Tuesday 6 May 2014


An ounce of prevention is worth a pound of cure.
I think any rational and objective assessment of the health care spend in any Western country will show that many forms of prophylaxis can be extremely cost effective. Money from the exchequer that encouraged children to get off their sofas and exercise would pay for itself many times over against the costs of diabetes, obesity, heart attack and general lost work days later.  Handing out free condoms to students at the beginning of fresher's week might offset the costs of numerous visits to the pox doctor later. But some ideas of prevention and preparation are just not on the rails.  In a poor third world country you'd have to ask cui bono when some cunning plan involving a lot of money is shown to be wrong-headed, ineffectual or positively harmful. 

In 2002, apparently driven by the squawking of chickens after the 9/11 bombings, The Health Minister authorised the distribution of a little packet of Iodine tablets to every person in the country.  The argument was that the terrists might decide to blow up Sellafield/Windscale across the water to release a plume of radioactive Iodine I(131) into the atmosphere which would rain down on the plain people of Ireland, get concentrated in the thyroid glands and lead to widespread cancer and early death. It concentrates in the thyroid because Iodine is an essential building block of thyroxine a key hormone regulating growth-and-development. The thyroid has the ability to filter iodine out of the bloodstream and incorporate it into thyroxine. If the only Iodine available is radioactive then that gets concentrated and incorporated and also zaps the DNA locally leading to mutations and cancer.

There is an elegant solution to the potential damage that might ensue from such a disaster movie.  You can't stop the radioactive Iodine when it is raining down in the very air that we breathe but you can dilute it so that it doesn't accumulate in the beleaguered thyroid gland.  That dilution was the function of Minister Harney's gift-wrapped tablets. That's pretty clever and I think we'd all row in behind it if it didn't cost someone (me the tax-payer in this case) something.  In this case, it cost €630,000 to deliver three tablets each across the country. The associated advertising campaign, printed propaganda "FOR EMERGENCY USE ONLY IN THE EVENT OF A NUCLEAR INCIDENT", planning meetings etc. added a bit more, but nobody is claiming that the exercise cost more than €2million or 50c each.  Of course, any actuary working for any of the insurance companies which are increasingly running our lives might have been asked to estimate the likelihood of a nuclear meltdown or upblow at Sellafield within the shelf-life of the tablets  . . . and found that it it was so vanishingly unlikely that the €2m spend was about as useful as plunging €2 on the Lotto each week.

In 2005, it was announced that the sell-by date for the tablets had indeed arrived and we were asked to dump them, un-opened, in the trash for landfill.  Sell-by date?  For potassium iodate?  The transmutation of elements departed from rational thought when Lavoisier outed and dismissed the alchemists in about 1780. So potassium iodate isn't going anywhere, let alone 'off'.  In 2008, the Minister confirmed that Iodine pills would not be reissued.  There are AFAIK no plans to issue freeze-dried bolognese sauce sachets in case the Flying Spaghetti Monster comes to earth. 

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