What would you do to sort out the HSE?

blackcard

We have had a succession of Ministers for Health from Mary Harney to Brian Cowen to Michael Martin to Leo Varadkar. We have thrown billions at the Health Service. Any time I am in a hospital, I have found staff to be hard working and professional. But we still have patients on trolleys and long waiting lists. I would say that there is no ideological differences between the various parties as to the type of service we should provide. What would you do to sort out the Health Service?

The Randy Riverbeast

Same way I would fix the trolley issue. Charge thousands for medical treatment. That way there are less people, its better funded and the poor will die off.

Ken.

Pay the managers/non medical people what we pay a nurse and pay a nurse what we pay managers/ non medical people.

The Backwards Man

Scrap it and bring back the health boards.

The Backwards Man

ken wrote: »

Pay the managers/non medical people what we pay a nurse and pay a nurse what we pay managers/ non medical people.

I was going to say pay them what they're worth but I suppose we can't have the managers starve either. :P

wendell borton

The Randy Riverbeast wrote: »

Same way I would fix the trolley issue. Charge thousands for medical treatment. That way there are less people, its better funded and the poor will die off.

I already thought that was official FG policy.

Means Of Escape

Put the new children's hospital to be in the midlands rather than Dublin on 30 acres where the whole country can have easier access to its kind if needed

Make every citizen contribute something to their future medical needs rather than it bring free.

blackcard

ken wrote: »

Pay the managers/non medical people what we pay a nurse and pay a nurse what we pay managers/ non medical people.

That might be the right thing to do but we would end up with a more expensive HSE

Fleawuss

It cannot be done by any political party that hopes to be re-elected.

Taxburden carrier

Allow workers that can't or won't do the job they're being paid for be sacked.

suicide_circus

Give it back to the nuns!

strandroad

Invest in 2nd level clinics to ease the pressure on hospitals. Hospitals are now dealing with everything above GP level, it's not a sustainable use of specialised resources.

Manage staffing levels better to reduce costly overtime and agency staff dependency.

Create a central patient database across all levels of care, with medical and prescription history etc. to reduce administration and patients taking up beds waiting for their test results to arrive.

There's this massive pressure on resources due to preventable conditions caused by obesity, smoking, alcohol etc but I honestly have no idea how to tackle that. People just seem to want to eat and drink themselves into an early grave, it just costs a lot in the process.

Earthhorse

I don't understand the HSE or the problems facing our health system and I don't think most people do either or the problem wouldn't be so bad.

Having said that a fairly safe bet is identify highly paid people doing next to nothing, get rid of them and use the excess funds to better pay the staff and invest where it needs it, in any failing organisation.

stimpson

Free GP care for all and medical cards only for those that actually need them (chronic and terminal cases only)

Specialun

Accountability

c_man

What would you do to sort out the HSE?

I don't really know what needs to be done exactly, and how this could be implemented. It seems like such a mess. But given the scenario and the constraints of the thread idea, I'd start with the following

1 - Select a group of doctors, admins and experts in the area.
2 - Give them 18 months to start a program with some initial deliverables. We want the best possible health care, lowest waiting times etc etc
3 - Failure to meet the targets and they'll all be taken out and shot.
4 - Repeat with new group of experts if necessary.

Eugene Norman

We're I health minister i'd ask high level managers in the HSE to provide a plan to fix the issue. They can ask for more money but the costs must be justified. If the plan is useless they are fired

Jimoslimos

Means Of Escape wrote: »

Put the new children's hospital to be in the midlands rather than Dublin on 30 acres where the whole country can have easier access to its kind if needed

Yes, remind me where the vast majority of children live in this country?

Could you also factor in the cost, not just of the hospital, but in providing adequate infrastructure (roads, railways, accommodation etc) so people can reach some sh1thole in the middle of nowhere to get medical attention or indeed work there?

blackcard

Eugene Norman wrote: »

We're I health minister i'd ask high level managers in the HSE to provide a plan to fix the issue. They can ask for more money but the costs must be justified. If the plan is useless they are fired

Didnt they try something like that with Brendan Drumm?

Keith186

They could have a mandatory visit to the GP once a year (or two years at lower ages) where they nag you about eating healthier and doing more exercise kind of lecture tailored to the individual. If you don't go to that, you don't qualify for free treatment in hospital. Could improve general health by being more preventative.

Employ the qualified staff that is needed open up the wards that are close in all the hospitals and create a on call home medical care group that can call on people who their GP at the moment has to send to hospitals for check ups and other minor cases like a change of dressing and others that can easily be done by the home medical care group, of course all of this will probably cost extra money so bring in a low cost health contribution program that is affordable by all.

Jawgap

1. Bring in a proper compulsory redundancy scheme to get rid of the the deadweight.

2. Re-organise, and close most of the units/sites - every poxy little town doesn't have to have a hospital.

3. Develop and apply unified coherent IT and Data strategies and invest in technology

4. Bring in proper managers (on fixed term contracts) to run the service and empower them to do so, reward and sanction based on outcomes, not outputs or processes

5. Introduce a strong primary care focus

Superhorse

As someone who worked in the HSE and walked away from a well paying job for life with a decent future pension I have to say it can't be fixed. I went in to the job from the private sector and literally was stunned at the waste and lack of accountability from top to bottom. I just couldn't work in that environment for any longer as it is sole destroying. Also the health service is being let run into the ground as a means of "encouraging" people to sign up for private health cover and that has been the policy of the last two governments.

thee glitz

Jimoslimos wrote: »

Yes, remind me where the vast majority of children live in this country?

Not Dublin?

Could you also factor in the cost, not just of the hospital, but in providing adequate infrastructure (roads, railways, accommodation etc) so people can reach some sh1thole in the middle of nowhere to get medical attention or indeed work there?

Would it cost more to build a hospital down the country? There are already roads, motorways even, and railways in place. Accommodation too in many places. Many thousand people spend hours commuting to and from Dublin every day, and not out of any love of the place. Providing services and creating jobs outside of there would be widely welcomed.

quickbeam

Get the Scandanavians to come in and run it for us.

While we're at it, can we ask them to run the whole country for us?

c_man

quickbeam wrote: »

While we're at it, can we ask them to run the whole country for us?

*groan* look can all the people who continually hark on about how great Scandinavia is, move to one of their countries? A surprisingly few amount of them do. I wonder why...

maudgonner

EHS

quickbeam

c_man wrote: »

*groan* look can all the people who continually hark on about how great Scandinavia is, move to one of their countries? A surprisingly few amount of them do. I wonder why...

Actually, there's a very good chance I will.

Jimoslimos

thee glitz wrote: »

Not Dublin?

I should have said population density.

Regardless my point stands.

thee glitz wrote: »

Would it cost more to build a hospital down the country? There are already roads, motorways even, and railways in place. Accommodation too in many places. Many thousand people spend hours commuting to and from Dublin every day, and not out of any love of the place. Providing services and creating jobs outside of there would be widely welcomed.

It wouldn't cost more to build. It most definitely would cost more to run, and you're living in cloud cuckoo land if you think the infrastructure and services are adequate in the midlands to support it.

I'm all for developing areas outside of Dublin, but just plonking a big hospital in the middle of nowhere isn't the right way to go about it.

c_man

quickbeam wrote: »

Actually, there's a very good chance I will.

Ha! Well good for you. You'd be the first I've ever heard of doing so, during the crash all the main proponents of the Nordic model I knew from college fuked off to Oz, Canada and the UK. I just knew one guy who got a job in Finland. Threw it in after six months saying they were the most boring, alcoholic nation and he'd go daft.

Ken.

Even outside Dublin a bit would have done. Somewhere between Citywest and Naas. There's lots of greenfield sites and the closer to Citywest means you just have to add a bit to the already existing Luas line.

Jan Laco

[quote="mhge;98145959"

Manage staffing levels better to reduce costly overtime and agency staff dependency.
.[/quote]

There needs to be more staff during weekends as the weekends have similar workloads to working week, but with one third of the staff. Surgeons are bringing their private patients to public hospitals on weekends (taxpayers are paying nurses to do work of private profits).
But that would create more overtime pay...so maybe a 7 day working week needs to be introduced.

thee glitz

Jimoslimos wrote: »

I should have said population density.

Regardless my point stands.

My point is that most people don't live in Dublin. And many that do live outside the city.

It wouldn't cost more to build. It most definitely would cost more to run, and you're living in cloud cuckoo land if you think the infrastructure and services are adequate in the midlands to support it.

It wouldn't cost that much more to run and the benefits to society would make it worthwhile. There is a shortage of housing in Dublin, not so much in the midlands, even though accommodation is far less expensive. Why not take some of the pressure off the capital? It's a hospital, not the olympics.

I'm all for developing areas outside of Dublin

Except when it might mean inconvience for Dubs?

Anita Blow

Besides the obvious cutting of excess admin staff

1) Close many of the smaller regional hospitals and invest in larger centres. We have a higher complement of nurses than the OECD average but a lower nurse:bed ratio because so many of them are tied up in smaller centres full of elderly people awaiting discharge and not in larger centres where they're needed.

2) Increased investment in step-down facilities so the increasing elderly population can be discharged there when better but not ready for a return to home, rather than taking up acute beds while awaiting a spot in a nursing home or receiving some rehab.

3) Withdraw the free GP care for under-sixes. Access to healthcare should be based on need rather than ability to pay. Makes no sense that little Fiachra whose parents are well-off can take up limited GP resources for a cold meanwhile a 35 year old with CF on their 10th chest infection of the year must go without because they can't afford another GP visit.

Anita Blow

thee glitz wrote: »

My point is that most people don't live in Dublin. And many that do live outside the city.


It wouldn't cost that much more to run and the benefits to society would make it worthwhile. There is a shortage of housing in Dublin, not so much in the midlands, even though accommodation is far less expensive. Why not take some of the pressure off the capital? It's a hospital, not the olympics.

Except when it might mean inconvience for Dubs?

The hospital has to be co-located with maternity hospitals and with the large teaching hospitals. There's no point sticking it out in the midlands when the three national maternity hospitals are all in Dublin. A very sick neonate doesn't have the couple hours it would take to transfer from the Rotunda to somewhere in the middle of the country. Also needs to be attached to university hospitals to avail of the specialised services they offer and education of medical students of the three main medical schools.

thee glitz

Anita Blow wrote: »

The hospital has to be co-located with maternity hospitals and with the large teaching hospitals. There's no point sticking it out in the midlands when the three national maternity hospitals are all in Dublin. A very sick neonate doesn't have the couple hours it would take to transfer from the Rotunda to somewhere in the middle of the country. Also needs to be attached to university hospitals to avail of the specialised services they offer and education of medical students of the three main medical schools.

Some good points there. It could be colocated with a maternity hospital outside of Dublin city, maybe Blanchardstown. The simplest solution is keep everything in the city. With a bit of vision and planning, it needn't always be so. There are hospitals, universities, babies born and sick children outside of DCC.

Hammer89

I don't concern myself with these matters, but if several elected officials have tried and failed, then the answer probably doesn't lie with someone on Boards.ie.

You all seem to be talking in term of business like run hospitals, the problem with hospitals is A&E and all these designate hospitals where people has to travel miles is just simply not working not because its a bad system but because all the minor cases are sent there as well.

As always you're going to have someone sitting behind a desk and passing the calls onto someone else, there is a simple solution to the problem and that is listen to those on the floor who know how to do their job, in other words get rid of those fecking assholes to love problems because it give reason for their fat pay cheques.

Corpus Twisty

Are there no Taxi-drivers on AH? They generally have all the answers.

Cork Lass

Anyone who presents to A&E with a problem that could have been treated by a GPshould be charged at least double the standard fee. That would keep a lot of time wasters at home.

Jimoslimos

thee glitz wrote: »

It wouldn't cost that much more to run and the benefits to society would make it worthwhile. There is a shortage of housing in Dublin, not so much in the midlands, even though accommodation is far less expensive. Why not take some of the pressure off the capital? It's a hospital, not the olympics.

Except when it might mean inconvience for Dubs?

The most heavily populated areas in the country are on the east coast. Most of the major arterial routes originate from Dublin. Sticking a hospital in somewhere like Athlone doesn't necessarily mean less travel time.

Take a journey from the second largest city by car (using Google Maps)
Cork - Dublin: 2hr 40m
Cork - Athlone: 2hr 41m

Not even going to consider doing this journey by public transport.

I'm not arguing for a hospital to be built in the city centre. As another poster suggested, somewhere outside the M50/Blanch area would be best.

It has nothing to do with inconveniencing Dubs, it's about ensuring that the hospital serves the greatest possible population density and reducing the overall travel time.

oppenheimer1

blackcard wrote: »

We have had a succession of Ministers for Health from Mary Harney to Brian Cowen to Michael Martin to Leo Varadkar. We have thrown billions at the Health Service. Any time I am in a hospital, I have found staff to be hard working and professional. But we still have patients on trolleys and long waiting lists. I would say that there is no ideological differences between the various parties as to the type of service we should provide. What would you do to sort out the Health Service?

The problem with the HSE isn't a money issue per-se. Its extremely well funded. The truth is that many of the staff are relatively overpaid relative to their peers in other countries. This hoovers up resources and leaves the system short staffed. the ongoing crises in the health services play into the hands of the unions who want more gravy for their members - just look at the recent proposed strike over what was meant to be about patient safety and the reasons why it was called off:

RTE wrote:

A deal between the Health Service Executives and the Irish Nurses and Midwives Organisation, which has averted planned strike action, involves cash bursaries to attract nurses, promotions, extra annual leave and a review to establish appropriate staffing in emergency departments.

Its all about the gravy....

trixychic

Jimoslimos wrote: »

Yes, remind me where the vast majority of children live in this country?

Could you also factor in the cost, not just of the hospital, but in providing adequate infrastructure (roads, railways, accommodation etc) so people can reach some sh1thole in the middle of nowhere to get medical attention or indeed work there?

While I don't agree with putting the new children's hospital in the Midlands ( for the exact reason of lack of infrastructure- i.e. roads railways etc) I don't agree with where they are putting it either. Smack in the middle of Dublin city???

IMO all roads in the country eventually lead into the M50, and the luas runs out of the city bearer to tallaght. I would have thought putting it somewhere off the M50 where it can be reached easy enough. And it will have lots of room for playgrounds and walks and gardens etc.

trixychic

Earthhorse wrote: »

I don't understand the HSE or the problems facing our health system and I don't think most people do either or the problem wouldn't be so bad.

I have to agree. I am not 100% sure what exactly the problems are. All I know is that there are stupidly long wait lists and the hospital beds are always full.

Another problem... why can't Irish nurses work here??? They all normally have to go abroad coming straight out of college.

BattleCorp

Jimoslimos wrote: »

I'm not arguing for a hospital to be built in the city centre. As another poster suggested, somewhere outside the M50/Blanch area would be best.

I think time will show us that the site for the new children's hospital will be a disaster.

It will be poxy to get to. There will be no parking if you do get there. There won't be room for expansion in the future.

It will be a disaster.

A greenfield site on the edge of Dublin city in an easily accessible area is what was needed.

Terrible decision to locate it at St. James'.

Paulzx

oppenheimer1 wrote: »

. The truth is that many of the staff are relatively overpaid relative to their peers in other countries. .

Then why can't we attract enough Doctors and nurses into the system? The salaries on offer seem incapable of bringing Irish doctors and nurses into the system that are working elsewhere.

I would have thought that if our medical staff were overpaid as you say we would have people from all over the world beating the doors down to get a job in the gravy train that is the HSE.

Corpus Twisty

I've visions of Leo reading this thread with batted breath...dipping in and out, going "ah ffs lads, will ye be specific.."

All nursling home be required to train staff to give IV antibiotics, home care teams that can give IV antibiotics ( Vhi already have it ) Do everything possible to keep elderly people out of hospital that means more home care, step down fatalities that are not run by he state. Hospitals only for the acutely ill.

Roger_007

The problems of the HSE are not unique to this country. Any country where the average age of population is increasing is going to run into healthcare problems no matter what they do. Most healthcare resources are absorbed by the elderly simply because most health problems increase with age.
There seems to be almost an expectation that everyone can live forever and that death is not an acceptable outcome no matter what.
Because the proportion of the population which is paying the bills is decreasing all the time and because healthcare costs are increasing all the time, there is an inevitability that the point will come where the whole system becomes unmanageable and unaffordable.
Things are not going to get better, they are going to get worse.

blackcard

mariaalice wrote: »

All nursling home be required to train staff to give IV antibiotics, home care teams that can give IV antibiotics ( Vhi already have it ) Do everything possible to keep elderly people out of hospital that means more home care, step down fatalities that are not run by he state. Hospitals only for the acutely ill.

I think this is part of the answer. People are living longer but a lot of elderly people are in poor health and need a lot of care and attention and this is using a lot of resources and taking up hospital beds. If more elderly people could be cared for in nursing homes, it would release some of the pressure

Paulzx

Roger_007 wrote: »

There seems to be almost an expectation that everyone can live forever and that death is not an acceptable outcome no matter what.

I think you are way off the mark here.

People accept death. What they don't accept is undignified death in circumstances where care and respect is lacking. Most people are well prepared for the death of an 85 year old parent but they are not prepared for it happening on a trolley in a corridor with their parent in pain and frightened.

Just because a patient is terminally ill doesn't make the expense of their treatment a wasted resource. Prolonging life and quality of life due to medical science is something humans have aspired to for hundreds of years.

The problems of the HSE are most certainly not down to societies unreasonable expectation that illness abd death can be treated in a humane fashion