Ireland's Health service ranked 28th in the world

star gazer

The World Markets research centre did the study which found the Irish Health services as the worst in the EU. In an article in Ireland on Sunday, the department of Health spokesperson tried to blame historical under-funding. This was a strong argument in 1997, not so much anymore. The inefficient use of the entire income tax take of €10 billion has led to a near stagnation of our second rate Health services. A&E units in several major hospitals have been unable to cope with the expected numbers of patients that they get every winter. The promised end to waiting lists in two years by the previous government has been disowned by the present government eventhough it is the same minister for health in the job. Under-funding is no longer the issue, it's the way the money is being spent. The health reforms that should be on the way seem to be eyeing up the funding of local hospitals for other hospitals.

The health boards are notorious for their inefficiency, but it's hard to see how their heads can be chopped off and replaced by a centralised board without serious structural harm being done. Cultivated organic reform is what is needed, but it doesn't look like there is going to be any big cultural reform. There isn't much talk about refocussing the services towards user needs. The same vested interests are fighting for their own patch and as usual the end user suffers. When will things change?

TomF

I think the root cause is that Ireland was so poor for so long, and got so rich so fast that concrete action hasn't caught up with present expectations. Think of the road network, the public transit system, and-yes-the health care system.

It is like pouring molasses out of a jar. It takes forever to start moving no matter what angle you hold it, but when it starts moving, it is hard to stop. In Cork the University Hospital suddenly began to look like a city with all the cranes and scaffolding and hoarding. Eventually there will be a modern medical center emerging from the chaos.

TomF

These two stories published yesterday and today certainly give me reason to think the Irish government is wise to suspect that the current climate of wealth in Ireland may not be destined to last much longer and that we may soon see waves of layoffs here followed by a precipitous decline in the market value of property. If that happens, we may be glad to climb as high as #27 in health care next year!

Sunday Business Post
"US tax amnesty to hit investment here
By Eamon Quinn"

"Legislators return to Washington this week to continue work on a tax amnesty bill that Wall Street commentators say will make it less attractive for US corporate giants to reinvest billions of dollars in Ireland."
...

"Ireland has more to lose than most countries, because a big share of the foreign direct investment here has been sourced from a pool of earnings netted in the country. After the Netherlands, Ireland is the most dependent on foreign investment in Europe from reinvested earnings."

<http://www.sbpost.ie/web/Home/Document%20View%20Business/did-97723853-pageUrl--2FBusiness-2FNews-Features.asp>

"IBM Data Give Rare Look at Sensitive 'Offshoring' Plans
Mon Jan 19,12:53 AM ET

"In a rare look at the numbers and verbal nuances a big U.S. company chews over when moving jobs abroad, internal documents from International Business Machines Corp. (NYSE:IBM - News) show that it expects to save $168 million annually starting in 2006 by shifting several thousand high-paying programming jobs overseas, Monday's Wall Street Journal reported."
...

"Among other things, the documents indicate that for internal IBM accounting purposes, a programmer in China with three to five years experience would cost about $12.50 an hour, including salary and benefits. A person familiar with IBM's internal billing rates says that's less than one-fourth of the $56-an-hour cost of a comparable U.S. employee, which also includes salary and benefits.

According to the documents, which also provide managers with detailed advice on how to talk about the moves and their effect, IBM plans to shift the jobs from various U.S. locations to China, India and Brazil, where wages for skilled programmers are substantially lower."

<http://news.yahoo.com/news?tmpl=story2&u=/dowjones/20040119/bs_dowjones/200401190053000033>

star gazer

The question for the Health services is less and less about the amount of money and more and more about the way money is being spent. Inflation seems to have sky-rocketed in the past seven years indicating probably several bottlenecks in the system. It's important to recognise that there are two sides to the health services, the clinical and the administrative. The administration side needs some change of ethos to focus more on delivery of service and the clinical side needs to lose some anti-competitive practices (ie doctor numbers, therapist numbers etc.)