Wherever two or more people gather to bemoan the state of our hospitals, be it about hygiene, diagnostics or patient care, sooner or later somebody will mention the nuns. In fact just about the only time you’ll hear a heartfelt lament for the decline of religious influence in Irish life is when talk turns to the chaos and filth of our public hospitals. Say what you like about the church, runs the consensus, but dying cancer patients were never sent home from hospital with a couple of aspirins when the nuns were in charge. And you could eat your dinner off the floors of the public wards.

Part of this perception is, of course, rose-tinted nostalgia for a time when hospitals were safe places, but there’s a strong element of truth there too. If the hospitals ran better when the nuns were in charge it wasn’t because the sisters read the X-rays themselves, or even that they spent their days in Marigold gloves scrubbing the loos and scouring the floors. The hospitals ran better because somebody was in charge.

The medical sisters took a fierce proprietorial pride in the institutions they ran. If standards slipped, if a dying patient was erroneously discharged or there was stale vomit in a wash basin, those responsible would be answerable to the nuns. Now they are answerable to nobody, and that lack of accountability is a black hole into which every expert report, every caring initiative and every penny of health funding inevitably disappears.

When journalists try to pursue a grievance with the HSE, they are fobbed off with the standard escape clause, “We can’t comment on individual cases”. Approach them as an individual with a grievance and they’ll fob you off without even the courtesy of an excuse. I know this because I’ve tried both routes.

Earlier this year my son put his hand through the window of our bathroom door. It was a lovely etched-glass panel as old as the house itself, but the Victorians weren’t much concerned with safety standards so the glass splintered into lethal shards and almost amputated his thumb. We wrapped his hand in a towel and drove straight to A&E in a hospital in the greater Dublin area, where he was seen immediately and the laceration temporarily bandaged to stop the bleeding. When an X-ray — promptly ordered and taken — showed glass in the wound, we were told he’d need to be admitted that night for surgery the following morning. We were installed in a small cubicle and told to wait until a doctor was free.

We waited for two hours or more — but then acute hospitals are busy places and we reckoned that as walking wounded we were among the luckier casualties in the emergency department that night. Then the doctor arrived.

It’s risky even to mention that he was coloured and of a non-Christian persuasion with less-than-fluent English, but I truly believe that misplaced sensitivities towards his race and religion facilitate the jaw-dropping behaviour we witnessed. Every three to five seconds during the 15 minutes or so that he was in the cubicle with us, he blew his nose into his bare hand and wiped it on the trousers of his scrubs. Snort, blow, wipe . . . flick through the X-rays and the paperwork . . . snort, blow, wipe . . . grab my son’s arm, which was flecked with small uncovered puncture wounds up along the forearm, in a snotty ungloved hand . . . snort, blow, wipe . . . go back to turning and examining the injured arm . . . snort, blow, wipe . . . go back to fingering the paperwork . . . snort, blow, wipe.

I should have said something but it was 1am, my son needed a hospital bed, and picking a row with a doctor didn’t seem the smartest way to secure one. Fortunately he disappeared and we never saw him again. Over the next two days my son got the best of care, including lengthy expert microsurgery to repair severed nerves, and thanks to a brilliant young surgeon he has now almost fully recovered sensation in the injured thumb. I was so grateful to the hospital and staff that I was reluctant to complain about the Snorting Doctor, as my son still refers to him, but two separate spurs finally compelled me to act.

One was a sanctimonious Health Service Executive ad campaign urging us patients to ask our doctors, “Have you cleaned your hands?” At what point in the snorting and blowing and wiping ritual, I wondered, was I meant to put that particular question? The other incentive was the extremely prompt arrival of a series of increasingly ill-tempered and threatening demands for the €132 I owed for my son’s hospital stay. Right then, as now, the newspapers were full of stories about missed cancer diagnoses and hospital-acquired infections, and all were ascribed to the demands and workloads on overstretched staff. So the only abnormalities they seemed competent to spot promptly and investigate thoroughly, it irked me to note, arose in the accounts department.

With my cheque I enclosed a letter to the hospital authorities describing our experience with the Snorting Doctor and expressing my concern at such blatant disregard for the most basic hygiene standards. If he’d been making sandwiches behind a deli counter he wouldn’t have lasted an hour. Did nobody in the hospital have a problem with this man’s unpleasant habit? Why wasn’t he advised to use a tissue when he blew his nose, or to wear gloves when he examined an open wound? Could it be that other staff feared being accused of racism if they spoke up? Or that his conduct was nobody’s responsibility but his own?

I don’t know, because I never got a reply to my letter of last April. Beyond a brief acknowledgement, illegibly initialled by some untraceable clerk, I haven’t heard a word. No request for further details, no assurance that this lapse of hygiene was unacceptable, no undertaking to speak with the doctor in question. So I can only assume that the Snorting Doctor carries on because it’s less trouble, all round, to ignore his charming little quirk.

The woeful lack of accountability in the HSE will allow him, just like the staff that misdiagnosed Ann Moriarty’s fatal cancer in Ennis General Hospital, to hide behind anonymity and systemic buck-passing. Nobody has been disciplined over that blunder because nobody has had to come forward and take responsibility, because that’s how the HSE works. Given the enormity of the ineptitude the HSE has had to defend in the past, I’m not surprised that the Snorting Doctor is way down its list of priorities.

But I bet he wouldn’t be wiping his snotty hands on his trousers if the nuns were in charge.

brenda.power@sunday-times.ie

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