All animals are equal in a pandemic, but some are more equal than others

There is a fundamental contradiction between good health and budgeting that stretches from the lowliest household to the biggest hospital or healthcare institution

We have been aware of this in a vague and ephemeral sense for years, but Covid-19 has brought it home. Literally.

It starts with your home, your castle, if you have one. The size of a home and its comforts made a huge difference to the average Irish person’s experience of Covid. You could say the same thing is true even in non-pandemic times, and it is, but Covid is a kind of prism – separating the benefits of wealth and possessions so that they can be viewed clearly.

Diet makes a big difference too. I paid €10 recently for a can of orange soda (Italian) and a ham and cheese sandwich. I don’t know if it had any superior nutritional advantage, but my heart is still palpitating and pounding in my chest.

My heart, of course, needs lots of exercise to function at its best. And it’s impossible to exercise without spending a great deal of money on an annual Gym membership. Or so we’re told by Ben Dunne and Co. whose desire to keep Ireland healthy is his one great dream.

We’re told many things. We are constantly bombarded by media – mainstream and social – that tell us how we can avoid all the bad things by simply spending money. This is the capitalist way. The American dream. You just have to work hard, make millions, and then spend it all on things that make you feel good.

And yet, we don’t feel good. We complain loudly and bitterly that things are wrong. We are not paid enough. Politicians are hypocrites. Dublin property is over-priced.

But now many of our beliefs and opinions on the world are being challenged by a pandemic that is changing the rules, changing the perspective.

One of the most profound changes is the realisation that health is not something that is shared equally between all members of society, but something that is a product of your own environment, your history (genetic and actual), your attitude, the healthcare you can afford and many, many other factors that are all acting on you. These individual factors mean that some people live long lives of fulfilment and contentment, while for others, life is, as Hobbes put it, ‘solitary, poor, nasty, brutish and short’. Joe Biden is still joking away in his new job which he will have until he is at least 83, a job many consider to be one of the most demanding in the world.

Many do not dig ditches in the cold Irish rain, however, so they can be discounted. “Malarkey!”, as the President might say. And no matter how demanding the job is, the medical expertise Joe will receive will keep him going until he is 83 and maybe more, because Joe is important. That’s not a demanding role.

What’s demanding is watching a relative die without being able to provide them with any care or medical help. ‘Demanding’ is being demeaned on a daily basis by a manager or boss who victimizes you because you are a woman, disabled or from a different culture.

It’s not demanding to be flown around on your own work-plane – adored and admired and assured of your place in ‘history’. You are significant, in the sense that any human is really significant. But you have this good feeling all day long that you count, that you matter.

Many people don’t matter. Heroin addicts, to name one group. Travellers to name two. Children with mental health difficulties who can’t afford to go to a private specialist are another in a long list.

They may matter to you individually, and you may be a kind or decent person, but to the world, these people do not really matter.

Yet, we want to live in a world where we are not the bad guys, where we are not to blame for our fellow humans’ pain and suffering. The need to ‘other’ such people and blame them for their own misery is a constant echo in the pub conversation – now elevated to social media, as if wisdom was locked in the ‘locked’ and only now freed by the ability to broadcast nonsense to the world.

But Covid has shown us one thing with clarity – we can’t go on as we have been. The problems we face are not isolated to individuals or groups but wrapped around larger societal concepts that need tackling by all – not just those affected by them.

In this context, there is a real need to improve not just the pay, but the terms and conditions and the overall lifestyle of healthcare professionals. We need more doctors, more nurses, more consultants and we need a range of other allied professionals to improve lives.

Pay is not enough, but it’s a start. And since pay can be compared, Ireland has to be there or thereabouts when it comes to pay. Otherwise, we’ll simply lose all our good people to other countries

But to get to where we need to go, we need a wholesale reform of the healthcare system where HCPs have the resources to do their jobs, the training and support to do their work at the highest standard, and a system that doesn’t require overwork as part of the terms of conditions of doing a regular job.

That’s the demanding part. That’s the demeaning part. That’s the bit that needs changing.

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