HSE proposed pay cuts for junior doctors from February 18th...

maninasia

Biologic wrote: »

You have no experience of being a doctor and you've spend the last 3 days telling doctors about it...

Deleted what I wrote as too inflamed, suffice to say read post above.

tallaght01

maninasia wrote: »

Deleted what I wrote as too inflamed, suffice to say read post above.

Sure, go see your doc, a simple case of inflammation can be dealt with in 2-5 mins

maninasia

Wood for the trees, wood for the trees. Can't help some people if they are not willing to learn. I supposed I should wait 2 years in Ireland for my 15 mins then or else pay 10 times Taiwan's rate to see a consultant, nice. Medicine for the rich and the poor and ****e in between.

tallaght01

maninasia wrote: »

Wood for the trees, wood for the trees. Can't help some people if they are not willing to learn.

The reality is that ignoring the patient/doctor interaction is "not seeing the wood for the trees"...exactly what you're accusing us of.

maninasia

maninasia wrote: »

I think a lot of you can't see the wood from the trees. Which is better for the patient, a 5 minute visit or NO VISIT? Optimum means absolutely nothing if you can't afford to avail of the optimum. Negligence is the state failing to look after the health of it's citizens by putting it financially out of reach.

A visit early in the disease progression state or late in the disease progression state?

Regular check-ups or infrequent check-ups?

A diversity of doctor's opinions or one opinion?

I'll take my 5 minute visit thanks very much and I can take it TODAY and EVERYDAY if I want (and it is often longer than 5 minutes anyway for more involved stuff), if I need more I can go to a private one or find a doctor who is less busy.

Repost.

tallaght01

maninasia wrote: »

Repost.

"no visit" isn't the benchmark against which we should judge healthcare.

maninasia

No visit means no healthcare, less visits mean later diagnosis of diseases, longer waits the same....it's simple isn't it. You have to start with access to healthcare before you talk about optimum healthcare.

dissed doc

maninasia wrote: »

No visit means no healthcare, less visits mean later diagnosis of diseases, longer waits the same....it's simple isn't it. You have to start with access to healthcare before you talk about optimum healthcare.

If there were productivity based financial incentives to doctors in Ireland as there is in Taiwan, perhaps visits would be shorter. Taiwan seems to work on a marketbased system and is not a generally funded free service. Netherlands works in a similar fashion to my knowledge, and the system works well. Unfortunately, it would require firing a lot of solid voters in the administration departments, so will never happen.

maninasia

Taiwan works under a universal health system, usually through contribution from labour income (although they also have a family and personal contribution system). The employer and employee contribute towards the health premium, in practice about 15-30 euro a month according to income level. The only part of society it lets down is the very poor and chronically unemployed, who rely on charity to pay their premium for them (opposite of Irish system which is weighted against honest working people). That is just a result of the society here which see self-reliance as being important.

After the premium contribution you don't have to pay much, 4 Euro for GP visit, 5-15 euro per hospital visit, practically free surgeries and hospital stays, very heavily subsidised meds and tests. One of the reasons it works well in Taiwan is the lower cost base for everything here (it must be emphasised that the equipment/training etc is world standard, in fact the facilities are superior to Ireland in many cases). To work such a system in Ireland you'd have to reduce the cost base across the board.

No system is perfect, there is certainly a productivity component (the hospital gets paid per patient/procedure from the government), sometimes it would definitely be better it they took more time. However the doctors also learn to work quickly too, in general the society is 2X faster paced than Ireland.

sam34

Ok, can we get this thread back on topic please.

the topic isnt the various styles of healthcare provision internationally, neither is it a doctors-are-greedy-and-overpaid soapbox.

maninasia

Nor is it your soapbox , where are the people saying 'doctors are greedy and overpaid' here. But if you inserted the word 'consultant' could you honestly argue with the statement? Thanks for your constructive contribution. I'm done here anyway.

sam34

maninasia wrote: »

Nor is it your soapbox , where are the people saying 'doctors are greedy and overpaid' here. But if you inserted the word 'consultant' could you honestly argue with the statement? Thanks for your constructive contribution. I'm done here anyway.

it's not my soapbox, but i mod this forum and as such it is up to me to ensure threads are not derailed by others soapboxing, among other things.

secondly, if you have a problem with mod decisions or instructions, then, as is site-wide policy, please take it to PM rather than disrupting the thread.

blackhorse139

As a new member on boards, can I bring some evidence to the debate. The WHO publishes a ranking of health services. The latest places Ireland at 19th and China 144th. Patient bias should always be excluded from any health service analysis

maninasia

Taiwan is not China, have you studied geography, know anything about Asia, this is embarrassing.

tallaght01

maninasia wrote: »

Taiwan is not China, have you studied geography, know anything about Asia, this is embarrassing.

I agree with you to an extent, in that the Taiwanese system is very different to the Chinese one. But, for political reasons, the WHO regards China and Taiwan as one and the same.

maninasia

That's like saying for political reasons 'chocolate' is the same as 'cheese', what is this a medical alterniverse?

Taiwan is an independent nation for over 60 years (although not fully recognised as such officially due to China), most of which it had absolutely no contact with mainland China, it is a parliamentary democracy with a medical system and infrastructure 50 years ahead of China. These is absolutely no crossover of state institutions or governing bodies...NONE.

Taiwan is an observer status member of the WHO, not being a UN member, this was only achieved over the last few years even though it has been applying for WHO membership for decades. They finally let Taiwan become an observer member when they saw the very dangerous hole left in global pandemic fighting systems during the SARS crisis. China had consistently blocked Taiwan's participation and then pretended to represent Taiwan at the WHO although the Chinese officials had never even set foot in Taiwan, they also didn't pass on messages to the Taiwan government as they should have during SARS and other crises.

Get your facts straight on this forum and we will have a debate.

tallaght01

Nothing you have said there is at odds with what I posted.

You're a pretty angry bloke. But I'd willing to talk about this more with you if you start a new thread.

Poor oul sam34 has enough to be doing on here singlehandedly without us messing up threads about conditions in the HSE.

maninasia

You are right I am angy because things are being misrepresented at every turn. You'd also be angry if you lived through the SARS crisis in Taiwan and saw the lack of support from the WHO and UN during that time but what a stand-up job local health workers did, many of which lost their lives in the process. I think there is something insular about a community who does not want to ask questions and learn more. I find this is a common island mentality in Ireland though, we are better because we say so. Being educated does not mean you cannot be ignorant (that goes for everybody around the world). You only get better by recognising the issues at hand and being open to learning from others. Learn from cricitism, debate the facts, consider where things can be improved.

People claiming the Irish system is better for the patient when on almost every metric except visit time it is not, it is also patently obvious that people who make these comments are almost entirely ignorant of the real facts. It's also indicative of a willful lack of perspective. Travel the world, look at things from different angles, don't check things just on the internet.

People saying Taiwan is in SE Asia, people even confusing Taiwan with China, people saying Taiwan is part of China under WHO which it is not, people saying I can't comment because I am not a Doctor, people saying I am attacking Doctor's pay when I am not, being accused of greed by working in business when I earn less than most healthcare professionals. Yes I am angry and I want to get the facts straight and that is why I am posting here even though I don't want to derail this thread further either.

maninasia

blackhorse139 wrote: »

As a new member on boards, can I bring some evidence to the debate. The WHO publishes a ranking of health services. The latest places Ireland at 19th and China 144th. Patient bias should always be excluded from any health service analysis

What does this actually mean? Is there anything useful in this whole statement?

opinion guy

maninasia wrote: »

People claiming the Irish system is better for the patient when on almost every metric except visit time it is not, it is also patently obvious that people who make these comments are almost entirely ignorant of the real facts. It's also indicative of a willful lack of perspective. Travel the world, look at things from different angles, don't check things just on the internet.

Ok hold up here. People are NOT saying the Irish system is good. In fact we think its pretty appalling - mainly because there are not enough doctors, they work shifts that are too long and weeks that are too long. But it is better than a system where doctors work even longer shifts, have shorter patient visits and work more frequent call.

You can't take a system that is **** for reason X, then compare it to a second system that has even more reason X, and then claim the second system is better

blackhorse139

The WHO figures were quoted to give some independant statistcally based figures to the discussion not to provoke argument on Tawain's sovereignty. If the WHO's figures on China are not representative of Taiwan , produce some figures ; infant mortality, maternal mortality, life expectancy etc. A health service is no solely determined by the cost and time one man spends with his doctor. I am open to be convinced !

tallaght01

Well why doesn't someone start a new thread comparing Ireland's system to others.

maninasia

blackhorse139 wrote: »

The WHO figures were quoted to give some independant statistcally based figures to the discussion not to provoke argument on Tawain's sovereignty. If the WHO's figures on China are not representative of Taiwan , produce some figures ; infant mortality, maternal mortality, life expectancy etc. A health service is no solely determined by the cost and time one man spends with his doctor. I am open to be convinced !

I don't need to, I've said enough already on Taiwan's system, it's been done to death. You quoted what are undoubtedly false Chinese figures contributed to the WHO that have no relation to the debate at hand and I have clearly outlined the rather massive mistake that was from a number of different angles.

Good idea to start another thread, somebody go for it.

maninasia

opinion guy wrote: »

Ok hold up here. People are NOT saying the Irish system is good. In fact we think its pretty appalling - mainly because there are not enough doctors, they work shifts that are too long and weeks that are too long. But it is better than a system where doctors work even longer shifts, have shorter patient visits and work more frequent call.

You can't take a system that is **** for reason X, then compare it to a second system that has even more reason X, and then claim the second system is better

I think you mean the system is better for the doctor, not for the patient . I don't want to repeat myself ad nauseum but Taiwan has a better health system than Ireland by most metrics (not all) from the perspective of a patient, stop misrepresenting the situation! Even a monkey would know it if they had experience of both systems.

Nowhere was it mentioned doctors work longer shifts are have more frequent calls. Many private doctors may do by their own discretion of course.

ORLY?

maninasia wrote: »

but Taiwan has a better health system than Ireland by most metrics (not all) from the perspective of a patient

That's very interesting if true, can you provide any objective metrics and their sources?

maninasia

Honestly speaking I'm not a healthcare expert, I can only give some reasonable insight into both systems, their costs (I've shown that Taiwan does more with less), their availability, their diversity, their facilities etc.

I've described that already. As for metrics, please search online yourself but you cannot take from the WHO website as it is politically influenced.

http://prescriptions.blogs.nytimes.com/2009/11/03/health-care-abroad-taiwan/
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/
http://findarticles.com/p/articles/mi_m0843/is_4_31/ai_n15874711/

ORLY?

maninasia wrote: »

Honestly speaking I'm not a healthcare expert, I can only give some reasonable insight into both systems, their costs (I've shown that Taiwan does more with less), their availability, their diversity, their facilities etc.

I've described that already. As for metrics, please search online yourself but you cannot take from the WHO website as it is politically influenced.

http://prescriptions.blogs.nytimes.com/2009/11/03/health-care-abroad-taiwan/
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/
http://findarticles.com/p/articles/mi_m0843/is_4_31/ai_n15874711/

So, cutting through the waffle, the answer is no, you can't produce any of the metrics which show that the Taiwanese system is better than the Irish system. Your claim is completely baseless then. I'm not saying it's false, but you have no evidence other than opinion and anecdote for it being true.

sam34

seriously.

take it to a new thread or to PM


this thread is about HSE's treatment of NCHDs

Jane5

Anyone see this???

http://www.imn.ie/index.php/news/3807-ireland-in-breach-of-european-working-time-directive

Quote from article:


"One hospital also told IMN that in countries where the Directive has been successfully implemented, they have hired additional NCHDs, whereas HSE policy is to reduce the numbers of NCHDs and increase the number of consultants, which hasn’t happened.
As reported by IMN in January the European Commission has already issued Ireland with a letter of formal notice about our failure to comply with the Directive, and the Department of Health demanded a plan form the HSE to show what measures were being taken to improve compliance.
The Department last week refused to give an update on its contact with Europe in relation to our EWTD compliance saying those dealings were “confidential”.
However it did confirm that measures are being taken to allow for greater flexibility under the Directive.
“The Department has recently engaged with relevant stakeholders (HSE, IMO, training colleges, IBEC) on proposed amendments to the earlier transposition of the Directive with a view to allowing greater flexibility in relation to the use of compensatory rest provisions as allowed for in the Directive. It is envisaged that an amending Statutory Instrument will be made before year end”, a spokesperson told IMN."


In other words, those few interns who occasionally were allowed to go home at 12 noon after being on all day the day before and up all night also, will now work the 35 hour days and endanger their patients and their own health. Like the SHOs and registrars have been doing all along.


I can't even believe they are talking about, not HIRING MORE DOCS TO WORK LESS HOURS EACH AND CUT THE OVERTIME BILL, but instead, making it "legal" to work what are illegal hours.


Everyone still invertebrate here? Yeah? Nobody up for a good long strike? Thought not.


"

tallaght01

sam34 wrote: »

seriously.

take it to a new thread or to PM


this thread is about HSE's treatment of NCHDs

BUt the other thread about it got locked!!!!