mainly female – and I did again wonder what they were doing?
The managers I wanted to see were the CEOs of one of these major hospitals where complex surgery was being carried large teams of nurses and doctors with accompanying specialist staff. What were their opinions on the work being carried out in their hospital that day? Did the production team seek to get their views or did the programme brief ask for that? Did they sit in on even one meeting that day to let us judge what was happening at the administrative level?

Without these gaps filled the series – wide ranging and ambitious as it was – does not achieve what it set out to to: tell the story of Ireland’s health service in one day.
But to give credit where it is due: yes we do tend to overemphasise the problems and shortcomings of Ireland’s health service and forget at times the talent commitment and sheer skill of our health service staff. To them well done. They work hard and should be given credit for that.
Let’s hope though that when the Powers that Be in RTE are reviewing the series and thinking of their next year’s output that they think about a series I would really like to watch: the family doctors at work. Not over one day mind you but over a series of months. Rural and urban big and small older and younger.

DECLARATION OF INTEREST: Some time back I was involved with a TV production company in a pitch for a series like the last paragraph there and as you can have guessed we didn’t get it over the line. RTE chooses to make series following vets, zoos, chefs and god knows what else. Maybe they will get around to the family doctors some day soon.