Much has been made in recent days about James Reilly's plans to close down the A&E service in Roscommon Hospital. He claims that the unit is unsafe and that patients are at more risk by being treated there than by traveling to Galway, Longford or Castlebar. This resulted in FG TD Denis Naughten losing the whip after voting against the government on the issue.
In my mind there are two major issues at play here. Firstly there is the conflict between the rationalization of services to provide economies of scale and the requirement for geographical spread of services to ensure no patient is too far from acute services. Secondly there is the political issue of promising rainbows and unicorns before an election and then not being able to deliver.
There are studies that show quite clearly that the further away from an A&E a patient becomes ill, the more likely the outcome will be bad. Therefore it makes sense to try and dot hospitals around the country in strategic locations so that people are not too far from help. In the current situation, closing Roscommon may lead to people driving to Galway for assistance. Having driven that road only a few months ago in some pretty heavy rain I can assure you that it is not something that you would like to do with a sick child or heart attack victim in the back seat. Double that length of time if you have to call out an ambulance and you can suddenly see why the people of Roscommon are up in arms about keeping the hospital open.
However, the flip side is that an A&E that doesn't see many patients will not have the experience and practice at dealing with serious problems. The figures speak for themselves in the Roscommon case where mortality rate was over three times higher in Roscommon than in Galway. In an ideal world, every city and town would have top class health (and education and transport and ...) infrastructure and services. But it doesn't work that way. There is a finite pot of resources and it can only make sense to invest heavily in areas that will provide the maximum return - ie where the population catchment area is sufficiently large.
People have to live with the choices they make. If you choose to live in a lightly populated area you can't expect the same level of services as those who live nearer each other. Density is king, and when you compare Dublin at nearly 1400 people per km^2 and Roscommon at 25 per km^2 you may begin to see where the problem comes from. I've been called on my urban bias before and accused of not understanding the rural way of life. And yes, maybe it's true. But you make choices in life and one of those choices is where you live. Living in Dublin 5, I can't have an expectation of waking to mooing cows and fields of corn outside my window. Likewise, if I lived in a rural area I couldn't have an expectation of rapid public transport, high-tech hospitals and third level education on my doorstep.
Politically it is also true - people have to live with the TDs they elect. The TD also has to live with the electorate and should stand by positions held in the run up to the election. That is why I have some grudging respect for Denis Naughten. It will be interesting to see ho long he remains outside the whip and if he will vote against the government on any other issues. It is not good enough for TDs to say the people have spoken and elected them to the Dáil if the premise on which they were elected is false. In any other sphere that would be a breach of contract and render the whole relationship void. Pity our politicians can't be held to account in that way.
Showing posts with label Rural. Show all posts
Showing posts with label Rural. Show all posts
Friday, July 8, 2011
Thursday, August 12, 2010
Divided Ireland
To paraphrase Julius Caesar, Hibernia est omnis divisa in tres partes. There's the well known north/south divide that has split the island since 1922 or thereabouts. But another division also exists between the greater Dublin area and the rest of the Republic. While it's origins can be dated back to the 14th Century, it is a long standing division that is unlikely to disappear any time soon.
Having married a country lass (Tipperary to be exact) I'm occasionally on the receiving end of statements like "Dublin is no place to bring up a family" or "Dublin is grand when you're young but you couldn't settle there" to which I just nod and smile. I know that I like living in the city and in fact I'm pretty content with my choice of Dublin as a place to live. It's big enough that you can find new and interesting people but not so big that you end up living an anonymous life not knowing anyone. For all its flaws I wouldn't move anywhere else bar some remote cliff top in Kerry or Donegal that was still able to get a decent DSL link.
On a political stage this bias is even more pronounced. Every few weeks you see a story from a Jackie Healy Rae, Michael Lowry or General O'Dea about how they have delivered great services for their local area. This championing is never done on behalf of a constituency in Dublin. Perhaps it is because the areas are relatively compact and that large infrastructure like hospitals and bridges in Dublin benefit all 12 constituencies so for one TD to claim responsibility would be laughed at. In fact when projects such as Metro North and the Interconnector were announced there was more moaning from rural TDs about Dublin getting all the goodies than column inches given to Dublin TDs applauding the decision.
Most recently the proposal to take water from the Shannon to be used in the greater Dublin area has been met with the same sort of reaction. Local interest groups appeared out of the woodwork insisting that their water should not be given to Dublin. Instead the multi nationals should come to Offaly or Leitrim and set up shop there. In theory that's great, until you realize that large companies need the economies of scale and transport links that only come with a reasonable sized city and unfortunately there are only 2.5 of them on the island.
If the people outside the Pale want Dublin to keep it's paws off their natural and human resources then that is fine. They just have to accept that the flip side of that is no longer receiving tax transfers from the million or so people who choose to live and work in the capital. That ought to shut them up for at least a few weeks. And don't get me started on the sporting (GAA and rugby) bias - that post would end up as long as War and Peace.
(Full disclosure, I was born in Cork but like the A-Team I promptly escaped to the Dublin underground)
Having married a country lass (Tipperary to be exact) I'm occasionally on the receiving end of statements like "Dublin is no place to bring up a family" or "Dublin is grand when you're young but you couldn't settle there" to which I just nod and smile. I know that I like living in the city and in fact I'm pretty content with my choice of Dublin as a place to live. It's big enough that you can find new and interesting people but not so big that you end up living an anonymous life not knowing anyone. For all its flaws I wouldn't move anywhere else bar some remote cliff top in Kerry or Donegal that was still able to get a decent DSL link.
On a political stage this bias is even more pronounced. Every few weeks you see a story from a Jackie Healy Rae, Michael Lowry or General O'Dea about how they have delivered great services for their local area. This championing is never done on behalf of a constituency in Dublin. Perhaps it is because the areas are relatively compact and that large infrastructure like hospitals and bridges in Dublin benefit all 12 constituencies so for one TD to claim responsibility would be laughed at. In fact when projects such as Metro North and the Interconnector were announced there was more moaning from rural TDs about Dublin getting all the goodies than column inches given to Dublin TDs applauding the decision.
Most recently the proposal to take water from the Shannon to be used in the greater Dublin area has been met with the same sort of reaction. Local interest groups appeared out of the woodwork insisting that their water should not be given to Dublin. Instead the multi nationals should come to Offaly or Leitrim and set up shop there. In theory that's great, until you realize that large companies need the economies of scale and transport links that only come with a reasonable sized city and unfortunately there are only 2.5 of them on the island.
If the people outside the Pale want Dublin to keep it's paws off their natural and human resources then that is fine. They just have to accept that the flip side of that is no longer receiving tax transfers from the million or so people who choose to live and work in the capital. That ought to shut them up for at least a few weeks. And don't get me started on the sporting (GAA and rugby) bias - that post would end up as long as War and Peace.
(Full disclosure, I was born in Cork but like the A-Team I promptly escaped to the Dublin underground)
Sunday, July 25, 2010
Bridge to Nowhere
Throughout the world, bridges are some of the most iconic landmarks that man has built. Think of the Sydney Harbour Bridge, The Golden Gate Bridge in San Francisco, Venice's Ponte Vecchio and the Pont Neuf in Paris. Add to that our own Ha'penny Bridge in Dublin, the Barrow Rail Bridge and the Boyne Bridge on the M1 and you can see that even in Ireland we have some fantastic constructions. Each of these bridges has a purpose of connecting communities, enabling safer and faster passage or even to make money through tolls.
Unfortunately not all bridges are built with such noble purposes. There is a history of bridges to nowhere - expensive, pork barrel projects that serve no purpose except for politicians to claim that they have delivered infrastructure for their voters, even if the infrastructure is unwanted. The most famous of these edifices was never actually built - the Gravina Island bridge in Alaska. This project was to cost almost $500M and connect an island with 50 inhabitants to the mainland and shot to fame during the last US presidential election when it turned out that Sarah Palin was strongly in favour of the project.
With that in mind, it came as a surprise to me last week on holidays in Donegal to discover the Harry Blaney bridge that joins Fanad to Carrigart across Mulroy Bay. A little research determined that the bridge was opened in 2008 by Brian Cowen at a cost of about €20M, quite reasonable when compared to Gravina Island.
On the south side, the bridge is connected to the Carrigart to Milford road by a new sweeping stretch of tarmac. The road then rises high into the air over Mulroy Bay and lands in Fanad in the middle of nowhere. There is a good stretch of road up the hill from the bridge for perhaps 300m at which point the road turns into a rural backroad, no more than 3m in width all the way to the R246 about 10km away. I had the pleasure of sitting by the bridge on a nice sunny morning for an hour while I read the newspaper. During this time about 30 cars crossed the bridge along with 3 German tourists on bicycles. The only other traffic was 4 lorries carrying materials for the road widening that is currently underway.
Certainly a more picturesque location or bridge you couldn't imagine. At times I felt like I was in a scene from Sim City where someone had just started laying out their city with a crossing point. I'm sure the bridge is of benefit to the community. It brings people in that part of Fanad close to the shops, post office and Garda station in Carrigart and substantially shortens the distance from the beaches in the north and east of the Fanad peninsula to holiday makers based in Downings and Dunfanaghy but you really have to wonder was this just another example of parish pump politics in action or was there a real demand for the link to be built.
Unfortunately not all bridges are built with such noble purposes. There is a history of bridges to nowhere - expensive, pork barrel projects that serve no purpose except for politicians to claim that they have delivered infrastructure for their voters, even if the infrastructure is unwanted. The most famous of these edifices was never actually built - the Gravina Island bridge in Alaska. This project was to cost almost $500M and connect an island with 50 inhabitants to the mainland and shot to fame during the last US presidential election when it turned out that Sarah Palin was strongly in favour of the project.
With that in mind, it came as a surprise to me last week on holidays in Donegal to discover the Harry Blaney bridge that joins Fanad to Carrigart across Mulroy Bay. A little research determined that the bridge was opened in 2008 by Brian Cowen at a cost of about €20M, quite reasonable when compared to Gravina Island.
On the south side, the bridge is connected to the Carrigart to Milford road by a new sweeping stretch of tarmac. The road then rises high into the air over Mulroy Bay and lands in Fanad in the middle of nowhere. There is a good stretch of road up the hill from the bridge for perhaps 300m at which point the road turns into a rural backroad, no more than 3m in width all the way to the R246 about 10km away. I had the pleasure of sitting by the bridge on a nice sunny morning for an hour while I read the newspaper. During this time about 30 cars crossed the bridge along with 3 German tourists on bicycles. The only other traffic was 4 lorries carrying materials for the road widening that is currently underway.
Certainly a more picturesque location or bridge you couldn't imagine. At times I felt like I was in a scene from Sim City where someone had just started laying out their city with a crossing point. I'm sure the bridge is of benefit to the community. It brings people in that part of Fanad close to the shops, post office and Garda station in Carrigart and substantially shortens the distance from the beaches in the north and east of the Fanad peninsula to holiday makers based in Downings and Dunfanaghy but you really have to wonder was this just another example of parish pump politics in action or was there a real demand for the link to be built.
Tuesday, June 1, 2010
Farmers milking it
There is a brief report in the Irish Times today outlining the payments made to various landowners in respect of the Gort bypass on the N18. The payout for land was €37.7M for a road scheme approximately 23km in length. With the overall cost of the road being €207.5M, this means that the land cost came in at approximately 18% which initially doesn't look like an outrageous cut of the costs.
In standard EU motorway construction each lane is 3.65m in width. Therefore, it is safe to assume that the mainline of the route is about 50m in width (2 lanes + hard shoulder in each direction comes to 22m, then allow for central median and edging). This makes the total area of land covered by the purchase just over 1.1M m2 or around 280 acres of agricultural land. When the amount paid for the land is divided evenly by this area, it puts the price at around €135k per acre.
This is a complete rip off as the average price for agricultural land in Ireland is somewhere between €10k and €15k per acre. Why do the NRA continue to pay massive premiums on land required for vital infrastructure? It can't be argued that split land becomes unusable since as part of the scheme, multiple access roads, bridges, underpasses and culverts will be provided to allow the continued agricultural use of the land as part of the remaining €170M. It's plain and simple, the farmers are yet again taking the tax payer for a ride and we're just letting them away with it.
If only there was some sort of report, say by someone called Kenny, which could be implemented to limit the massive windfalls on land prices. The state should not continue to line the pockets of a small few who happen to live in the right place at the right time.
In standard EU motorway construction each lane is 3.65m in width. Therefore, it is safe to assume that the mainline of the route is about 50m in width (2 lanes + hard shoulder in each direction comes to 22m, then allow for central median and edging). This makes the total area of land covered by the purchase just over 1.1M m2 or around 280 acres of agricultural land. When the amount paid for the land is divided evenly by this area, it puts the price at around €135k per acre.
This is a complete rip off as the average price for agricultural land in Ireland is somewhere between €10k and €15k per acre. Why do the NRA continue to pay massive premiums on land required for vital infrastructure? It can't be argued that split land becomes unusable since as part of the scheme, multiple access roads, bridges, underpasses and culverts will be provided to allow the continued agricultural use of the land as part of the remaining €170M. It's plain and simple, the farmers are yet again taking the tax payer for a ride and we're just letting them away with it.
If only there was some sort of report, say by someone called Kenny, which could be implemented to limit the massive windfalls on land prices. The state should not continue to line the pockets of a small few who happen to live in the right place at the right time.
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