IRISH PEOPLE ARE polite. We thank the bus driver. We thank the waiter. And we definitely thank the doctor.

A few months ago, I was invited to speak in a panel discussion at a health promotion event in the Midlands, aimed at over-65s. The theme of the day was health literacy, and ways older people could take control over their health. I was there, as a doctor, to share some practical tips on how people could get the most out of their interactions with the health services.

I had prepared some notes. Always bring an up-to-date list of your medications, for example. Never be afraid to ask questions. But, on the day, I ended up asking if sometimes we say thank you too much – or in the wrong way.

Put it this way. Whose health service is it? Who owns the local hospital? If I’m a doctor or a nurse, who’s my boss? The answer is you. You’re my boss, actually, and it’s your hospital. My manager might be the consultant, and they answer to the hospital chief executive – but who do they work for? They ultimately work for you – for all of us. All of us interact with the health system, sooner or later. We fund that system through our taxes as well as through private health insurance and out-of-pocket charges.

However, I believe that we as Irish people relate to our health system in a way that is too deferential, too apologetic, and yes, sometimes too grateful. Our health services should instead be regarded as something collective, a source of collective stewardship and responsibility – something we see as ours.

What’s more, it’s not just because we’re paying for it. If you are a customer in a hotel or a restaurant, yes, you hold some power in that interaction. However, that power is of a........

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