Building a Better Health Service


Communicating Clearly - Navigating the Health Service with Literacy Difficulties

“They say that life begins at 40 but, for me, it began at 39 when I did my Leaving Cert.”

For most of his life, 54-year-old Tipperary man Michael Power hid a secret, and one that hung over much of his daily routine – that he could barely read or write.

Michael Power NALABut after finally empowering himself to throw off the shackles of the ‘slow learner’ tag to return to school in his late 30s, Michael is now a Student Representative with the National Adult Literacy Agency (NALA). NALA worked in partnership with the HSE to develop guidelines for Communicating Clearly with patients and staff.

The guidelines are part of the HSE’s improvement programme to support staff to communicate clearly and to be aware of health literacy issues during their daily work with patients and service users.  

Read more about Communicating Clearly here

“Change is coming. There is an awareness at last that there are people all around us that are struggling to read and write. And if I can help them by sharing my journey to literacy, then that is fantastic,” Michael explained.

“Going back to my childhood, my father had his own struggles with literacy but I never realised it. He had hidden it so well. And I think it was why he lost his leg. He had been told that he had bad circulation but I don’t think he understood what was being said to him and he never really got a grip on it. And then he ended up losing his leg.”

He stressed that health literacy helps people to own their own healthcare and empowers them.

“I think it is brilliant that an organisation like the HSE is taking this initiative and raising awareness among the health sector. A lot of people simply don’t understand the scale of the problem – the fact is that one in six adults in Ireland have a below average literacy. People working in the sector need to understand that some people have very limited literacy. Often they are very busy and don’t notice the signs so it’s important to raise awareness,” he said.

He explained his own experience when his baby daughter Michelle was taken very ill with kidney stones.

“Myself and my wife Mary were up in Temple Street. Suddenly we were told she needed a lithotripsy in the Mater Hospital and Mary had to race off with her in the ambulance. I was left behind in shock and complete panic. A nurse saw me and came over to tell me that it just meant that they were going to blast the kidney stone that wouldn’t pass itself and that it was fairly routine. That put my mind at ease instead of being completely in the dark and fearing the worst. Everything sounds worse when it’s in medical speak,” said Michael.

The second oldest of a large family, Michael’s literacy problems were never picked up on in school.

“I went through school being told I was a slow learner. I was labelled slow by the rest of the lads and teachers and that was a label that stuck with me. There were no catch-up classes in those days,” he said.

“I had a tough time in school. I was the boy who never did his homework and was constantly in trouble at the CBS where I went. My routine for a number of years was not doing my homework and then getting the belt. Nobody ever tried to find out what was causing my refusal to do my homework. It was a horrible time for me at school.”

He left school at 16 with very poor reading and writing skills but soon learned how to hide his illiteracy.

“I took a job in a hardware store down the road. People constantly came in with handwritten dockets that I couldn’t read. So when I’d hear people coming, I’d go up the ladder for the timber and they would have to tell me what they wanted. It was my way of masking the fact I couldn’t read.”

He took his first permanent job in the glass factory in Nenagh, where he ended up working for the next 20 years. The job was a manual labour position so it suited Michael down to the ground.

“It was all grand until everything started to become computerised and it really became an issue for me. I always had to be six or seven steps ahead so I wouldn’t get caught not being able to read,” he said.

It was the birth of his son and daughter that really spurred Michael on to finally do something about his illiteracy.

“I was scared that I wasn’t going to be able to be part of their education, not be able to read them their bedtime stories. I didn’t want people to be telling them that they were stupid like people used to tell me. And I realised that to help them, I had to first help myself.”

It was then that Michael took that ‘terrifying’ first step.

“One October night I finally plucked up the courage and met with a woman at a literacy group in Roscrea and told her that, in my 30s, I wasn’t able to read or write. It was truly terrifying but the six months in that group were the most exciting time of my life,” he said.

He was then nominated from the group to join the NALA national executive as a student voice. After four years on the executive, he was invited by the outgoing chairperson to replace him.

“I was in a really good place. I had taken redundancy in my job and had decided to go back to school full-time and do my Leaving Cert. It was a daunting thing for me, wondering if there was going to be a teacher that was going to hit me. But it turned out that I had a teacher that I became friendly with on a first-name basis and who really spurred me on to learn.

“In those two years, I read the first books of my life. I was sucked into the world of stories. I was dreaming about books, it was so exciting. We were learning a four-line poem and I couldn’t wait to go home and talk about it with the kids. They thought I was mad.”

The Leaving Cert brought its own challenges but he found a way around it.

“I was worried that I wouldn’t be able to do the English exam in the time given because I was constantly struggling to find an easy way to say something. But a teacher just told me that no matter how bad your spelling is, you will only lose 10pc of the marks. That really took the pressure off.”

He admitted that waiting for the results was pure agony but he will never forget the feeling that came with seeing that C in English.

The next step for Michael was a three-year college course in Business Studies in Thurles.

“I completed the first year before taking up a full-time position in St Anne’s in Roscrea. I had been working part-time and I couldn’t really pass up the opportunity,” he explained.

Michael loves being part of the NALA family as a literacy ambassador and helping people to transform their lives in the way he did his own.

He quietly recalls the day he was taking his father to hospital in Limerick and passed a training centre that he had recently given a literacy talk in.

“He quietly told me that he had travelled 20 miles on the bus to that place when he was in his 40s to try to go back to school but got cold feet and went home. It makes me proud to think that I was able to do something that he had wanted for himself all those years ago. It was for him and for my family as much as it was for me,” Michael added.

Download Communicating Clearly Guidelines and supporting materials here.