Prof O’Keeffe co-founded the Irish Hospital Consultants Association and was president of Vision Sports Ireland
Professor Michael O'Keeffe was an ophthalmic surgeon at the Mater Private Hospital and Beacon Hospital in Dublin. He had also worked at the National Maternity Hospital, the Rotunda hospital and CHI at Temple Street. Fri, 27 Jan, 2023 - 18:57
Niamh Griffin,  Health Correspondent
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Tributes have been paid to Professor Michael O’Keeffe who has passed away, with colleagues remembering him as a “true visionary” in the medical world. Originally from Ballylough, Mitchelstown, he was an ophthalmic surgeon at the Mater Private Hospital and Beacon Hospital in Dublin. He had also worked at the National Maternity Hospital, the Rotunda hospital and CHI at Temple Street. He was clinical professor of paediatric ophthalmology at University College Dublin. Prof. O'Keeffe was the brother of Ned O’Keeffe, former Fianna Fáil TD for Cork East. His niece, Fianna Fáil councillor for Fermoy Deirdre O’ Brien, said: “Beyond sadness at the passing of my uncle Prof. Michael O’Keeffe RIP. Tributes expressed to him summon it all.” 
Prof O’Keeffe co-founded the Irish Hospital Consultants Association which advocates for reform in the health services and improved working conditions. The organisation said after his passing that consultants are deeply saddened. “He was a true visionary in medicine and his leadership was invaluable, including as a founder member of the IHCA. He is reunited now with his beloved son Philip Michael. Our deepest sympathy to his family,” they said. The Royal Victoria Eye and Ear Hospital, Dublin’s postgraduate education and research department, said: “a great teacher, mentor, supporter and above all one of the kindest and most generous giants of ophthalmology who will always be missed.” 
The National Council for the Blind said they were saddened to hear of his passing, describing him as one of “Ireland’s leading ophthalmologists”. They highlighted his involvement with Vision Sports Ireland, of which he was president, in promoting inclusive sports for the vision impaired or blind. The Royal College of Physicians Ireland also mourned his loss. “The Royal College of Physicians of Ireland is deeply saddened to learn of the passing of our Fellow, Prof. Michael O’Keefe,” they said. “Prof. O'Keefe was renowned for his work in paediatric ophthalmology and as a vanguard for laser eye surgery in Ireland.” 
Many patients also shared memories of Prof. O'Keefe online on Friday, saying he was a kind man with many noting they owed their sight to him. The funeral mass is at the Church of Our Lady of Perpetual Succour in Foxrock, Dublin on Saturday at 11am. A link to view the mass remotely is available on the rip.ie website . Read More

'True visionary' — Tributes paid to Cork-born Professor Michael O'Keeffe

A new contract for hospital consultants will see private care  being phased out of public and voluntary hospitals as part of the Sláintecare reform programme for the health service. A new contract for hospital consultants will see private care  being phased out of public and voluntary hospitals as part of the Sláintecare reform programme for the health service. Mon, 12 Dec, 2022 - 02:00
Niamh Griffin,  Health Correspondent
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A new contract for hospital consultants will bring many changes to the public hospital system — among them, an end to private maternity care. Under a new deal for salary and working conditions, private care is being phased out of public and voluntary hospitals as part of the Sláintecare reform programme for the health service. This is a significant change for maternity services — 24.8% of pregnant women opt for private or semi-private maternity care, according to the most recent research. The rate of private care in larger hospitals is estimated to be as high as one in three patients. This is quite different from the National Health Service (NHS) in the UK, where just 5% of women opt to give birth in a private hospital or a private wing of a public hospital. At the moment, women in Ireland can pay for a private pathway in public or voluntary hospitals. There is no standalone private maternity hospital since Mount Carmel closed in 2014 following financial difficulties. The new consultants' contract, announced last week, is to be phased in between now and 2025 as part of an overall change to the health service. “In line with the principles of Sláintecare, and like the NHS, consultants will be entitled to treat private patients off-site, as we move to a system where all patients of public hospitals are treated in accordance to need rather than ability to pay,”
a spokesman for the Department of Health said. “This applies to all private care in all public hospitals, irrespective of voluntary or HSE status.” 
All 19 maternity units in Ireland offer private options, including Cork University Maternity Hospital and the National Maternity Hospital (NMH). The new consultants' contract, approved by Cabinet, is now under discussion by the Irish Medical Organisation and the Irish Hospital Consultants Association (IHCA). Professor Declan Keane, former master of the National Maternity Hospital, was involved in negotiations on the deal as a member of the IHCA. “I don’t think the Department of Health has really thought this out,” he said, pointing out that the option for off-site operations would not apply to birth. “The option for maternity patients going privately is going to go,” he said. “I don’t really feel that message has got out there.” 
Prof Keane, who oversaw the establishment of a homebirth pathway at the National Maternity Hospital, said there are a number of concerns. Choice
“Let’s forget the headline issues around the salary, what this is about, I believe, is women’s choice,” he said. “We are currently at a time in obstetrics where we offer women so many choices, whether they want to go for homebirth, whether they want to go public, private, combined care or want to do Domino care where they have their baby in the hospital and are looked after by midwives when they go home.” 
In his experience, women go private because they want the same doctor by their side throughout pregnancy and giving birth. “At one stage during the Celtic Tiger I’d say 40% of our (NMH) patients were private or semi-private, now it’s down to about 32%,” he said. “That would be pretty much the same in all of the Dublin maternity hospitals, it is fairly similar in Cork and Limerick, some of the smaller units would be less than that.” 
Others involved in maternity care have urged greater focus on midwifery-led care instead. Interventions
Typically, in Ireland and internationally, the C-section rate among private maternity patients is higher than among public patients. Advocacy group AIMS Ireland has particularly queried the high rate of interventions among first-time mothers across public and private care. An Irish study on C-section rates among private maternity patients identified a “complex” association between private health insurance and this higher rate. These findings, published in the journal BMC Pregnancy and Childbirth (2020), found women opting for private care were more likely to have a history of infertility, a history of miscarriage, a multiple pregnancy, and to be older than 35. Despite these needs, interest in private maternity care has been dropping since 2008. A separate study on maternity trends, by UCD Centre for Human Reproduction and the Coombe maternity hospital, found bookings never rebounded after the recession. This is perhaps not surprising, with VHI estimating the average cost for private maternity patients ranges from €2,500 to €5,000. “We are, in Holles Street, expected to generate a percentage of our budget from private patients,” Prof Keane said. “That obviously will go, the Government will say they will fill that from the Exchequer but I think the greatest effect will be on women’s choice.” 
Minister Donnelly has already confirmed the State will make good these costs for all hospitals, with the gap for this year estimated at €450m to €460m in private income. Many women will no doubt be watching the consultants’ discussions with interest and waiting to see how their care options could change over time. Read More

Private maternity care to end under health service reforms

Many in the Greens accept that any electoral backlash to this Government will focus on them, meaning they are concentrating on amassing as many legislative wins as possible before then 
Eamon Ryan took over as leader after the Green Party lost all its Dáil seats in the 2011 general election. Picture: Gareth Chaney/ Collins
Sat, 26 Nov, 2022 - 10:51
Daniel McConnell and Paul Hosford
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In the run-up to the 2007 general election, then taoiseach Bertie Ahern approached his scriptwriter and adviser Brian Murphy with an unusual request. Ahern, mired in major controversy over his own financial affairs, was chasing but not assured of a historic third term in office. “I was surprised when Ahern instructed me to heavily focus on the environment in drafting his opening address for the pre-election Fianna Fáil ard fheis ,” says Murphy. “This was hardly the traditional fare for such a speech and I expressed concerns that the taoiseach might not connect with the delegates. “Bertie told me he was less worried about those in the hall and more interested in sending a message to the Green Party . He told me that he and the late Séamus Brennan had been crunching the numbers and they were convinced that Fianna Fáil would need the Greens after the election.” 
Throughout the subsequent election, Ahern was careful not to say anything that would exclude the Greens from his post-election permutations. In the end, Fianna Fáil won 78 seats, falling just short of an overall majority and Ahern’s hunch he might need the Greens to form a Government proved correct. “In the aftermath of the election, Green Party members voted overwhelmingly at a special conference to go into government with Fianna Fáil,” Murphy says. Despite the decision to enter government for their first time in their history, the strain on the Greens was immediately obvious, with the resignation of then leader Trevor Sargent, who said in good conscience he could not lead his party into power with Fianna Fáil. The historic Fianna Fáil/Green Party/Progressive Democrat government was soon engulfed by the financial crash and for the four Green ministers who took office, reconciling their green ideology with the realities of government proved highly complicated. Plunged into an era of austerity, the Greens, now led by John Gormley, quickly became lightning rods for public anger and outrage at the nature of the cuts introduced. As the months went on, the Greens sought to implement their policy agenda but found the going tough, while all the time having to implement savage cuts to the most vulnerable in our country. Tensions with Fianna Fáil
Tensions with Fianna Fáil were never far from the surface, with the party being blamed for forcing the resignation of then defence minister Willie O’Dea in March 2010 and for tabling laws to ban stag hunting when the country was imploding. But the party also found itself under attack from its more radical wing for compromising core values on issues like the Corrib gas field. In truth too, the party looked downright amateurish in government, with figures like Senator Dan Boyle becoming lightning rods for criticism over seeking to play opposition from within government. Green party deputy leader Catherine Martin unsuccessfully challenged Eamon Ryan for party leadership in 2020. Picture: Gareth Chaney/Collins
In terms of wins, the party did force a renegotiation of the programme for government in 2009 to its significant advantage and the Bike to Work Scheme was the stand-out legacy win for the Greens from its time in office. Ryan in office also set in place the foundation for Ireland’s drive to increase its wind energy capacity. However, such victories were rare and the humiliating end to that era came with the arrival of the IMF-led Troika in late 2010. Just a few months later, Fianna Fáil were nearly decimated at the 2011 general election and the Greens were totally annihilated at national political level, losing all of their Dáil seats. Gormley stepped back from the party and Ryan took over the mantle as leader. Life in opposition was tough but Ryan was still afforded a media profile on Green issues during that time, which proved invaluable in his successful bid to re-enter the Dáil in 2016. Catherine Martin also was re-elected on that day in Dublin Rathdown, proving there was a viable future for the Green Party. A term in opposition allowed the party space to renew its policy agenda, which became a major issue in both the 2019 local and European elections and the 2020 general election. Record wins on both occasions saw the party reach its peak in terms of political representation, but once again, the Greens' ability to make life difficult for themselves came to the fore. The party, or leading figures within the party, including Martin as deputy leader and new TD Neasa Hourigan, was decidedly uneasy at the prospect of entering government again with Fianna Fáil and Fine Gael. Bitter attempt to oust Ryan
There was a somewhat embittered attempt to oust Ryan as leader, with many complaining about his style of leadership and his lack of connection with rural voters. Despite the turmoil, Ryan not only won the leadership contest over Martin, but his desire to go into government won a thumping majority from party members in late June 2020. Nine years after being dumped unceremoniously by the Irish electorate, the Green Party and Ryan found themselves back at the top table of Irish politics. However, if the party thought a return to government hammered out in weeks of fractious negotiation would ensure unity, they were mistaken. The first few months of government were an adjustment, to say the least. On the same day Ryan was squeaking by his deputy leader in a leadership battle, one of the Green Party's most high-profile members announced she was leaving. Hazel Chu: her election as lord mayor of Dublin in 2020 was one major positive for the Green Party after a number of public resignations of party members. Picture: Sam Boal/RollingNews.ie
Saoirse McHugh had not won an election for the party but her put-down of Peter Casey in the 2019 RTÉ European Parliament debate and her passionate advocacy had made her a burgeoning star. However, in July 2020, McHugh was out. McHugh said her reasons for leaving were “obvious” and she had become disillusioned with the "toxic" party over the previous year. She, among others, had been vocally against entering government with Fianna Fáil and Fine Gael over concerns social justice issues would be cast aside. McHugh’s resignation came after a number of public resignations from members including chair of the Queer Greens, the LGBTQ+ contingent of the party, Rob O’Sullivan. However, Hazel Chu's election as lord mayor of Dublin was one major positive. The tumult continued during that summer as just ahead of the summer break, party whip Neasa Hourigan voted against the Government. Hourigan along with Junior Minister Joe O’Brien were sanctioned by having their speaking rights withdrawn for two months, but this happened when the Dáil was not sitting and rendered the punishment meaningless. If Ryan had hoped the restarting of the Dáil would calm things, he was mistaken. Roderic O'Gorman came in for huge criticism for his handling of a decision to seal testimony of mother and baby homes survivors for 30 years. Having been outwardly critical of the programme for government, as well as the Green Party's handling of the Shannon LNG project, the issue forced Cork City councillor Lorna Bogue to tender her resignation from the party. She would be followed by three more councillors within months, with Peter Kavanagh — who had negotiated the Irish language elements of the programme for government —among them. Almighty row
Before the year was out, the party encountered what has been one of its defining issues in this government when a routine vote turned into "an almighty row". The Ceta free-trade agreement between Canada and the European Union was due to be ratified in the Dáil after a 55-minute debate, but was kicked into the following year after some Green TDs, notably Hourigan and Patrick Costello , said they would not vote for it. Green party TD Neasa Hourigan after gthe Supreme Court ruling on the Ceta trade deal. Picture: Gareth Chaney/ Collins Photos
Taoiseach Micheál Martin and Tánaiste Leo Varadkar felt the issue had been in hand and a "robust" exchange was had as the three leaders met that week, while the Greens themselves had "an almighty row". Dublin South Central TD Patrick Costello took it a step further, lodging a legal challenge to the deal, which he would take 18 months and a trip to the Supreme Court to win. Between the High Court and Supreme Court, Costello would also be suspended from the party when he and Hourigan voted with a Sinn Féin motion to locate the new National Maternity Hospital on State-owned land. Candidly and privately, many in the Greens accept that any electoral backlash to this Government will focus on them, meaning they are concentrating on amassing as many legislative wins as possible before then. Ask for a list of these wins in Government and the party's members are not shy about listing them: they point to the enactment of the Climate Act 2021 and the Climate Action Plan , they talk of the investment in public transport, of retrofitting and commitments to the arts and sport, but for one party source, the major focus "has to be on Ukraine ". Integration Minister Roderic O'Gorman: Party members are generally glowing in how he has handled the refugee crisis, praising his 'humane approach. Party members are generally glowing in how O'Gorman has handled the crisis. While they are reluctant to agree that the Dublin West TD was handed a hospital pass by being the line minister responsible for housing and integrating 70,000 new arrivals in just nine months, they do believe he has "carried a lot of the load" at Cabinet level. They praise his "humane" approach to the situation and point to this as an example of why the Greens are necessary in this coalition.

Government has been tumultuous for Greens but party is focused on policy wins

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LAST week I posed the question here: “Why do we still allow these religious orders to exist?” And I gave my own answer immediately — they are nothing more than vehicles for corruption and abuse, and they need to be shut down. I got, shall we say, a mixed reaction. And the piece opened up a flood of personal correspondence that I’ve spent a good bit of the week reading. It’s been difficult reading, and I’ll come back to that in a minute. But there are also people with whom I’ve debated issues over the years (I hope on a basis of reasonable respect) who have chosen to see something pretty sinister in what I wrote. One letter to the editor of this newspaper made the point that while he agreed with me about shutting down the orders, it’s a pity I didn’t take that view a while ago, when I ‘endorsed the religious Sisters of Charity’s ownership of the National Maternity Hospital’. That’s actually the opposite of what I did back then. I endorsed a piece of serious work whose outcome was to make certain that no religious organisation would own the National Maternity Hospital; and no religious ethos would influence its operation. A letter writer has compared this columnist to 
The Iona Institute director and Sunday Times columnist David Quinn, on the other hand, compares me to Kim Jong-un. I used my column to call for the suppression of the religious orders, he says. “Yes, there are precedents for that sort of thing historically,” he goes on, “China, the USSR, North Korea.”
Later on Twitter, he ran a poll among his followers asking them whether I was right or wrong. I was of course shocked and horrified when 75% of David’s followers decided they disagreed with me. (I do have to say that it is possible to disagree with David Quinn — often trenchantly — without him being personally rude or abusive. He’s a divil for inventing “straw man” arguments, but he’s always civilised. He must get terribly depressed sometimes at the antics of his supporters online. I know he tends to complain about the abuse he gets himself, but if I were him, I think I’d be a bit more anxious about my friends. They’re quite a bunch, even if the vast majority of them prefer to spew bile anonymously.) At the other end of the spectrum, I guess you’d say, I was criticised by Michael Nugent, the chair of Atheist Ireland. In a tweet he said: “Like Fergus Finlay, I grew up resisting an authoritarian Ireland. I’m shocked to see Fergus now suggest making religious orders illegal. They should pay tax and be accountable to the law, but they have the same right to exist as any other group.”
In a longer article on the Atheist Ireland website, it says that “it’s not the existence of religious orders that is the problem in Ireland — it’s the privilege and undue influence they have been given by the State”. But then the article immediately goes on to say that religious orders have consistently abused that privilege and influence — and still do. That leads to the article concluding “in Ireland, we hand over control of most of our schools to an organisation that has enabled paedophiles and covered up their crimes, and whose Irish bishops have lied to and deliberately misled state tribunals about these crimes”. As Father Dougal once said, ‘I’m hugely confused Ted’. When I call out the behaviour of the religious orders — in slightly more measured language, actually, than Atheist Ireland — I’m being authoritarian. But in its language, we’re handing over control to paedophiles and their protectors. Someone somewhere needs to get a grip. Here’s the real point of the thing. In a different context entirely, I’ve just finished reading a high court judgment about an Irish private sector enterprise that stood accused, and was found guilty, of various “crimes and misdemeanours”, many of them involving the Revenue Commissioners. One after the other, the directors of that enterprise were told by the judge, directly, that they were prohibited from serving as directors of any company established under Irish law for the maximum period he could impose. I’d love all these people who think I’m being Kim Jong-un, or just a common or garden authoritarian, to explain why people who run organisations that pay their taxes on time, but cover up the emotional, physical, and sexual abuse of children, shouldn’t be disbarred as leaders of their organisations in exactly the same way. I’d love them to explain why their organisations should “have the same right to exist as any other group” — as long as they pay their taxes. If cheating the tax system is grounds for disbarment, why isn’t destroying the lives of children? I received a more important reaction to the piece, I have to say, from the people who contacted me to tell their individual stories. Stories of brutality and abuse
In the past week, I have read and heard more stories of individual brutality and cruelty — physical, sexual, and emotional — than would be possible to detail here. That brutality left deep scars. All the more so, maybe, because they were inflicted on generations of boys who couldn’t talk about them, who carried secrets of shame in their heads for a lot of their lives. Which brings us to what we need to do about it. There’s talk of restorative justice, and it’s a pretty vague concept being promoted by the Holy Ghosts themselves. It may be the case that for some people there’s a mechanism there that enables them to come to terms with the past in a satisfactory way. And that, I guess, is a good thing. But restorative justice is not justice — especially when the perpetrator has escaped a reckoning, with the help of his organisation, for his entire lifetime. Justice demands full and open accountability, by or on behalf of people who committed awful crimes, and by the organisations that protected them. Justice also demands redress. And justice demands disclosure — not just an accounting, but a full and open accounting. Is there a mechanism that can achieve all those things? To be honest, I don’t think our Constitution as written allows it. We’ve tried different forms in the past. Anyone who is trying to closely follow the way in which the Commission of Inquiry into the Grace case is doing its work — six years, round after round of secret meetings, families traumatised, €7m in costs, and no relevant findings at all — would recoil in horror at that approach. The “least bad” option is probably a full and open tribunal of inquiry, with carefully drafted terms of reference that need to be published in advance and examined by an Oireachtas committee before being settled. All hearings must be in public and (most importantly) broadcast live, the inquiry chaired by a judge, with two panel members, one representing the broad public interest and the other representing survivors. Going at it that way might make a difference. But in the meantime, the question remains. As Atheist Ireland puts it, why do we “hand over control of most of our schools to an organisation that has enabled paedophiles and covered up their crimes”? Why do we do it? And what are we going to do about it? Read More

Fergus Finlay: Tribunal of inquiry could deliver justice for religious orders’ crimes

The menopause service at the National Maternity Hospital only sees women in person between 3pm and 6pm every Tuesday — and only sees women from five counties. File picture: Sasko Lazarov/RollingNews 
Sun, 16 Oct, 2022 - 20:30
Ciara Phelan,  Political Correspondent
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Critical understaffing has left women waiting more than five months to get initial contact from one of the State’s menopause clinics with concerns raised of a postcode lottery system. Women who have complex issues or may have had treatment for diseases such as cancer are referred to the specialist clinics through their GPs. The service at the National Maternity Hospital (NMH) only physically sees women between 3pm and 6pm every Tuesday. It has also taken the decision to only see patients from five counties — Dublin, Kildare, Wicklow, Wexford, and Kilkenny — due to demand. The Rotunda is due to open its clinic tomorrow to mark Menopause Awareness Week, but thereafter it will open for just one day per week and treat women from the catchment area initially. Deirdre Lundy, clinical lead at the NMH menopause clinic, said 'critical understaffing' is causing delays to the opening of clinics elsewhere in Ireland. Picture: Colin Keegan/Collins
Health Minister Stephen Donnelly has claimed that the Coombe’s clinic is up and running, but the hospital has confirmed to the Irish Examiner that it has yet to open. The minister previously announced funding to open six specialist clinics across the country. However, clinics in Cork and Galway have yet to open while the service in Nenagh, Co Tipperary, is only treating local women, a specialist doctor has claimed. Deirdre Lundy, clinical lead at the NMH menopause clinic said “critical understaffing” is causing delays to the opening of clinics elsewhere. She said it took six months for a nurse with the required expertise to be released to the NMH clinic, because the health service could not find a replacement. Social Democrats co-leader Catherine Murphy TD  said: 'The postcode lottery system raises serious red flags in terms of equality of treatment. ' File picture: Damien Storan
Mr Donnelly has denied that staffing is an issue and said clinics in Cork and Galway will open before the end of the year. Between November 2021 and August 2022, the NMH clinic has physically seen 250 women and up to 15 new patients every week. Dr Lundy said: “What happens if you live in Athlone and you are on your knees and you’re 25 and somebody gave you radiotherapy for bowel cancer and now your ovaries have shriveled up, and you’ve flushes and sweats, brain fog, mood issues, and no one can help you? “Half of the letters I’m getting are from people whose counties are out of my patch.”
Social Democrats co-leader Catherine Murphy said: 
The postcode lottery system raises serious red flags in terms of equality of treatment. She said it is not the fault of the staff running the clinics and has called on Mr Donnelly to “get this service fully up and running, because it can’t be there in theory”. Dr Lundy said the NMH clinic has three staff with some working part-time, and also holds a phone clinic on Wednesdays, but this is to follow up with patients that are in the system. She revealed that she spends more time responding and giving advice to GPs who have referred patients rather than treating women, and often works unpaid to get through administrative work. Read More

Understaffing leaves women waiting five months or more for complex menopause treatment

University College Dublin has its origins in the mid-nineteenth century under the leadership of the renowned educationalist John Henry Cardinal Newman. Since its foundation in 1854, the University has flourished and made a unique and substantial contribution to the creation of modern Ireland, based on successful engagement with Irish society on every level and across every sphere of activity. UCD is one of Europe's leading research-intensive universities; an environment where undergraduate education, masters and PhD training, research, innovation and community engagement form a dynamic spectrum of activity.

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