What should our new minister for health do???

bonkey

Following from a quote by arcade in another thread....

arcadegame2004 wrote:

I still stand by my proposals made on this forum a good while ago for resolving the problems of the Health Service, i.e. tempt more Health-Insurance companies into the Irish market so that premium competition can take a firmer hold. Then move towards compulsory universal health-insurance with means-testing, so that the State's cost-burden with respect to the Health-Service would extend only to the premiums of the very poor. In this situation, hospitals would be getting increased revenue for each patient treated, thus acting as an incentive to treat patients quicker and better.

And I still think you're kidding yourself if you think that increased competition in the health-insurance industry will lead to a decrease in costs to the insured as well as an increase in revenue-paid-per-patient to the hospitals.

Basically, you're saying that competition will allow the insurance companies to earn less and pay out more. I'm guess that - as usual - there is a dearth of figures to show how this can be done, or where the savings will be made (other than some handwaving "increased efficiency" arguments)???

I'm not against the idea of private health-insurance. its the model that he Swiss system works off, and I'd trade their health-care for the Irish system any day. However, bear in mind that for this vastly improved system, I am paying a premium of approx €150/month, which covers me to public ward level only (over here that means 4 people to a room, semi-priv being 2) and only up to 90% of any hospital costs after an annual personal liability of something like another €200. So a serious accident could still costs me thousands, if not tens of thousands.

Now don't get me wrong...like I said...I'd take the Swiss system any day, but thats because in the relative state of affairs, I'm in a pretty good paying job, and can afford to pay that type of money for myself and herself for our insurance without thinking, and will up it to higher levels as soon as I can afford that.

I would also point out that the current price-levels were imposed by government regulation when the various health-insurers wanted to jack their prices through the roof and/or withdraw massive amounts of services. IIRC, It was a public referendum which required that the cost- and service-levels not drop below where they are now - a situation that may be required to change in the coming years as it becomes untenable costwise.

Personally, I don't think that the "solution" to Irish health care lies in privatising either the hospitals or the insurance as a first step. The first step lies in correcting as much as possible of the sh1t implementation thats there at the moment. Only after that have we a realistic chance of being able to consider what aspects can be privatised, how much they should realistically cost, how much they realistically need to be subsidised, and what level of service we can realistically expect from it.

Privatising before that point, in my opinion, is going to give rise to a disastrous situation which could make the privatisation of Eircom look like the best-run privatisation project the government could possibly conceive.

jc

ishmael whale

Encouraging the provision of private medicine (just on operational grounds – not ideology) would seem at least to take people with resources out of the mess. However, I agree that a job needs to be done simply improving the operational management of service delivery, without the necessity for any big ideological change towards or away from private or public financing.

But, inevitably, this brings us crashing into the middle of the political agenda. It might be the case that, for example, a downgraded hospital in Monaghan would both release resources and enable expertise to be developed to provide a better service for people in the North East. It might also be the case that the benefits accruing to people in that region in terms of lives saved and enhanced would outweigh any risk of a rare emergency case that might have benefited from the more limited service that might have been provided in Monaghan. But none of that matters. Decisions are not based on what outputs are required from health services, or how those outputs might best be delivered.

I think this extract from the Farmer’s Journal about Monaghan is a sample of the real difficulty. (Let me say I have no particular axe to grind about Monaghan in particular – the whole Cashel vs Clonmel debate probably offers an even starker example of the issues involved.) The views expressed by people in this extract implies a reluctance to recognise that their county benefits from services delivered outside their county boundry. Equally, the prospect that it might actually enhance their county if certain services could located in their region instead of in Dublin just does not seem to enter the equation.

There also seems to be a lack of realism about the extent to which they are contributing to national coffers. According to the CSO’s ‘County Incomes and Regional GDP’ publication Monaghan contributes 171 million in tax. 151 million of that goes straight back out to Monaghan households in form of income support. So Monaghan makes a net contribution of 20 million. Monaghan has 1.3% of the national population. Their 20 million contribution to national finances would pay 1.3% of the combined annual cost of the Departments of Finance, Defence (including army pensions), Foreign Affairs(including international co-operation), Tourism and the CSO. That leaves no contribution for the Courts system, prisons, Garda, roads, education, agriculture, marine, communications etc etc. So even the narrow idea that their contribution to national finances in some way entitles them to a local hospital is based on illusion.

I stress again I’m not getting at Monaghan in particular, or suggesting they should go around in sackcloth and ashes. I’m just pointing out that trying to bring reason to the operation of the health services very quickly gets us up to out necks in local politics where emotion overshadows reality.

The key to promoting operational efficiency in the public health services is to find a way of convincing Monaghan people to join a ‘close our cr@p local hospital’ campaign. I'm not sure how any Minister can do that, as careful explanation of the need seems to have little impact.

http://www.farmersjournal.ie/2002/0810/ruralliving/countrylifestyle/feature.htm
“There are large poultry, mushroom and furniture industries -started by local people and employing locals.
``We have turned our hand to a huge variety of projects including ducks, chicken, deer, feed mills - you name it, it has been tried in Monaghan. All this has contributed handsomely to the coffers and we now feel that our effort has been ignored,'' explains Leslie Quinn of Corby Rock Feed Mill. ``Future investment in the county will be severely affected if we do not have a hospital. This will impact on health and safety and insurance for all our businesses.''
``As a county we feel we have given a huge amount to the economy and while this has been gratefully accepted, we have got very little back. The county is not drawing down state funds for any major project. We now have no swimming pool, no public library, two of our bacon factories and a poultry factory have closed and the only new development on the cards seems to be an incinerator,'' says Paddy Sherlock, farmer and member of IFA National Council.”

ishmael whale

Its hard to see how the new structures will be able to harness efficiencies if they’re forced to carry costs from the old structure. Its also interesting to see how changes simply aimed at increasing efficiency can so easy be tarred with a brush. What seems to be at stake here is the redundancy of the head office staffs of the abolished health boards. However, in this article this is spun as ‘Limerick health workers’ to create the initial impression that some frontline service is being removed. At the same time there is a fudge of saying the changes ‘offer nothing to patients’, which is really just another way of acknowledging these are not frontline staff and the resources saved by abolishing these posts could of course offer something to patients.

Naturally the people behind this are ‘bosses in Dublin’. Of course the same ‘bosses’ are shortly to be moved to Naas, but undoubtably they will retain the Dublin mindset that health expenditure should be about providing efficient health services for the nation instead of inflating the payroll with unneeded administrative staff in regional locations.

http://www.limerickpost.ie/dailynews.elive?id=5822&category=Daily-Mon

Limerick health workers could be forced to move

by Mary Earls
LIMERICK health workers were told by their Dublin-based bosses last week that they may be forced to work as far away as Nenagh or Ennis once the Mid-Western Health Board (MWHB) is abolished on January 1…………. "There are also growing fears that Limerick workers’ careers could be damaged by plans to centralise services like IT, human resources, and finance. Many staff who have trained and specialised in these disciplines - often in their own time and at their own expense - could find their work transferred to five centres in Dublin, Kilkenny and Manorhamilton in County Leitrim,” said Mr Clinton………."These so-called reforms offer nothing to patients. But they contain real dangers for staff. IMPACT is not against change, but we want to see real reforms that improve the quality of our health services and put an end to the two-tier health system. And it’s not unreasonable for dedicated staff to have safeguards over their job security, working conditions and careers,” he said……The changes to health administration structures will see 11 existing health boards replaced with a national Health Service Executive and four small regional offices, including one in Galway, from January.

mycroft

arcadegame2004 wrote:

I still stand by my proposals made on this forum a good while ago for resolving the problems of the Health Service, i.e. tempt more Health-Insurance companies into the Irish market so that premium competition can take a firmer hold. Then move towards compulsory universal health-insurance with means-testing, so that the State's cost-burden with respect to the Health-Service would extend only to the premiums of the very poor. In this situation, hospitals would be getting increased revenue for each patient treated, thus acting as an incentive to treat patients quicker and better.

And the last light gives you insight into the overly simplistic mindset of arcadegame.

Quicker=better.

Look mate forcing hospitials in your logic would then have the incentive to dump half well patients out off the wards and onto either nursing homes or home. They'll never get completely better and a continued cycle of patients which hey is good for business in your competely over simplisitic worldview.

Let me break it down for you. A hospitial's priority is not to make money. A hosipital's priority is to make people better, and any system which views patients as comodities is in my mind inherantly flawed, and not making patient care your primary concern and budget second is whats getting us intot this mess.

Take MRSA's. Now in bonkey's lovely city of bern (which after watching what I watched this morning I'm seriously considering moving to) like in most hosipitals in Swiss the number of MRSAs is nigh on non existant. Ireland has a level of deaths due to MRSA fatalities comparble with our road deaths; all due to budgetary cutbacks in the 80s which slashed cleaning budgets. Dust and dirt are MRSA's friends and Irish hosiptials are beaten only by the UK and Greece for the amount of MRSAs generated. The UK privatised health care and slashed health care budgets in the 80s. We are reaping what we sow.

Arcadegame if we follow your model and you get in a car crash you are going to be f*cked. Because before you get to your shiny private ward you'll go to the public A&E where you're likely to pick up your MRSA. And hey if you can't afford your private ward well the public ward will dump you as quickly as possible (because hey faster=better) so they don't spot the infection earlier and you'll be in and out of hospitial drawing up ten times the resources battling your vicious infection you would have originally taken up. Or you could invest properly in public health services and have clean effective hosipitals

Sparks

mycroft wrote:

Ireland has a level of deaths due to MRSA fatalities comparble with our road deaths; all due to budgetary cutbacks in the 80s which slashed cleaning budgets. Dust and dirt are MRSA's friends and Irish hosiptials are beaten only by the UK and Greece for the amount of MRSAs generated. The UK privatised health care and slashed health care budgets in the 80s. We are reaping what we sow.

It's not even that much of an acadamic economic point. Personal perspective: my grandmother is currently in hospital following a stroke. Went to visit her last night, and after a longish drive had to use the bathroom before calling in to her. Turns out, the bathroom doesn't have a washbasin, soap, towels or any other way to wash your hands.
No offence guys, but when you can't even wash your hands after urinating in a hospital, I think we can leave the academic economic points on the shelf for the time being.

Sleepy

Sorry for the dumbass question but what's an MSRA?

Sparks

Staphylococcus, sleepy, or "staph" for short. It's become notorious as a "superbug", a bacteria that is resistant to all our current antibacterial drugs. Usually, it's quite common (it causes pimples, for example), but variants of it are lethal, especially in immunosuppressed (ie, sick) people. And it's showing up more in hospitals as a result, because you have a lot of sick people being visited by a lot of healthy people (who'd carry the infection but who wouldn't notice as their immune systems are healthy) and all in one place, with poor hygiene facilities.

Moriarty

http://www.google.com/search?sourceid=mozclient&ie=utf-8&oe=utf-8&q=define%3A+MRSA

Definitions of MRSA on the Web:
Methicillin Resistant Staphlococcus Aureus. An antibiotic-resistant infection often acquired in hospitals.

Afaik it's one of a whole host of infections that have become resistant to varying degrees that are in hospitals.

On the wider health service, I really don't have a clue how to fix it. I know very little on how they're run in the first place, but the HSA seems like the right direction to take. If it does what I think it's meant to be doing, it could help cut down on duplication of a whole crap load of stuff, aswell as bureaucracy in general. One in ten people employed in this country are directly employed by the health services in their various guises. From the outside, that seems like an entirely untenable position.

dabhal

Sleepy,
You'd have seen mrsa as superbug in the papers.
Stands for Methicillin Resistant Staphylococcus aureus.
Most people carry it and its harmless but in a hospital with operations etc and people with decreased resistance it can become extremley serious.
General ways to stop it are simply to wash hands with soap etc.

Dabhal

mycroft

dabhal wrote:

Sleepy,
You'd have seen mrsa as superbug in the papers.
Stands for Methicillin Resistant Staphylococcus aureus.
Most people carry it and its harmless but in a hospital with operations etc and people with decreased resistance it can become extremley serious.
General ways to stop it are simply to wash hands with soap etc.

Dabhal

Its more complicated than that. Most Doctors hospital staff feel that it's all well and good them cleaning there hands but feel that it's pointless if the hosiptials themselves aren't clean. Staphylococcus thrives in dust, and hosiptials just aren't clean anymore. An effective dedicated cleaning staff supervised in the old matron system is the only way forward. In the fifties they're have been murder if a cross infection like MRSA took place. Again because of their growing tolerance to antibotics it's more difficult to treat, but that means a serious well funded cleaning regieme is the best way to tackle this killer.

bonkey

Mycroft wrote:

Now in bonkey's lovely city of bern (which after watching what I watched this morning I'm seriously considering moving to)

And to make it even better...I only work here I leave in the evenings so as not to lower the tone of the place

What did you watch this morning, BTW? FIS Sprint Event that was on over the weekend?

Sleepy wrote:

Sorry for the dumbass question but what's an MSRA?

MRSA, not MSRA. Use google. And check for the link which mention "superbugs".

jc

dabhal

On the original question,
The health service needs major organisational change.
The new health services executive is a step in the right direction but I won't hold my breath.
Even if it has all the right ideas and solutions the unions are going to block it at every turn.
The health service is old, the people in charge are out of touch and adhere to 40's 50's type management styles.
The unions dictate what happens and when.
It virtually impossible to fire someone from the public service.
The health sector needs a major cull and an infusion of fresh blood.
Unfortunately I don't think that that’s possible in a lot of cases.
Money will not solve the real problem unless the organisational changes are made first.

Most of the admin staff in hospital are untrained.
A large number of supervisors /managers etc have been in the health sector all their working life’s having started at the bottom.
They proceeded through the ranks not by hard work but by simply being there.

Most health service bodies do not have staff reviews and wages are allocated on a scale. Every year you are there you get more pay, more holidays. (There are caps) How motivated would you be? Good, bad or indifferent you'll get the same as everyone else.

I personally believe that a private sector CEO would be the way to go but only if they had a free hand.

The nurses and doctors do an extremely good job given what they work with.
I for one am in favour of scrapping the current work procedures for junior doctors. (Not by strike)
Your average consultant needs a good slap in the head. They consider themselves elite there to be obeyed. I can understand why but it doesn't help.

In summary someone would need to go into the hospitals and really take peoples jobs apart, fire some, hire others, reorganise and train the rest.

It will never happen. :eek:

Dabhal

Sleepy

I personally believe that a private sector CEO would be the way to go but only if they had a free hand.

Couldn't agree more. Why the government don't just lock out the unions I'll never understand. Sure it'd cause some controversy for the first few deaths but I think we're approaching the point where public support would be with the government in taking on the unions that cripple our health service.

dabhal

I never suggested dumping the unions?
Loosen the grip but I wouldn't get rid of them completely.

BuffyBot

The UK privatised health care and slashed health care budgets in the 80s. We are reaping what we sow.

The UK didn't "privatise" health care in the 80's, though undoubtly they changed the nature of the NHS and cut funding dramatically. Is there any evidence of this being linked to rise of MRSA though?

mycroft

mycroft wrote:

all due to budgetary cutbacks in the 80s which slashed cleaning budgets. Dust and dirt are MRSA's friends and Irish hosiptials are beaten only by the UK and Greece for the amount of MRSAs generated.

Interesting that you should mention that,I firmly believe that it's attitude and laziness in the cleanliness routine aswell that is the MRSA's friend.
My Father died in a well known private Dublin Hospital from an MRSA related illness. At the time there were at least five or six other patients in isolation.
Now I know the VHI paid that hospital an awfull lot of money for him to be there yet it still was rife with the super bug.
MRSA has a lot to do with medical staff and visitors washing their hands, particularally the former and to be honest I'd imagine they were just slipshod in that. Not good enough really.

ishmael whale

According to the Irish Medical Journal, “Most regions within the United Kingdom (UK), apart from the southeast, had a low prevalence of MRSA until recently, whilst MRSA has been endemic in hospitals in the Republic of Ireland for some years, especially in Dublin.” so they don't seem to link the UK problem to events in the 1980s.

http://www.imj.ie/news_detail.php?nNewsId=2293&nVolId=89

mycroft

BuffyBot wrote:

The UK didn't "privatise" health care in the 80's, though undoubtly they changed the nature of the NHS and cut funding dramatically. Is there any evidence of this being linked to rise of MRSA though?

The evidence is statisical and ancedotal. The rise in MRSA's happened dramatically in the 80s and 90s. The high morality rate from MRSAs at the moment is due to;

The overuse of antibotics, few antibotics now can be used to treat MRSAs as they've developed antibotic resistant strains.

Ancedotal evidence, MRSAs were unheard of in the 40s,50s,60s esp in hosipitals run by religious orders. Cleaning was done with military discpline and rigor, and a MRSA would be considered a serious issue, matron would not be pleased (stop tittering the back carry on fans) In Ireland and England in the 70s religious orders and the role of matron was one of the first jobs to go in cutbacks, and the evidence is there now in black and white in the MRSA league tables.

The PDs have until the next election and I look forward to their canidate trying to justify Harney if they've not made an improvement by 2007

daveirl

This post has been deleted.

daveirl

daveirl wrote:

This post has been deleted.

Well yes, the bug is super because it is resistant to virtually all antibiotics except some increasingly few very strong antibiotics.
However cleanliness with as simple a step as hand washing every time between patients and using a different mop where there is someone infected with it, would all but eliminate its spread.

BuffyBot

The rise in MRSA's happened dramatically in the 80s and 90s. The high morality rate from MRSAs at the moment is due to;

The overuse of antibotics, few antibotics now can be used to treat MRSAs as they've developed antibotic resistant strains.

So it happened during the same period of time - doesn't nessecarily mean it's directly related.

Ancedotal evidence, MRSAs were unheard of in the 40s,50s,60s esp in hosipitals run by religious orders. Cleaning was done with military discpline and rigor, and a MRSA would be considered a serious issue, matron would not be pleased (stop tittering the back carry on fans) In Ireland and England in the 70s religious orders and the role of matron was one of the first jobs to go in cutbacks, and the evidence is there now in black and white in the MRSA league tables.

I have to say, anecdotal evidence does very little for me.

Sparks

BuffyBot wrote:

So it happened during the same period of time - doesn't nessecarily mean it's directly related.

No, not on its own. However, combined with the nature of how MRSA spreads, and the effect of the actions in question, it's a strong indicator of a problem.

Besides, seriously, sick people crowded into a dirty room - does that sound healthy to you?

mycroft

BuffyBot wrote:

So it happened during the same period of time - doesn't nessecarily mean it's directly related.

What part of dust based virus confuses you?

I have to say, anecdotal evidence does very little for me.

To be honest, I don't

By ancedotal I'm talking about the head of a UK based patients rights group, a former nurse from the 50s who suffered an MRSA in the 90s. I apologise I read an interview with her in the guardian as part of research for a project, unfortunately a cursory search of their engine I can't find it. If you continue to dispute this I'll spend five minutes digging over the net for it, I just don't have the time right now.

Suffice to say the best combatant we have againist MRSA is cleaniness. Experts are stating that the miracle age of antibotics will end in 10 years time.

BuffyBot

Bah..just lost a post.

To summarise though:

No, not on its own. However, combined with the nature of how MRSA spreads, and the effect of the actions in question, it's a strong indicator of a problem.

It's a possible cause, but I don't think it's a huge contributing factor. It's more likely that a drop in hygiene standards coupled with the "evolution" of the disease into it's resistant state through overuse of antibiotics may be a bigger factor.

What part of dust based virus confuses you?

Isn't it a bacterial infection?

arcadegame2004

And I still think you're kidding yourself if you think that increased competition in the health-insurance industry will lead to a decrease in costs to the insured as well as an increase in revenue-paid-per-patient to the hospitals.

No I don't think I am. The problem in the US system is that regulators are, in my opinion, not doing their job right. They costs of heath-insurance there spring from a culture in which, in spite of the clear gap between Europe and the US in terms of growth, there are certain sectors of US industry where the competition authorities are seemingly unwilling to tackle cartels. There surely most be cartels between certain players in the Health-Insurance market for the premiums in the US to be so staggeringly high. But things cannot stay as they are in Ireland. I note the calls again on this forum for yet another increase in health-spending. We have already doubled it in the past 7 years. If the problems of the health-service could be resolved by simply throwing money at them they would have been resolved long before now.

I propose true competition involving multiple health-insurance companies, where a vigorous regulatory regime (with real teeth including the power to grant immunity to whistleblowers and to prosecute suspected cartels and companies involved in collusion). I am not necessarily saying that the Health-Service would get additional money from the health-insurers. The problem in the health-service is the way in which resources are currently apportioned, together with the disincentive for the health-service to treat the 51% of us who are not on health-insurance. True competition between the health-insurers would keep prices at the lowest possible level of cost of treatment for the patient. The State would retain a role paying the premiums to the health-insurance companies of those below a certain low threshold of income, who identities would be determined by means-testing, and would be required to choose the cheapest option.

Someone here expressed distaste at the concept of patients being treated as "commodities". I personally wouldn't mind being considered a "commodity" if it meant I got treated quicker and better. If the system isn't working, fix it. Throwing money at the health-service without making the necessary reforms to divert resources away from wasteful duplication of resources e.g. fatcats on health-boards, and fulfilling the insatiable demands of vexatious protesters that each country have a hospital in every town, with every hospital therein having a maternity hospital and other facilities etc. is just throwing good money after bad. Ishmael Whale did a very good job depicting the way in which kind of nonsense prevents reforms being taken. Politicians on health-boards are often too concerned with the likely impact of a hospital's facilities being downgraded on his/her poll-ratings to take what action is best for the nation as a whole.

The trade-unions, too, are part of the vested interests impeding the changes needed to reduce wasteful expenditure on bureaucracy. No sooner has Mary Harney started trying to implement the scrapping of the HEalth-Boards than the unions opportunistically and disgraceful see a chance to extract concessions from the Government but holding the reforms to ransom in return for something or other. It really shocks me sometimes, in spite of having seen this carry-on going on for donkey's years, how incredibly selfish and lacking in any sense of national-interest some of our public-sector unions have been.

dabhal

when did this become a superbug thread, maybe we could start a new one since it's causing so much interest?

mycroft

BuffyBot wrote:

Isn't it a bacterial infection?

Nope viral, it's a virus that lives in dust, one of the reasons it's become so tolerant is because most of us carry it, and GPs tendancy to prescript antibotics to a baterical infection.

propose true competition involving multiple health-insurance companies, where a vigorous regulatory regime (with real teeth including the power to grant immunity to whistleblowers and to prosecute suspected cartels and companies involved in collusion). I am not necessarily saying that the Health-Service would get additional money from the health-insurers. The problem in the health-service is the way in which resources are currently apportioned, together with the disincentive for the health-service to treat the 51% of us who are not on health-insurance. True competition between the health-insurers would keep prices at the lowest possible level of cost of treatment for the patient. The State would retain a role paying the premiums to the health-insurance companies of those below a certain low threshold of income, who identities would be determined by means-testing, and would be required to choose the cheapest option.

Okay, lets just look at our insurance industry for a moment. It's allegdly regulated yet somehow comes out ten times more profitable then our UK counterparts. If we can't regulate that, how do you propose your system.

See Arcadegame you're quick to poo poo anyone who comes up with a "socialist" ideal saying it'll never work in practice, and accuse the person of being a dreamer, I say we have plenty of evidence that given how ineffective the system is at present theres no proof that your plan would work.

Someone here expressed distaste at the concept of patients being treated as "commodities". I personally wouldn't mind being considered a "commodity" if it meant I got treated quicker and better.

Again wheres your proof that you'd get treated better? Furthermore patients are already seen as objects to staff, I'm terrified of the day that I go into hospitial and get treated as a customer.

when did this become a superbug thread, maybe we could start a new one since it's causing so much interest

Hand up. I did it. I did it to illustrate a point that arcadegame has choosen to ignore. It doesn't matter how shiny and star trekky Arcadegame's private ward is, if he is involved in a car crash the first thing that'll happen is he'll be taken to a public A&E and if it's underfunded he could come in contact with a MRSA, and because he equates faster=better in terms of medicial treatment (hey arcade does this equate in everything in life to you, cause if so, McD's is better then the four star michellen restaurant) he'll likely to be dumped home before the MRSA is spotted, leading to months of treatment in and out of hosipital at great expense. Sorry to thread jack, I was just using MRSA to illustrate a point

ishmael whale

mycroft wrote:

Nope viral, it's a virus that lives in dust, one of the reasons it's become so tolerant is because most of us carry it, and GPs tendancy to prescript antibotics to a baterical infection.

Are you sure its a virus? This link suggests its bacterial.


http://www.healthhub.ie/index.cfm/loc/17/articleId/AB3B63C5-A03C-411F-ABDC0C69EC014876.htm
What is MRSA?
Staphylococcus aureus is a bacterium commonly carried on the skin or in the nose of healthy individuals. Around one third of the population may be colonised with S. aureus at a given time (i.e., the bacteria are present on or in the body, but are not causing illness). However, when S. aureus gains access either to deep tissues, the bloodstream or the lungs, it can cause infection.
In the past, these serious infections were treated effectively with certain types of penicillin-related antibiotics. However, the past 50 years have seen the bacteria becoming increasingly resistant to antibiotics. This is due to natural genetic mutations in the bacteria, which give some strains the ability to resist antibiotic attack. These strains prove harder to kill with antibiotic treatment - and if a treatment course is not completed, the resistant bacteria will survive and proliferate. Such resistant strains have become known as Methicillin-Resistant Staphylococcus Aureus (MRSA), although the term can describe a strain of S. aureus bacteria with resistance to any conventional antibiotics. MRSA is more likely to occur among patients in hospitals and healthcare settings.

mycroft

ishmael whale wrote:

Are you sure its a virus? This link suggests its bacterial.


http://www.healthhub.ie/index.cfm/loc/17/articleId/AB3B63C5-A03C-411F-ABDC0C69EC014876.htm
What is MRSA?
Staphylococcus aureus is a bacterium commonly carried on the skin or in the nose of healthy individuals. Around one third of the population may be colonised with S. aureus at a given time (i.e., the bacteria are present on or in the body, but are not causing illness). However, when S. aureus gains access either to deep tissues, the bloodstream or the lungs, it can cause infection.
In the past, these serious infections were treated effectively with certain types of penicillin-related antibiotics. However, the past 50 years have seen the bacteria becoming increasingly resistant to antibiotics. This is due to natural genetic mutations in the bacteria, which give some strains the ability to resist antibiotic attack. These strains prove harder to kill with antibiotic treatment - and if a treatment course is not completed, the resistant bacteria will survive and proliferate. Such resistant strains have become known as Methicillin-Resistant Staphylococcus Aureus (MRSA), although the term can describe a strain of S. aureus bacteria with resistance to any conventional antibiotics. MRSA is more likely to occur among patients in hospitals and healthcare settings.

Doh in the words of the great man Willy Wonka "Scratch that reverse it." It is a bacteria that lives in dust, and doctors are treating virual infections with antibotics which are totally ineffective.

bonkey

arcadegame2004 wrote:

Someone here expressed distaste at the concept of patients being treated as "commodities". I personally wouldn't mind being considered a "commodity" if it meant I got treated quicker and better.

Uh-huh. And if you instead fitted into the "not a terribly profitable commodity" which meant you got treated slower, less well and more expensibely then at present.... Would you mind it then?

See, the problem is arcade that you can't actually point to a single privatised health-care service and say "thats how its done right". Instead, you point at systems which have problems different to - but arguably as significant - as our own systme and decide "if we did that, only without the bad stuff, it would be great".

Well guess what. If we got rid of the bad stuff from a public system, it would be great too.

If the system isn't working, fix it.

I thought thats what the "don't privatise" argument is. Privatisation isn't a fix, its a fundamental change, based on an unproven (that I can see) premise that a public-service healtcare system is inherently worse then a privatised one.

See, you keep comparing a well-run privatised system to a badly-run public one, and concluding that it makes no sense not to change. Why not compare apples with apples? If we can run something well, then compare well-run private vs. well-run public. If we can't run something well, then compare badly-run private vs badly-run public.

jc

dabhal

Has anyone ever looked at the Canadian health system?

"Canada's publicly funded health care system is best described as an interlocking set of ten provincial and three territorial health insurance plans. Known to Canadians as "medicare", the system provides access to universal, comprehensive coverage for medically necessary hospital and physician services."
Source http://www.hc-sc.gc.ca/english/care/index.html

Bottom line its public it's free, it works

ishmael whale

Just noticed this. Sort of raises the question of what’s the vision now.

Govt to shelve Hanly Report on hospital reform - report
03/02/2005 - 10:16:33

The Government is reportedly set to shelve the recommendations contained in the contentious Hanly Report on hospital reform.

Reports this morning said Health Minister Mary Harney was expected to tell David Hanly, who has been drawing up a plan to implement the reforms, that his services are no longer needed.

Mr Hanly’s report recommended the downgrading of several smaller hospitals, which would have lost functions such as accident and emergency services if the plan had been implemented.

The Hanly Report, which met with intense opposition from politicians and the public, recommended that such services be centralised in regional hospitals.

Moriarty

Fantastic. Were condemned to a **** health service because politicans wont ignore the ignorant masses.

Villain

MRSA is primaryly caused by doctors and nurses not washing their hands!!

MrPudding

Here is something I find interesting. If you are on a waiting list over a certain length of time they ship you up North to get treated privately. I think this is great, sick people should not have to wait for extended periods of time to be treated. Here is the thing. If you are in the North and you have been waiting too long you get sent down here to be treated privately.

Does anyone else find this a bit wasteful? I know 1 person personnally from the North that availed of this service and I met the family of another on the train to Belfast at the weekend. It seems like a bit of a waste of money. The health board in the north pays for a hotel for immediate relative of the person being treated. I presume the same is the case for someone going the other way.

It is obvious that both systems have slack which allow them to care for patients from the other state. Would it not be cheaper to treat them privately in their own state? Does anyone know why this happens?

MrP

Boggle

There is probably no cleancut solution to healthcare issues but a start might be to look at why the costs are so high. I would make it easier to get into medicine, thus increasing the generation of new doctors (i.e. cheaper doctors). The theory being that if they were cheaper, then you could have more - making overtime unnecessary for them.
A useful side effect would be to bring down the GP's fees so people get diagnosed quicker as they might be more used to going to the doctor when somethings up.

I would preferably set up a faster turnaround system whereby for example you come in with an injury(break), you get x-rayed, get the x-ray read and the wound treated in 1 visit instead of having to come back on a couple of occasions as is currently the case. Whereby Hanley appeared to want to develop specialised illness treatment centres I would instead rather have the system set up in such a way that when we so get rid of the backlog that currently exists - we would then be in a position to tout for business from other countries.

I know its too simplistic a solution but as I see it the insurance isn't the problem - its the capacity and ability of our medical sector thats the problem. Also, I reckon there should be no insurance - it should all be covered by the state and payed from our taxes so that all people get the same level of treatment. That is to say the best level of treatment. When you are lying sick on a trolley the last thing you should be worried about is 'how am I going to pay for this?'!!

cdebru

just a quick point
we already have compulsory health insurance
its called PRSI

arcadegame2004

I still stand by my proposals. I also favour abolishing the stupid Health-Boards, which enshrine parish-pump politics in the health-service. The country-jersey mindset of a lot of Irish people also needs to be confronted by politicians. Something like the Forum on Europe needs to be set up whererby politicians travel the country to explain to people in lay-man's terms why it is bad for the country to have every county having every facility in its hospitals. Having all the counties having that in the end leads to them having to be downgraded again due to unsustainable costs. Mary Harney is to be lambasted for planning to throw the Hanley report off the political-cliff (if the story is true).

Bonkey Irish health-insurance costs are a lot lower than in Switzerland. I pay 39 euro a month for my VHI cover. Maybe costs of living in general are higher there and it would take a long time for us to reach those levels of cost. But if this is not so, then maybe the regulation of the health-insurance market in Switzerland is not what it should be to allow premiums to reach that frightening level. Are you sure private-health-insurance is compulsory in Switzerland? I would like more information if you have it on this matter.

A market-based solution is the best because demand breeds suppliers to profit from the demand, while vigorous regulation should be able to prevent profiteering.

billy the squid

arcadegame2004 wrote:

No I don't think I am. The problem in the US system is that regulators are, in my opinion, not doing their job right. They costs of heath-insurance there spring from a culture in which, in spite of the clear gap between Europe and the US in terms of growth, there are certain sectors of US industry where the competition authorities are seemingly unwilling to tackle cartels. There surely most be cartels between certain players in the Health-Insurance market for the premiums in the US to be so staggeringly high

Are you certain of that, has the thought that the US is one of the most litigious of cultures in the world not occoured to you. We have the same "compo culture" here. the health insurance system would end up in exactly the same way as the US if what you proposed were done.

and would be required to choose the cheapest option.

sounds like the system we have now to be honest. except you would have to pay for it your self as opposed to having a medical card. people on lower incomes would have to do two years of tests to find out they have 6 months to live and have lung cancer when they might have been saved with chemtherepy two years earlier. The problem is not with health insurance, the problem is with the amount of beaurocracy and management issues within the health service.

arcadegame2004

I thought thats what the "don't privatise" argument is. Privatisation isn't a fix, its a fundamental change, based on an unproven (that I can see) premise that a public-service healtcare system is inherently worse then a privatised one.

See, you keep comparing a well-run privatised system to a badly-run public one, and concluding that it makes no sense not to change. Why not compare apples with apples? If we can run something well, then compare well-run private vs. well-run public. If we can't run something well, then compare badly-run private vs badly-run public.

The current system is not working. Something new has to be tried. I suspect Galileo would have had similar accusations thrown at him when he dared suggest the world is round e.g. unproven.

cdebru

arcadegame2004 wrote:

The current system is not working. Something new has to be tried. I suspect Galileo would have had similar accusations thrown at him when he dared suggest the world is round e.g. unproven.

I think you are stretching credibility comparing yourself to galileo