by Noël Browne
On 14 January 1944, Phyllis Harrison and I were married at a rather strange ceremony which took place in a small church near Uxbridge. Three people attended. Since none of us knew that a Registrar should have been asked to attend, the marriage could not take place until the following day. No doubt relieved after the disappointment, confusion and delay of the first day, a Highland Scot colleague at Harefield, feeling to some extent responsible, drank the only bottle of Irish whiskey which we had for the celebration. There was no conventional honeymoon; to use the phrase of the time, ‘there was a war on’.
Phyllis was the youngest child of a large middle-class North Dublin Church of Ireland family, all intellectually gifted. Like so many children of big families, she suffered the emotionally barren milieu inevitable where a parent is already pre-occupied with considerable family worries and work. From a very early age, she believed that she was the last straw for a mother who had given to the other children the limited capacity for love she possessed. In place of a Christian name, her birth certificate carries the bleak message, ‘female child’. When her mother lay dying, some thirty years later, her last words to Phyllis, as if she was being deliberately hurtful, were ‘Who is she? Who are you?’
Exceptionally quiet, shy and sensitive, Phyllis lived a home life of uncared-for loneliness. Observant from an early age, sceptical and critical, she noted the squalor and humiliation of the black face and dirty clothes worn by the wretched man draped in a damp canvas sack who delivered the coal down the long passages and steep stairs of her Victorian home. A surprising child in many ways, she favoured what she knew of the old Jim Larkin and his work for trade unionists, and became a republican despite her Anglo-Irish background.
She considers love to be the only civilized dynamic of relationships in an egalitarian society; it was typical of her, rearing our own family, to say, ‘you should spare the rod and you should spoil the child’. It was she who supplied the rational structure to back my own instinctive powerful feminist faith. With growing knowledge and experience of practical politics on the left during fifty years in the harsh testing grounds of Irish public life, she reinforced her conviction that the proper path for us to follow was that of social revolutionaries. She accepts the Marxist analysis of society, and what some have described as its mechanistic coldness, as mediated for her by that fine Italian socialist philosopher and political martyr, Antonio Gramsci.
Her socialist attitudes were absorbed from two gentle ladies, Miss Savage and Miss Beck, who taught her at the Church of Ireland Sunday School. Phyllis did not get a conventional academic education at university level, though she did attend both the College of Art and Miss Read’s school of Pianoforte in Harcourt Street. This did not prevent her from applying her fine intellect to the unravelling of the complex emotional processes by which we humans are motivated. Because she rarely accepted or judged the act or comment by its superficial meaning, at all times she looked behind the facade of behaviour for a deeper explanation and understanding. She was always moved so much more easily to compassion than to anger. Believing as we both do in the psychodynamic effect of childhood experience in determining later behaviour, forgiveness came more easily and resentment was rare. The arcane world of psychology has in Phyllis lost a creative, original, ruggedly independent and adventurous mind. Happily for me and for our two daughters, Ruth and Susan, psychology’s loss has been our inestimable gain.
Her special virtue for me was not alone our loving relationship, but, within this, her inexhaustible patience. She could help me find my way back out of the maze of emotional defence mechanisms with which, after the dissolution of my family life, I had learned to surround myself. Her patience was needed in abundance. While it is true that I have gained most from our relationship, we each complement one another’s intellectual and personality needs.
Once the war was over, it was very tempting for us to consider continuing to live and work in what we both felt to be congenial company and surroundings. Yet we believed that now that our responsibility of making a contribution to the allied struggle against fascism was over, we would and should return to Ireland. With the experience I had gained we would try to create similar conditions of care and efficiency for our fellow countrymen.
Unhappily, because I was a ‘Trinity Catholic’ I was suspect and unwelcome within the state medical services. To admit to a medical training in TCD, irrespective of the quality or extent of one’s subsequent training, was an automatic disqualification from posts in any of the local authority sanatoria, the only sanatoria which provided medical care for public patients suffering from pulmonary tuberculosis. There were plenty of doctors ready to treat private patients, but this work did not interest me. Eventually I was offered a post with a salary of £21 monthly, and a lodge, at my former hospital at Newcastle, Co. Wicklow.
While I was glad to return to Ireland, I soon realised that nothing had changed at Newcastle or, indeed, at any of our hospitals. Indifference, apathy and complacency that amounted to sheer neglect prevailed everywhere. Our sanatoria were staffed for the most part with one or other of Peter Edward’s categories: drunks, dope addicts, or simply lazy bastards. There was, of course, one exception, the gentle, hard-working and talented Dr John Duffy of Dublin Corporation.
It was impossible to work to any real purpose with the substandard, ill-equipped facilities in our own hospital. I decided to meet the more active of my colleagues in the tuberculosis service. After a number of such meetings, we decided to try to form an association of doctors concerned with the disease. I also lobbied the Red Cross and members of the trade union groups to see if they could help. We hoped to raise enough funds to build a properly-equipped 250-bed sanatorium. People expressed their full support and sympathy for the idea, but nothing was done.
Incredibly, our attempt to form a TB association was sabotaged by religious complications. Those of us who had started the project hoped to include doctors from all hospitals concerned with pulmonary tuberculosis. Invitations were sent to Dr Synge, a distinguished Fitzwilliam Square physician and brother of J. M. Synge, and Dr Rowlette. Both were fine physicians, neither of whom was interested in financial gain. To my surprise the steering committee, of which I was not a member, received an instruction from the Catholic Archbishop of Dublin, Dr John Charles McQuaid, that he would not permit Protestant doctors to sit on our committee. The committee accepted this ruling, the usual practice at the time at all levels in the country. Dr Rowlette and Dr Synge were excluded. The association was established, but did nothing to establish the primary physical needs of tuberculosis services. It was surely naïve of me to expect that collectively they would do much more together than they had done singly over the years.
Thirty or forty years ago doctors enjoyed a popular respect, born of a mixture of gratitude, mystification and fear. Only this could account for the fact that no matter how clearly in virtually any Western country the case has been made for radical change, the money-making part of our health services remained unchanged or even, from the doctors’ point of view, simply improved. From the actuarial point of view, as well as in a professional sense, there is no logical or valid reason why a national health scheme should not be based on a salaried system of payment. Such is the successful practice in our limited state health services as they apply to infectious diseases in Ireland. The nearest comparable profession is that of the salaried nurses, than whom there is no finer group of individuals in service to the community. Yet the ‘best’ general medical practices in Ireland are based on the crude donkey-and-carrot money stimulus. Unlike the salaried postman, who is trusted to deliver every single letter given to him, the doctor cannot be trusted to work conscientiously for a salary like everyone else. Together with his colleagues in the law, the doctor must have a sweetener in the form of a fee every time he serves each individual in the community. Contemplate the success of the postman’s union or busman’s union were they to demand payment for every letter delivered, or every ticket checked. What about paying eve
ry nurse for every bed made and for every post-operative painkiller given when needed?
Time and again through recent history the medical profession has successfully resisted a fair and even distribution of their services all through the community. One of the results of the fee-for-service medical practice system here has been an enormous growth in the cost of the health services without a significant increase in their efficiency.
It was the practice for Dublin consultants of varying specialities to visit our patients at Newcastle in an advisory capacity. There were many conscientious consultants whose conduct was selfless and impeccable, but there were also those who simply used the hospital to unload those patients from whom fees could no longer be extracted. These consultants could be callous and careless about keeping sick men and women, who were not paying, needlessly waiting. They would then stroll into the consulting room as if the delay was of no importance.
One evening, after a considerable wait for the consultant, one such clinic began, attended by Harry Kennedy, a friend of mine. Harry, a journalist of considerable distinction, had written widely from a liberal point of view on many subjects in the Irish Times, then a liberal newspaper under the editorship of R. M. Smyllie. However, because he had preferred to help others with whatever money he had, he remained relatively penniless. He had frequently watched the long-suffering patients treated with cavalier indifference, and could no longer tolerate the injustice of it.
It was a hopelessly uneven struggle. On the medical side was the imperious, tall, impeccably-coiffed consultant, who dyed his hair jet black until he was in his mid-seventies. His hands were carefully manicured. He wore a gold seal and pendant watch across his taut, well-stretched waistcoat, and flourished that useless hallmark of his omniscience, the stethoscope. He was clearly a busy man and in a hurry. There was obviously little to be gained in financial terms: anyway he had a social committment, a dinner party.
The journalist was a small tubby unhealthy-looking man, sandy-haired and pink-faced. His well-worn pyjama trousers had slipped down on his hips. But his powerful thoughtful eyes, of a distinctive brittle blue, told of a mind of power and courage not often encountered. Public patients had been taught to behave submissively but there was no submission here. Too late, the consultant realised that this was not just another bucolic ‘grateful patient’. Instead this tousled, half-dressed, terminally ill man slowly looked up and, in his clear musical voice whose origins were in the Glens of Antrim, asked the consultant if he had any understanding of the measure of the mental and physical stress of the father or mother, wife, son or daughter, represented by the huddled weary patients still waiting outside the door. He asked the consultant was it his practice to treat his wealthy consulting room patients in this way; was it money or medicine which most motivated or concerned him? Were his patients divided into the sick rich and the sick poor? Did he believe that the sick poor could suffer and feel pain and separation and even avoidable or inevitable death less than the sick rich? He declined to submit to the cursory examination, took a dignified leave of all of us present, and left the room to the deeply embarrassed consultant. This was a moral victory for my courageous friend, yet there was no doubt who would win in the end.
The consultant made only one comment to my colleague, who was in charge of the hospital: ‘I would get rid of him if I were you’. Simply because he had spoken freely and truthfully to one of those responsible for the discrimination between rich and poor in Irish medical care, this sick man was to be denied any treatment whatever. It was a particularly callous decision to send him home to die because it put at risk his wife and small daughter. Fortunately I arranged that he be re-admitted the next day, with the tacit approval, I believe, of my medical colleague, whom I did not consult.
The story has a bleak ending. Because of the inadequacy of the surgical and other facilities at Newcastle, Harry, through the generosity of his fellow journalists, was sent to a London surgeon at Brompton Hospital. Unhappily, his condition was already too advanced, and he died shortly after his operation.
6
Into Politics
AFTER THE war, though a secure, well paid and professionally rewarding job in the English health service was open to us, Phyllis and I chose to return to Ireland to work towards some form of socialised medicine. In pursuance of this aim, I entered politics in 1947 on the recommendation of two politically experienced friends, Noel Hartnett and Harry Kennedy. Through Hartnett, whom I had met when he visited Harry Kennedy at Newcastle, I was to be introduced to Seán MacBride, Clann na Poblachta and Irish public life. I felt the Clann na Poblachta party was the only political option open to me, as the three main political parties were conservative, and the Labour Party said that my membership would not be welcome.
MacBride and Hartnett had been involved as defence lawyers in a number of Republican trials. Their relationship developed so that in the Law Library, when MacBride appeared, it was certain that Hartnett would be there, two paces behind him. He became known as ‘The Shadow of a Gunman’.
Their most important republican trial was their appearance at a coroner’s inquest into the death of a young republican named McCaughey who had died on hunger-strike at Portlaoise jail. (Later, as Minister for Health, it was one of my first official acts to inspect McCaughey’s cell deep underground, a truly awful place in which to die, hungry or not). At the conclusion of the inquest, Seán MacBride asked ‘You would not keep a dog in conditions like that, would you, doctor?’ The doctor declined at first to answer. Following persistent questioning he finally agreed. Though young McCaughey did not survive to enjoy it, this was considered to be a victory for the Republican cause.
Hartnett was the Junior Counsel in the case. He was to suffer because of public revulsion at the disclosures at this inquest of what it was like to live and die in one of de Valera’s jails. Shortly after the case he was sacked from his post in Radio Éireann: it appears that, in a moment of vindictive reprisal, de Valera had convinced himself that Hartnett was a security risk. With all his family, Hartnett had been a lifelong de Valera admirer, and was shocked by the pettiness of the act. After all, was he not honouring the universal code of offering a defence which the legal profession must give any client? For this and other reasons, Hartnett decided to resign from Fianna Fáil. He told me that when he saw the first cheque for £1,000 from Denis Guiney, a shopkeeper, on the table at Fianna Fáil headquarters, he realised it was no longer the republican party he had joined.
Hartnett was well skilled in the intrigues and intricacies of fighting and winning elections, learned over the years at the highest level in Fianna Fáil. With widespread social discontent, economic stagnation, high unemployment, the teachers’ strike and unprecedented emigration, he realised that the time was ripe for the formation of a new political grouping in Ireland.
As Seán MacEntee was to disclose, Fianna Fáil knew of republican links with the Nazis, and MacBride had been a lawyer and one-time chief of staff of the IRA. It is difficult to believe that neither Hartnett nor MacBride knew of the links between the republican movement and the Nazis. How could these two men have concluded that it would be possible to found a social, democratic political organisation on the powerfully anti-democratic forces of the republican army?
Hartnett had much personal charm. In spite of the episcopal ban, he had as a Catholic chosen to go to Trinity on a Kerry County Council scholarship, in its time a dangerous thing to do. He was to become a distinguished scholar, winning the Berkeley Gold Medal for oratory. He was an Irish language revivalist in the early days but, as with so many others, was later repelled by the opportunism and jobbery associated with the movement. By joining with Seán MacBride to form Clann na Poblachta, he had made sacrifices of his own and his family’s treasured personal and political associations with Fianna Fáil. Above all he suffered a personal loss, the friendship of Eamon de Valera. Lemass is reported to have said that looking down the table at the Fianna Fáil executive, of which Hartnett and Erskine Childers
were members, it was Hartnett rather than Childers that he expected would join a Fianna Fáil cabinet.
Hartnett’s disenchantment with Fianna Fáil had more complex origins than his sacking from Radio Éireann by de Valera. His loss of enthusiasm for de Valera paralleled the change in the intensity of Fianna Fáil’s republicanism. This profound transformation into conservative sectarian nationalism was enshrined in the lamentable provisions of the 1937 Constitution. Hartnett used to give two illustrations of internal conflicts in Fianna Fáil during this period.
In the mid-1930s, it appears, Seán Lemass had made a speech in Cahir shortly after Fianna Fáil’s assumption of power, pounding out the simple grating truth — the romantic struggle to liberate Ireland is over; we must forget our old grievances, bind up our wounds, and get on with the work of building a new and a prosperous Ireland. These sentiments dismayed many of the old soldiers, inflamed by memories of their real and imagined heroics in the national struggle.
A call was made to discipline Lemass. Hartnett, who sided with Lemass, noted that de Valera sat through the long and heated executive debate and made no attempt to rescue Lemass from the old soldiers snapping at his heels. Late in the night, de Valera proposed to adjourn the debate. Lemass, who had sat silent, spoke up for the first time and said, ‘No, finish the debate. Make your minds up.’ In the end, after a close vote, he survived. What was clear to Hartnett was that while de Valera had feared no rival since Collins, he did not disapprove of Lemass’s power in the party being visibly curbed.