- Opinion
- 08 Oct 04
The lack of a Presidential election has its up side. meanwhile it’s time to re-examine our approach to such health issues as alcohol. but will Minister Harney see the light?
The European Union has given us many memorable terms in its time. Who can forget “subsidiarity”, “non-document”? Arising from freedom-of-information rules, any dog in the street could demand access to official documents. Hence the “non-document” became a way around the rules.
In the same spirit we may refer to President Mary McAleese’s re-election as a “non-election”.
It would have been interesting had Michael D contested it. But one also has some sympathy for the pragmatists who decided against it.
As for Dana, not even the principle that all political offices should be contested warrant having to listen to her waffle for three weeks. So it’s an ill wind that doesn’t blow some good.
Dana talks the talk about democracy, but essentially she’s a figure from the new American religious far right. These are the kind of people who surround George Bush. They have a particular and narrow view of what democracy means.
Some say they have destroyed American democracy and civic responsibility. The Irish national and local politicians were right to ignore her. An election would simply have been about promoting her and her views and her agenda.
But be careful. She hasn’t gone away, you know.
As for the reshuffle of Ministers, little change will follow, but one or two might prove interesting, such as the appointment of Mary Harney to Health. Much of her agenda will concern hospitals and consultants and services. But hotpress readers will be most interested in what she does with regard to health promotion in general, and alcohol in particular.
Her predecessor bought into public health in a big way. This was a change. Previously, many disciplines were involved in forming alcohol policy.
The difference is enormous. Psychologists, sociologists and economists are interested in the complex interactions of forces at work. Doctors (and I include psychiatrists) see only pathologies. Their approach is to prescribe the medicine and expect us to be thankful.
Public health is an ideology as much as a discipline. Like George Bush, its proponents often argue that if you are not with them then you are against them. They are also nanny-staters and strong proponents of restrictions on personal freedoms.
It will be interesting to see how Mary Harney squares this particular circle.
She might start with scientific method. In her previous post she hammered home the need to promote science and technology. She was right. But it isn’t just about a field of work. It’s also about method – objectivity, rigour and empiricism – and public health proponents are quite loose in these regards.
By way of example, two doctors in St. Patrick’s Hospital in Dublin examined whether there was a link between the State’s increased rates of suicide and alcohol consumption over the last ten years.
Their finding, that the rise in suicide was linked to increased levels of consumption and binge drinking, was headlined in the Irish Times which is, with RTE, the leading mouthpiece for the new priesthood of public health experts.
What the figures show is a correlation. But in science a correlation does not prove causation. In fact, the really significant change in binge drinking over the last ten years is in the behaviour of young females who now out-binge their male counterparts, while the significant rise in suicides is among young males.
Alcohol is certainly a factor in many suicides. But clearly, other factors are at work and are arguably of greater significance.
Here’s another correlation. During the last decade, girls surpassed boys in all public examinations in this state. This correlates with their increased binge-drinking. So will the good doctors accept that alcohol consumption causes higher examination grades?
Hardly. But if we are to get to the truth, we need to take account of all the variables in play.
Similar reservations apply to the calculation of costs to Irish society of alcohol abuse. In the various official publications on alcohol these costs are ‘estimated’. Estimates multiplied by estimates are very unreliable. But they are presented and, if repeated often enough, are accepted as facts. Yes, of course there are major costs, but they need to be scientifically calculated.
To finish, three thoughts for the new Minister.
– Firstly, let’s have the appliance of science.
– Secondly, always question the prescription. For example, a range of anti-drink and anti-tobacco measures has been introduced here. These were prescribed by the doktors to reduce drunkenness and consequent costs to the health system.
But, according to a senior counsellor with the Western Health Board, cited in the Sunday Tribune on September 12th, the result is an increase in home-drinking. In turn, this has led to ‘a direct rise in the number of children being taken into care’ where, of course, they are an added cost to the health system!
Furthermore, the counsellor said that this was also having a negative effect on the drinking habits of teenagers!
So, prescriptions are sometimes inappropriate. And indeed, other experts warned that policies can have unintended consequences.
– Which brings me to the third thought. There are many conflicting views on alcohol in Ireland. The last Minister adhered to one, the interventionist and prescriptive medical model. It’s time to hear the others.
Now that really would be a change.
The Hog