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Creating Opportunity Out of Change | SPECIAL FEATURE


(Photo captioned: Dr Austin O’Carroll, Trinity alumnus, GP for homeless and spokesman on disability issues)

Dr Austin O’Carroll M.B. (1988) tells Trinity Today why he believes that social inequality cannot be an afterthought if we are to move forward as a country.

As a Trinity student, Dr Austin O’Carroll worked with TCD's Society of St Vincent de Paul in the inner city. There, he was exposed to the realities of Dublin’s disadvantaged, and this became one of the biggest infl uences that led him to his current career as a GP for Dublin’s homeless.

“Ireland, unfortunately, is moving more and more towards creating an ‘underclass’ model in healthcare,” he says as he ponders the problems in modern society. “In terms of equality, this has serious problems for society.”

Quite apart from having day-to-day experience of the situation in the healthcare industry, Dr O’Carroll is well-versed on the ins and outs of policy, making casual references to research work and speeches from the Tánaiste. However, has the situation worsened for the poor, in comparison to the wealthy?

“I think it has,” he says. “The gap between the two has widened. Over half the population has taken out private health insurance – and as more and more people take this option, it means we are removing the middle class from the hospital system. They are the people who have the power, and are more likely to cause a disturbance if they are not getting a proper service. In other words, we are removing the pressure to change the system.”

"The best way to get rid of stereotyping is with exposure. Third-level education could go beyond the scientifi c model and begin social medicine and start challenging these stereotypes"

The proof, he claims, is in the media coverage of A&E departments. Since those are the areas of the healthcare system everyone is forced to use equally, we hear about their inadequacy. Waiting times for other services vary greatly between public and private healthcare, and services for many disadvantaged people are severely lacking. “We regularly see young people dying from drug overdoses. I know families who have lost two or three people to drugs but that doesn’t hit the press. When I talk to students, they know hardly anyone with a drug addiction. Ask anyone living in inner city Dublin and invariably they’ll know many people who’ve died from drugs. This is removed from the public consciousness.”

If not privatized healthcare model, then what? It turns out the Scandinavian model would be Dr O’Carroll’s choice. However, he would be happy to accept any model which redistributes wealth to encourage social inclusion. The only way for that to happen, though, is by hiking taxes.

More than once, O’Carroll stresses that he’s not pessimistic, and he doesn’t want to sound as such. In general, he believes there’s potential in the Irish public to fi x the system.

“We tend to think in terms of the American dream – that anyone can be anything if they work hard enough he believes.

“The corollary of this is that if you don’t make it, it’s your own fault. This is a stark landscape. Having said that, there has always traditionally been an element of charity among Irish people and that is something we can build on. I think what is lacking though is leadership. I think one of the saddest things is that there’s nobody at the top challenging our system.”

We need the brightest of minds trained on tackling the major challenges of today – if the universities don’t provide the intellectual leadership here, I believe we are in danger of drifting into a creating a society we did not intend to build or wish to inhabit. Universities can play a vital role in shaping a society in which would all want to live. “Look at the idea of changing student attitudes. There are medical courses in the US where students are taught for a month in a hospital for homeless people. It challenges attitudes.”

This is the type of initiative, he believes, which we need to introduce here. “In casualty, you can meet people with very negative stereotyping. The best way to get rid of this is with exposure. And so third-level education could go beyond the scientifi c model and begin social medicine and start challenging these stereotypes. However, to do this we must move outside of the walls.”


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