Adding to the celebrated Irish innovations such as cream crackers, rashers, and cheese-and-onion crisps, we ought to recognise another unparalleled creation: the cataract bus. It indeed provides a comprehensive essence of this daredevil nation, expressing an interesting fusion of neglect and favouritism.
Removing cataracts, an ancient surgical technique dating back to Greece’s antiquity, is among the simplest and oldest procedures. A general anaesthetic is rarely needed – a few ocular drops often do the trick. When considering the time and energy spent compared to the life-altering effects for patients, it undoubtedly is a remarkably effective health intervention. The procedure itself consumes a mere half-hour, while it can prevent a descent into blindness. That’s an impressive input-to-output ratio.
Apart from the enormous benefits to the individuals undergoing the surgery, the State also realises significant savings. Deteriorated vision dramatically affects the health of seniors, contributing to accidents and injuries. It can lead to cognitive deterioration and social disconnection, and it can render simple tasks such as taking a stroll quite daunting.
Lingering delays in cataract operations inadvertently raise health service expenses, as it is a sure-fire way to hike up future hospital costs. This avoidable agony has completely foreseeable repercussions on public funds.
Symbolising a quintessential Irish creation, the cataract bus sums up a blend of neglect and patronage.
Recent data indicate that as of the previous March, approximately 4,010 individuals aged 70 and above were on waiting lists to undergo cataract surgery, with over 314 of them waiting for over a year, and 97 for more than a year and a half. Of these, 1,803 were in Dublin, 552 in Waterford, 354 in Limerick, 307 in Sligo, 300 in Cork, and 268 in Galway.
It’s entirely possible to rectify this issue. The Nenagh Hospital is case in point. It introduced a bi-monthly specialised clinic for cataract patients in July 2022. Before its establishment, a staggering 647 patients were queued for cataract surgeries, facing shockingly long wait times ranging from two to four years. By March of the following year, the queuing list had dwindled to 131, allowing 90% of patients to receive their surgery within a span of four months and only a handful, 10 to be exact, had to wait beyond a year. What was achieved in Nenagh can certainly be replicated elsewhere. However, it may be the case that it hasn’t taken place because those with substantial financial resources – the ones who usually make the most noise – can avoid imminent blindness by paying their way out.
The operation can undoubtedly be obtained swiftly, if you’ve got the cash. Private entities like Optical Express are promoting cataract surgery rates “starting from a mere €3,195 per eye”, amounting to at least €6,390 for both eyes. They market the prospect of instant, clear vision upon awakening, effortless television watching or reading, and the promise that this is just the tip of the iceberg in terms of potential improvements to your lifestyle.
Private hospitals and clinics use the plight of the public waiting lists to their advantage when advertising their services. This is evident by Kingsbridge Private Hospital in Sligo’s statement, “No need to wait months to restore your sight. Bypass the waiting list for cataract surgery to correct blurred vision.” The Cathedral Eye Clinic, located in Belfast, specifically capitalises on its ability to offer treatment to patients from Munster without long wait times. Therefore, it’s clear that in this healthcare market, inequality is not a glitch but rather a deliberate design.
This then paves the way into a battlefield marked by public shortcomings and private gains, characterised by the unique Irish approach to resolving Irish issues: patronage. The long waiting lists for cataract surgery represent both a business and political opportunity. For instance, the Cathedral Eye Clinic doesn’t just promote the proficiency of its medical director, Prof Johnny Moore, but also highlights the generosity of another medical luminary, Independent Kerry TD Michael Healy-Rae.
In my perspective, it’s rather revealing that TDs name their dialogues with constituents as “clinics” or “surgeries”. Yet this figurative phrase has transformed into a literal depiction with TD Healy-Rae portrayed as the first assistant to the surgeon by the Cathedral Eye Clinic. It’s him, together with the doctor, who returns the gift of sight to the blind.
This is how Cathedral encapsulates their offering: “You’ll find that many residents in Munster could be on a waiting list for cataract surgery for years, unaware that a HSE scheme can restore their vision in mere weeks. This is possible through Belfast’s Cathedral Eye Clinic and Deputy Michael Healy-Rae.” Interestingly, they make it clear that the ability to regain sight is “thanks to” a TD.
Taking it a notch further, prospective patients are asked to dial a certain number – 064-6685782 to set up their treatment. However, a closer look reveals that 064 isn’t a Belfast code; it refers to Killarney, Kenmare, Sneem, and Kilgarvan, areas well acquainted with Healy-Rae. Surprisingly, the contact number doesn’t direct to a clinic, but to Healy-Rae’s constituency office. As stated by the TD himself on the Cathedral Eye Clinic’s website: “Anyone waiting for cataract removal – get in touch and we’ll arrange everything to expedite your treatment.”
In essence, this is an exceptional piece of political ingenuity. Another Independent TD, Michael Collins, runs the cataract bus route from Cork. It’s a strategy that directs public funding into a thriving venture, while positioning politicians as personal messiahs. It parallels the biblical narrative where the blind, now sighted, shares with the Pharisees: “He put mud on my eyes, I cleansed, and now I see.”
A sarcastic toast to that! Healthcare is a constitutional right. It’s funded by the taxpayers. Yet, gaps caused by inefficiency in public delivery turns basic healthcare provision (such as not being left blind) into a favour gifted “thanks to” the TD, for which votes may potentially be the repayment.
Cataract surgery aims to extract a clouded lens to restore vision. Yet, the foggy lens of bias tends to block the clear view that Irish citizens should have of their democratic entitlements.