What health Problem and other economic indicators

ISAW

The government are having different problems related to economic success compared to the problems in harder times.
The main problem one hears again and again is the health service. I think this problem is almost wholly in Accident and Emergency. So lets look at how many work in the health service. Look at the following http://www.cso.ie/statistics/empandunempilo.htm
One can look bace to 1970 if they want.

Anyway these stats cover the last eight years. In that time overall about 20,000 farmers and fisherman left their jobs, along with 8000 industrial workers. Everything else was up. People complain about not enough houses roads etc. being built. There are 16,000 extra construction workers and 31000 transport and communication workers.. People complain about schools . there are 20,000 extra education workers. Finally health increased for 114,000 to 188,000 - thats an extra 54,000 workers about a fifty per cent increase. Something like 12 or 13 billion extra has been spent on health. so who are all these workers? A&E camplain about lack of staff. Who are the extra 54,000 workers in the health service over the last seven years?
Mind you public administration and defence went from 71` to 98 thousand extra. Now we also hear about Gardai (a force of about 11000) and Army (about the same) not having enough people. But this (in spite of a so called "embargo" on public sector jobs) is an increase of 27,000 pen pushers, more than the Gardai and Army combined! Some no doubt do a good job (the stats I refer to were produced maybe by one of them) but I suggest the health service would do better with more nurses (who are paid less than admin) and doctors (who are paid per hour about level with middle Admin grades. ) than anything else. Can anyone tell me haowe many more doctors and nurses there are over the last eight years? Would not a few hundred gardai nurses and doctors be better than some of the 54,000 extra "health workers"?

BOHSBOHS

there isnt any shortage of nurses or doctors , there is a shortage
of capacity. plain and simple . altho in the michael martin days it would take a few 5 million euro "reports" to work that out.....
u cant have a 10% population increase due to immigration and just expect our few existing hospitals to cope. they clearly arent ,

dunno what kind of long term planning if any goes into the health service .
no doubt there is another "comphrehensive department-wide review of the situation" happening as we speak and a "detailed report documenting the issues" will be published in the next few years ...so dont worry :rolleyes:

dare i say it ..... the forbidden words ...... BUILD A NEW HOSPITAL :eek:

ps do all the workers in our new yuppie fitness centres count as "health workers"?? theres your increase right there lol

BOHSBOHS

BOHSBOHS wrote:

u cant have a 10% population increase due to immigration and just expect our few existing hospitals to cope. they clearly arent ,

This thread is not about that topic.While I'm at it,I've been to A&E many times and its often populated at peak week end times by drunken Irish people wasting time.
I've yet to actually see any immigrants[read foreign] people forming any significant part of the queue.

silverharp

I've no numbers to back this up but it is my guess that we are not training enough medical staff. No new medical colleges were openened in the 90's, we have an ageing and growing population, and there is a 10-15 year lead time to train competent staff. It's beyond me that they don't heed the ERSI's reports and plan accordingly

MrPudding

The numbers are increasing, in health, but I don't think it is frontline. I have heard that there are between 3 and 6 "administrators" for every available bed in the health service.

I think a good old fashioned management cull is needed. Of course, because this is a union protected, job for life regardless of performance easy number it will never happen.

I was listening to a consultant (vested interest I know but what he said makes sense) on Newstalk a couple of weeks ago. He was saying that a lot of the people running the HSA now have simply moved through the ranks.

What this means is you could have a man that joined the civil service 30 years ago straight out of school with no qualifiacations. He has never beened judged on his performance and now finds himself in a very senior position, not because of any particualar skill in what he does, simply because he has been there for years.

What the consultant was saying is that a lot of these people havn't got a rashers what they are doing and they are wasting money hand over fist making stupid decisions. Sounds possibl to me.

MrP

ISAW

MrPudding wrote:

I think a good old fashioned management cull is needed. Of course, because this is a union protected, job for life regardless of performance easy number it will never happen.

What this means is you could have a man that joined the civil service 30 years ago straight out of school with no qualifiacations. He has never beened judged on his performance and now finds himself in a very senior position, not because of any particualar skill in what he does, simply because he has been there for years.

What the consultant was saying is that a lot of these people havn't got a rashers what they are doing and they are wasting money hand over fist making stupid decisions. Sounds possible to me.

MrP

I spoke to someone today who informed me of a home economic third level college which is "closing down" and being relocated in sligo. Apparently the student intake has been stopped and they are phasing out students over the four year cycle. They are half way through this. so they now have half the students. But here is the rub. they still have all the teachers. One teacher has no teaching hours and two have one hour a week. Someone will have to find jobs for them sometime but for the next two years at least more will join their ranks and they will get full pay! the same happened when Careysford college was closed. How can we allow skilled people to be encouaged to get paid for doing nothing?

BOHSBOHS

firstly earthman lose the attitude with me

of course immigrants dont form a "significant part of queues" they make up a small percentage of the population , but they in only a few short years
have pushed up demand for our health services where they were already operating at full capacity or maybe immigrants dont get sick,drunk,injured or killed earthman? :rolleyes:
its basic common sense : population increase leads to health services demand increase, no increase in capacity in the health services = problem.

as u correctly stated the other aspect of the crisis is the increase in alcohol
abuse by irish people who feel more affluent after years of economic success
with more money in their pockets to blow on drink , and its huge problem in irish society with attitudes and habits towards drinking being formed at increasingly younger ages ( take a trip into town on junior cert results night if u want to see the extent of the problem)

mr pudding , although the HSE has been formed and the individual health boards scrapped , the supposed benefits of this streamlining have not really occured , the various managers in the different boards were all shifted sideways and new jobs created in the hse to accomodate them where perhaps there shouldnt be jobs at all ....as u said union protection. (unions/social partnership the future death of our economy ...but thats another thread )

BOHSBOHS

BOHSBOHS wrote:

firstly earthman lose the attitude with me

Well back up your assertions regarding the amount of immigrants chocking up the health services with statistics then rather than what looks like I heard this and I heard that...Such things dont cut it.statistics would.
The main problem is A&E and waiting lists.If you didnt have anything other than a prejudicial preperceived supposition that they are to blame, then you could say that and people could understand that youwere expressing an opinion in an uninformed way.

of course immigrants dont form a "significant part of queues" they make up a small percentage of the population , but they in only a few short years
have pushed up demand for our health services where they were already operating at full capacity or maybe immigrants dont get sick,drunk,injured or killed earthman? :rolleyes:
its basic common sense : population increase leads to health services demand increase, no increase in capacity in the health services = problem.

Well why mention immigrants specefically then? If not only to slip in a little racism for no apparent reason other than you wanted to.

BOHSBOHS

who said anything about blaming immigrants??
im blaming the government for failing to provide the services cope wit hthe increase demand

see earthman if u actually read peoples posts before having a coronary everytime someone mentions immgration ......:rolleyes:

1. our population has increased . do u deny this ?
2. this increase is due to immigration. do u deny this ?
3. this has increased demand for basic services inc health . do u deny this ?
4. the government has failed to increase services to meet demand . do u deny this ?

where is the rascism ?
for a mod u certainly throw around a good few accusations
maybe u need to check your own charter regarding civility towards other
posters , im sure calling me a racist doesnt fit in well...
theres only one person using " prejudicial preperceived suppositions "
and it isnt me brother ,

coolhandluke

The entire problem in the health service is down to 2 things
1.the lack of step down beds or "bed blockers" as they are known
2.the work practices of consultants (not nurses or junior doctors now but consultants,they have far too much power in hospitals)

BOHSBOHS

BOHSBOHS wrote:

who said anything about blaming immigrants??
im blaming the government for failing to provide the services cope wit hthe increase demand

You did.

see earthman if u actually read peoples posts before having a coronary everytime someone mentions immgration ......:rolleyes:

Well read your own then.

1. our population has increased . do u deny this ?

Never did.

2. this increase is due to immigration. do u deny this ?

only in part is it due to immigration.

3. this has increased demand for basic services inc health . do u deny this ?

See now that your surface has been scratched you are trying to state something again as a fact without the facts.
Why does it not surprise me that this is to make a fly by comment on immigration...

4. the government has failed to increase services to meet demand . do u deny this ?

Here you are again posting comment as fact.Services are not meeting demand for several reasons including bad management.Spending money on a hospital wing without thinking of the resources needed to staff it for instance.

where is the rascism ?
for a mod u certainly throw around a good few accusations
maybe u need to check your own charter regarding civility towards other
posters , im sure calling me a racist doesnt fit in well...
theres only one person using " prejudicial preperceived suppositions "
and it isnt me brother ,

Well it is you who posted the following..."u cant have a 10% population increase due to immigration and just expect our few existing hospitals to cope. they clearly arent ,"
You were asked in another thread to back up this 400,000 immigration figure and you declined.Your attitude to foreign immigration was clear in the same thread so dont expect posters here not to join the dots between threads when you post.
It's simply not the case that you can get away with having one attitude in one thread and try to pretend a different one in another.
You will be picked up on this.

As for your comments on modding...Well as mod I'm telling you not to express opinion as fact.
It's clear in the charter that you must state that it is only your opinion and not a fact unless you can back it up with facts.
Thats all you are being asked to do here.If you are taking issue with that,I suggest you post with more beef to back up your opinion and state that it is opinion that you are giving when that is all that it is.
If you were doing that already,we wouldnt be having this part of our discussion.
Remember this is a discussion forum and not a drive by Rant forum.

murphaph

BOHSBOHS wrote:

mr pudding , although the HSE has been formed and the individual health boards scrapped , the supposed benefits of this streamlining have not really occured , the various managers in the different boards were all shifted sideways and new jobs created in the hse to accomodate them where perhaps there shouldnt be jobs at all ....as u said union protection. (unions/social partnership the future death of our economy ...but thats another thread )

Yeah I'd agree on that. The benefits, if they ever come, will take years as people retire and their 'workload' is transfered to someone else rather than to a new hire. There's oodles of duplication in the HSE at all levels (although most of my infor comes from the IT side of things as I know someone working for them in there). They won't make any mass culls, they want to gradually transfer work to fewer people, which sort of makes a bit of sense on a purely pragmatic level (read: mass cull = mass strikes and a lot of unemployed people). If it took say 20 years to scale the HSE admin down by simply not hiring it wouldn't be too bad. Each time an admin retires you can hire a nurse or doctor and the cost shouldn't go up but the service should. Very simple way of looking at it I know but probably not too far from what's planned (if any planning actually takes place that is!).

ISAW

Earthman wrote:

Well back up your assertions regarding the amount of immigrants chocking up the health services with statistics then rather than what looks like I heard this and I heard that...Such things dont cut it.statistics would.

But to be fair he only replied to YOUR comment that:

While I'm at it,I've been to A&E many times and its often populated at peak week end times by drunken Irish people wasting time.

Which is you personal opinion and not in any way statistical.

The main problem is A&E and waiting lists.If you didnt have anything other than a prejudicial preperceived supposition that they [emigrants] are to blame, then you could say that and people could understand that youwere expressing an opinion in an uninformed way.
Well why mention immigrants specefically then? If not only to slip in a little racism for no apparent reason other than you wanted to.

I agree that the main problem is A&E. I also believe people coming into the counrty soak up resourses. the lareges group of immegrants are - IRISH people! But people coming back or foreigners coming here do drain childcare, health board etc. From my own observations foreigners represent a minority of people in the local health board but this might well be offset by an immegrant "black spot" i.e. a town with a large number of foreign immegrants might well have most of the local clinic filled with foreigners. Also from personal experience there are many many foreigners in the public pre natal clinics of maternity hospitals in Dublin City but few in the private waiting rooms.

I would add "and why not" . they contribute to the economy and the society so they have every right to partake in the services which sociey has. I dont think they are a drain since in my opinion by and large they contribute more than they use. Likewise with Irish returning home. The "drain" is people who were already here not contributing and using the resources whether Irish or foreign and the vast vast majoroity of them are Irish. I wouldnt judge them for that. take the old for example. they are a drain but have every right to be so. It is not ageist to say that nor is it racist to say foreigners are a drain iof they are so. I happen to believe then are on the whole not so.

My main point is who is doing all these extra jobs and what are they doing.

ISAW

murphaph wrote:

If it took say 20 years to scale the HSE admin down by simply not hiring it wouldn't be too bad. Each time an admin retires you can hire a nurse or doctor and the cost shouldn't go up but the service should. Very simple way of looking at it I know but probably not too far from what's planned (if any planning actually takes place that is!).

If that is supposed to be a plan then I feel sorry for the person with treatable cancer who can look forward to the fact that if his child gets cancer in 20 years time then by then there will be the staff there to treat their child and not allow it to become terminal. Unlike the parent who wont be around to see the child cured. guess why?

murphaph

ISAW wrote:

If that is supposed to be a plan then I feel sorry for the person with treatable cancer who can look forward to the fact that if his child gets cancer in 20 years time then by then there will be the staff there to treat their child and not allow it to become terminal. Unlike the parent who wont be around to see the child cured. guess why?

Heck I wasn't particularly trying to defend it but I reckon that's what's going to happen. However, I would like to see figures for people who've died of cancer as a direct result of the state of the health service. A&E is in bits alright with people being treated like cattle (not the fault of the frontline staff) but cancer patients perishing, is this really a problem?

ISAW

ISAW wrote:

But to be fair he only replied to YOUR comment that:

Which is you personal opinion and not in any way statistical.

Actually I was replying to his post which happened to be the first reply to this thread and contained the unsubstantiated drive by comment.I'll agree mine is unsubstantiated also.Theres no doubt that a tiny percentage of the load on the health service is from both returned Irish immigrants and new EU immigrants.
But to suggest what was suggested by the throw away comment "u cant have a 10% population increase due to immigration and just expect our few existing hospitals to cope." was ludicrous.

Captain Trips

coolhandluke wrote:

The entire problem in the health service is down to 2 things
1.the lack of step down beds or "bed blockers" as they are known
2.the work practices of consultants (not nurses or junior doctors now but consultants,they have far too much power in hospitals)

Actually the people who are in far more of a power position are the Clinical Nurse Managers. The consultants don't decide resources, planning, expenses, all the dayto day stuff. You'll find the managers of the hospital are by and lrge entirely composed of nurses or ex-nurses.

Nursing Administration in the hospitals are allocated on site with the executive adminstration (have a look at the major hospitals), and medical administration is usually in a bunch of prefab blocks, and spread over several sites.

Cork

coolhandluke wrote:

The entire problem in the health service is down to 2 things
1.the lack of step down beds or "bed blockers" as they are known
2.the work practices of consultants (not nurses or junior doctors now but consultants,they have far too much power in hospitals)

Consultants have too much power.

What our Health System needs is Managers - who will be accountable for budgets and service delivery.

darkman2

It would be interesting to ask the INO this question:

How much of the 13 billion put into health every year goes on wages?

Meanwhile they are looking for more money. We spend 50% more per head on health then the UK. Its work practices that have to change IMO. Get the drunks out of A&E too.

Widgeon

[: dare i say it ..... the forbidden words ...... BUILD A NEW HOSPITAL :eek:

Just clean and open some of the existing wards for now.

ISAW

Cork wrote:

Consultants have too much power.

Really ? Since you claim to know it what powers do they have that you think should be removed? and to whom should these powers be given?

What our Health System needs is Managers - who will be accountable for budgets and service delivery.

It has loads of them 45,000 extra (mainly administrators) over the last eight years. The think is they do NOT seem to be accountable but seem to be guaranteed contracts for life.

The government has been in power over that time but The Labour Party will not attack these people because their power base is the beaurocrat. I am surprised FG don't mention the plethora of extra admin when supposedly there was an embargo on public service jobs.

The system is costing us a fortune. tens of billions and we are not getting better health care. And the money has not all been soaked up by consultants. firstly they make more money on the other side of their wage packet in private care. Secondly how many more consultants are there since 1998. Probably none since there is a ratio of consultants to doctors and there ane little to no extra junior doctors.

when the problems will arise is when (in 2012 I think) the working time directive is enforced in health. Then doctors will be forced to work a 40 hour week. they will take a big pay cut but also half the capacity will disappear . In short they need to double the amount of doctors. About 4-5000 should see us straight. We have about five years to do it.

Cork

ISAW wrote:

Really ? Since you claim to know it what powers do they have that you think should be removed? and to whom should these powers be given?

Powers? Their job is to provide treatment for patients. The state has invested in their training. The state should get better return for this investment.

Better management is the system is needed. Reports of hospital staff arriving late should not be tolerated.

Every cent being spent needs justification. Effort needs to be put into effective service delivery. The spend has been tripled. The service should have seen an improvement.

ISAW

Cork wrote:

Powers? Their job is to provide treatment for patients. The state has invested in their training. The state should get better return for this investment.

Maybe true but beside the point. You said consultants have too much power. so ? What powers do they have what do you take form them and to whome do you give it?

Better management is the system is needed. Reports of hospital staff arriving late should not be tolerated.

I agree. dont tolerate the reports! And fire the people making them as well.

Every cent being spent needs justification. Effort needs to be put into effective service delivery. The spend has been tripled. The service should have seen an improvement.

It did! The number of admin improved.