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  1. Paul Crowley
  1. Aut Even Hospital, Kilkenny, Ireland;

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    The “Celtic Tiger”. Like it or loathe it, the country has changed beyond all recognition. It is in uncharted territory; a buoyant economy, unprecedented wealth, net immigration, and social change. The economy has grown at over 5% annually for at least 10 years. House prices have gone up tenfold. Helicopters are the way to fly for the wealthy, and employment is full. Inward migration has meant the arrival of 186,000 people between 2002 and 2006, a significant addition to the present population of about 4 million. Nearly 10% of the population was born abroad. There are even Polish supplements in the newspapers. Interpreters are required in hospitals. The Catholic Church and government institutions have suffered seriously over this period as a result of well-documented scandals, adding more social change.

    Change, change, change. Everywhere except the health services. These are still underresourced. Infrastructure, both physical and human is poor. Money has been spent but the cost of an upgrade to a truly 21st century service is considered too high. As in many countries there has not been an honest political debate about this. There is a lack of open …

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