Are the Irish people happy with way things are in this country?

Sceptic Orwellian

Hi everyone,

I am international student and I have been in Ireland for the last four years. Throughout these four years I have seen both good and bad things, like all places of course. But the "bad" things I saw in this country I have not seen anywhere else, certainly not in first world countries. I come from a third world country and some of the things I saw happening in this country would never happen back home.

Let me start with what makes my blood boil the most. Your public healthcare system. Utter chaos. Madness. Warzones. Looted from top to bottom with impunity. People on trolleys. People in pain on waiting lists. People leaving their jobs and families behind and flying to the Continent and the States to get their health back. It is utter shambles and unacceptable for a first world country. I thought my country (which again, is third world) and several other countries I've been to had the worst healthcare systems, but after seeing what I saw here, I have instructed my friends to fly me back home if I ever needed to be admitted non-urgently to one of these public hospitals. You will never see scenes like this back home, never. And if you did, the people will be on the streets the next day with the health minister resigning. Luckily, private health insurance is mandatory here for non-EU people like me.

It is very unfortunate because this country has excellent colleges that trains highly skilled professionals. But what good is it when an Irish citizen cannot access the care he or she needs? What good is it when these Irish citizens leave the country of their birth because of the way things are here?

Moving on to political corruption and nepotism, both of which I have noticed are rampant here. I was speaking to a very nice elderly Irish woman the other day who just had a knee replacement and she told me that she was on the waiting list for two years. Two years in constant pain. When she could not take it anymore, she called her local TD and explained her situation to him, two days later she gets a phone call from the hospital asking her to come in for her surgery the next week. If a politician has a say on whether or not a person is in pain, then this country is doomed. And again, this would never happen to a citizen back home. This lady was an elderly Irish citizen. She was born here and lived here all her life. She deserves the best treatment from her public healthcare system.

Why are the Irish people silent about what is going on in this country? Is this what the men and women of 1916 fought and died for? Why don't they get out on the streets just like they did against the water charges? If health is not important then what is?

And to those who say: "at least things are better than (insert third world country here). No it is not, it is absolutely not. I love Ireland, I love the Irish people, but this is not a country that I would want to settle in.

Inquitus

Try getting healthcare in the US for free.....it's not perfect but its better than a lot of places. Cancer treatments and outcomes are good and well delivered, emergency care is good if its truly an emergency. The issues come in when you get to getting elective stuff done, and in non-emergency situations. I have lived in the UK in the past and it was a similar experience.

Your post from a year ago said you had just arrived.

No system is perfect.

Sceptic Orwellian

I completely understand that and that is what I have been told and that is what I have seen. But that is not an excuse for the thousands on waiting lists. These things do not happen in most third world nations. This is a national emergency.

Ireland is a first world country. A first world healthcare system is what is expected. TDs getting to decide who gets to be in pain and who gets treatment? Really? What if an Irish citizen does not know anyone? Should he or she languish in pain?

The problem lies with your corrupt, disgusting politicians. Your corrupt government. Your corrupt political apparatus. They enable the rampant nepotism and corruption amongst citizens.

The men and women of 1916 are rolling in their graves.

CrankyHaus

Interesting OP. I've increasingly noticed that non-Irish people tend to go back to their home country for healthcare if they have a serious problem.

It seems the default for Americans and most Europeans, recently I spoke with a Chinese man who went home for his cancer treatments while continuing to live in Ireland.

When people with the option vote with their feet to get treated elsewhere it's evidence that our health system is relatively poor.

TJ Mackie

1 year, 3 months ago:

Sceptic Orwellian wrote: »

Hello there,

I just moved here from the UK and I seem to be quite confused at the pre-existing conditions rules regarding VHI policies.

Today:

Sceptic Orwellian wrote: »

I am international student and I have been in Ireland for the last four years.

Which is it?

EdgeCase

What happens usually isn't "corruption" it's at worst clientelism or constituency service. No money changed hands, she didn't buy influence. She used her elected representative to represent her.

Anyone can call their local TD and ask them to figure something out for them. That's part of what they do as public reps. They're not acting as gate keepers, they're just capable of making a formal representation on behalf of a constituent. Usually they don't even have any special access. It's just a case of raising an issue.

TD can and will advocate on behalf of their constituents - that's a big part of Irish (and other) democracies and isn't in anyway corruption.

If she was on a waiting list for that long, she's also entitled to use the NTPF (National Treatment Purchase Fund) to accass a private hospital or EU cross border treatment options.

The local TD's office lifted phone, called the hospital, asked what the hell is going on. He or she most certainly isn't deciding who gets treatment.

That isn't corruption.

Irish people will also tend to contact their representatives very quickly if they're having any issue with the public services. They often can help find information, ensure rights are upheld and so on.

It's nothing whatsoever to do with buying influence, nepotism or corruption.

Aspects of the health system work well, other aspects are ridiculous. The A&E mess it totally unacceptable and isn't being resolved.

Sceptic Orwellian

The latter. This is my brother's account who has recently joined me here and is already utterly shocked by the stories I am telling him.

Once again, I love Ireland and the Irish people, and this is just a rant for a foreigner who has nothing to do with this country other than education and a love for its people, culture, and history. I have noticed that most Irish people tend to be blindly patriotic, not seeing the faults in their country. I am sure that when they, God forbid, end up ill like that poor lady, and don't have health insurance nor the means to fly anywhere else, they will see things differently.

I ask once again, why don't the Irish people do something about it just like they did with water charges?

Sceptic Orwellian

EdgeCase wrote: »

What happens usually isn't "corruption" it's at worst clientelism or constituency service. No money changed hands, she didn't buy influence. She used her elected representative to represent her.

Anyone can call their local TD and ask them to figure something out for them. That's part of what they do as public reps. They're not acting as gate keepers, they're just capable of making a formal representation on behalf of a constituent. Usually they don't even have any special access. It's just a case of raising an issue.

TD can and will advocate on behalf of their constituents - that's a big part of Irish (and other) democracies and isn't in anyway corruption.

If she was on a waiting list for that long, she's also entitled to use the NTPF (National Treatment Purchase Fund) to accass a private hospital or EU cross border treatment options.

The local TD's office lifted phone, called the hospital, asked what the hell is going on. He or she most certainly isn't deciding who gets treatment.

That isn't corruption.

Irish people will also tend to contact their representatives very quickly if they're having any issue with the public services. They often can help find information, ensure rights are upheld and so on.

It's nothing whatsoever to do with buying influence, nepotism or corruption.

Aspects of the health system work well, other aspects are ridiculous. The A&E mess it totally unacceptable and isn't being resolved.

Sorry just noticed the quote button. The lady told me that the TD was her husband's friend and therefore a family friend. This sounded scary because there are surely those who go about with life with no "politician" friends, and if they get ill, are they supposed to languish in pain just because they don't know someone higher up the chain? So what you are saying is that a TD will respond to all and everyone who come to his or her "help"? I find that hard to believe.

Inquitus

EdgeCase wrote: »

The A&E mess it totally unacceptable and isn't being resolved.

Aye the key takeaway really has to be don't assess the whole healthcare system off the back of a visit to A&E. That's Irish Healthcare at its very worst.

munchkin_utd

The irish dont like paying taxes, and wont vote for politicans who would suggest that stuff costs money, because patently thats just a lie. Stuff like transport and water and medical systems just fund themselves by magic.

Local taxes were abolished because that was an evil tax, and it won the party suggesting it the general election.
Water charges had to be abandoned because that'd be double taxation

Yet, everyone wants more stuff, and lower taxes.
It is bonkers.

In Germany theres a small extra tax/ insurance for old age care, extra tax/ insurance for medical system, extra tax for the pension - beyond general social insurance, but that'd never work in Ireland because stuff should be free and funded by magic / someone else

EdgeCase

Sceptic Orwellian wrote: »

Sorry just noticed the quote button. The lady told me that the TD was her husband's friend and therefore a family friend. So what you are saying is that a TD will respond to all and everyone who come to his or her "help"? I find that hard to believe.

Try calling one and explain you're a constituent who votes.

Ireland has multi-seat constituencies which means that you've up to 5 sitting TDs in each district, constantly in battle for votes whether there's an election coming up or not.

If they don't provide excellent constituency service, they'll often lose their seat as one of their colleagues will step in to the gap and work their rear off for a constituent.

TDs are often so focused on constituents and responding to queries, letters, emails and face to face meetings that they do relatively little work on national legislative issues, which is their primary role. They has always been a big issue in the Irish system. It tends to be incredibly focused on local issues and the central government can sometimes be running on autopilot.

If you call a local TD (or write to them) about an issue I guarantee you will get a very detailed reply, research carried out, letters sent on your behalf querying things and making representations.

They quite literally will respond to some of the most ridiculous requests. Their currency is votes. If they don’t represent their constituent, they don’t get any and it’s a very interpersonal relationship where they are always at the end of the phone if someone has an issue.

Allinall

Sceptic Orwellian wrote: »

I ask once again, why don't the Irish people do something about it just like they did with water charges?

Do you not see the connection between people refusing to pay water charges and our ( possibly) under-funded health service?

For what it’s wirth, I know several people who have had excellent experiences with cancer diagnosis and treatment in the Public Health Service .

Sceptic Orwellian

EdgeCase wrote: »

Try calling one and explain you're a constituent who votes.

Ireland has multi-seat constituencies which means that you've up to 5 sitting TDs in each district, constantly in battle for votes whether there's an election coming up or not.

If they don't provide excellent constituency service, they'll often lose their seat as one of their colleagues will step in to the gap and work their rear off for a constituent.

TDs are often so focused on constituents and responding to queries, letters, emails and face to face meetings that they do relatively little work on national legislative issues, which is their primary role.

I see now. I guess this is genuinely good then if the main job of the local politicians the Irish people vote for is to look after them. But does that really address the main issue? Turning the healthcare system into a political football field only makes things worse.

Wheeliebin30

Waiting lists?

You know 40% or thereabouts don’t turn up for appointments?

That’s what’s stoppInt the real people in need from accessing the help they need.

Ignorant self important people who couldn’t be bothered to ring and cancel appointments.

Sceptic Orwellian

Sceptic Orwellian wrote: »

Sorry just noticed the quote button. The lady told me that the TD was her husband's friend and therefore a family friend. This sounded scary because there are surely those who go about with life with no "politician" friends, and if they get ill, are they supposed to languish in pain just because they don't know someone higher up the chain? So what you are saying is that a TD will respond to all and everyone who come to his or her "help"? I find that hard to believe.

This is a small country and TDs are elected with about 8,000 votes and represent about 20,000 people. They often hold open meetings where you can walk in and complain if you don't have a direct contact.
Often they don't do anything other than send a letter to the correct person but that might be enough to get the right person to look at your file. Healthcare and planning are the two notorious areas where people struggle with bureaucracy and want politicians to make a representation to the organisation. I imagine it is almost non existent in tax and justice.

Sending a letter no matter how pointless or useless it might be will get you a few votes and could be the difference between being elected or not.

EdgeCase

I know of one old lady who used to call the local TD to come around and change her light bulbs and fix the sink - and what's worse he did it!

LeinsterDub

munchkin_utd wrote: »

The irish dont like paying taxes, and wont vote for politicans who would suggest that stuff costs money

Our health is fundamentally broken. It's the worst of all worlds. Some what public some what private. We are spending massively on it too. If we went with the NHS model it would be unlikely to be more expensive.

https://www.google.ie/amp/s/www.rte.ie/amp/923592/

Sceptic Orwellian

EdgeCase wrote: »

I know of one old lady who used to call the local TD to come around and change her light bulbs and fix the sink - and what's worse he did it!

I guess it is good then if TDs are genuinely taking care of citizens and their everyday problems in that way and I sincerely hope they do that for all who come to their help even after they are long elected (not for changing light bulbs of course :pac:)

EdgeCase

Sceptic Orwellian wrote: »

I see now. I guess this is genuinely good then if the main job of the local politicians the Irish people vote for is to look after them. But does that really address the main issue? Turning the healthcare system into a political football field only makes things worse.

There are a number of major issues in healthcare here.

They're largely not political, they're mostly administrative and organisational but what has tended to happen is any minister who's tried to tackle them hard has found themselves badly burnt by the system and usually pilloried by the media and the electorate.

We've also had very significant population growth and relatively little expansion of A&E and acute hospital facilities. That was compunded by a complete pause in public sector recruitment, capped wages and so on due to the 2008 financial crisis and bailout T&Cs which drastically capped public expenditure. We are only really back to normal for the last few years.

There's also a legacy issue where we haven't ever had a normal public health service. Instead we has a public system that evolved out of a private and charitable system where the state began to pay more and more of the bills as it evolved, but never fundamentally turned it into a genuine public system.

It's actually quite well funded. It's just extremely badly organised. I often feel like it's more of a collection of hospitals rather than a system.

Wheeliebin30

LeinsterDub wrote: »

Our health is fundamentally broken. It's the worst of all worlds. Some what public some what private. We are spending massively on it too. If we went with the NHS model it would be unlikely to be more expensive.

https://www.google.ie/amp/s/www.rte.ie/amp/923592/

Isn’t the NHS in just as much turmoil?

realdanbreen

Wheeliebin30 wrote: »

Waiting lists?

You know 40% or thereabouts don’t turn up for appointments?

That’s what’s stoppInt the real people in need from accessing the help they need.

Ignorant self important people who couldn’t be bothered to ring and cancel appointments.

I actually believe that half the people hanging around a & e's shouldn't be there in the first place but regarding appointments- I wanted to reschedule an appointment I had, rang the number, straight to mailbox, mailbox full could not leave message. I emailed, got an auto response saying the recipient would not be back until 4th January 2108!

So that explains top me why a lot of appointments are not kept.

realdanbreen

Sceptic Orwellian wrote: »

Hi everyone,

I am international student and I have been in Ireland for the last four years. Throughout these four years I have seen both good and bad things, like all places of course. But the "bad" things I saw in this country I have not seen anywhere else, certainly not in first world countries. I come from a third world country and some of the things I saw happening in this country would never happen back home.

Let me start with what makes my blood boil the most. Your public healthcare system. Utter chaos. Madness. Warzones. Looted from top to bottom with impunity. People on trolleys. People in pain on waiting lists. People leaving their jobs and families behind and flying to the Continent and the States to get their health back. It is utter shambles and unacceptable for a first world country. I thought my country (which again, is third world) and several other countries I've been to had the worst healthcare systems, but after seeing what I saw here, I have instructed my friends to fly me back home if I ever needed to be admitted non-urgently to one of these public hospitals. You will never see scenes like this back home, never. And if you did, the people will be on the streets the next day with the health minister resigning. Luckily, private health insurance is mandatory here for non-EU people like me.

It is very unfortunate because this country has excellent colleges that trains highly skilled professionals. But what good is it when an Irish citizen cannot access the care he or she needs? What good is it when these Irish citizens leave the country of their birth because of the way things are here?

Moving on to political corruption and nepotism, both of which I have noticed are rampant here. I was speaking to a very nice elderly Irish woman the other day who just had a knee replacement and she told me that she was on the waiting list for two years. Two years in constant pain. When she could not take it anymore, she called her local TD and explained her situation to him, two days later she gets a phone call from the hospital asking her to come in for her surgery the next week. If a politician has a say on whether or not a person is in pain, then this country is doomed. And again, this would never happen to a citizen back home. This lady was an elderly Irish citizen. She was born here and lived here all her life. She deserves the best treatment from her public healthcare system.

Why are the Irish people silent about what is going on in this country? Is this what the men and women of 1916 fought and died for? Why don't they get out on the streets just like they did against the water charges? If health is not important then what is?

And to those who say: "at least things are better than (insert third world country here). No it is not, it is absolutely not. I love Ireland, I love the Irish people, but this is not a country that I would want to settle in.

If you were critical of the Government in your country you would be locked up so just relax and enjoy your stay here.

_Brian

I don’t think our healthcare system is that bad.
Yes there are a few problems patients on trollies and waiting lists for some procedures.

I’m having treatment myself at the moment and appointments are prompt, never kept around too long, staff are professional and hard working.

draiochtanois

This post has been deleted.

LeinsterDub

Wheeliebin30 wrote: »

Isn’t the NHS in just as much turmoil?

Not really, the English like to complain that it's not as good as it use to be , and it most certainly isn't but it's still excellent . They have a 4 hour target to treat and then admit, transfer or discharge in A&E for example .

Compare these targets with Irish hospitals complete lack of targets
https://www.nhs.uk/NHSEngland/appointment-booking/Pages/nhs-waiting-times.aspx

James Brown

EdgeCase wrote: »

What happens usually isn't "corruption" it's at worst clientelism or constituency service. No money changed hands, she didn't buy influence. She used her elected representative to represent her.
..

I disagree. Money need not change hands by way of a sack with 'swag' written on it. Positions and favours for friends and family go a long way. Favouring one person or company, over another because it benefits you personally, in some way, is corruption. Be it state or council contracts or planning permission etc.
You are describing people asking politicians to represent them, that's what they are supposed to be doing.

EdgeCase

_Brian wrote: »

I don’t think our healthcare system is that bad.
Yes there are a few problems patients on trollies and waiting lists for some procedures.

I’m having treatment myself at the moment and appointments are prompt, never kept around too long, staff are professional and hard working.

As long as you avoid A&E and certain specialities.

For example there were utterly disgraceful waiting lists in ophthalmic surgery for cataracts. They're being rapidly cleared now with the NTPF, but they shouldn't have happened in the first place.

Things like access to ENT services here are an absolute disgrace. Even the private system isn't great. It took me 3 months to get a private appointment in Cork for an urgent ENT issue.

EdgeCase

Matt Barrett wrote: »

I disagree. Money need not change hands by way of a sack with 'swag' written on it. Positions and favours for friends and family go a long way. Favouring one person or company, over another because it benefits you personally, in some way, is corruption. Be it state or council contracts or planning permission etc.
You are describing people asking politicians to represent them, that's what they are supposed to be doing.

Petitions in favour of family and friends aren't on, but there are actually arguments about constituency service here going too far too i.e. clientelism.

We've two issues:

1. TDs can set themselves up as the local 'fixer' and that can create issues where they create an impression that they're getting people things that they are already entitled to. I've seen plenty of things where people were thankful to TDs who put a phone call in that they / anyone could have put in to find out some information or because they helped them fill in a form.

2. TDs can become so locally focused that major issues of national policy become totally distorted. We see that a lot here with health. Try reforming the local hospital system for example and centralising acute services into specialist centres and you'll have small towns going crazy demanding that they have services that are extremely difficult and even dangerous to support on a small scale.

I've always thought that Ireland could do with a version of a "mixed member" system where you'd a % of TDs elected from bigger constituencies that take in whole regions as well as the local ones.
This is what they do in Germany to counterbalance the tendency for everything to focus on local. You need a balance between everything being local and a need for some kind of serious national debate on issues.

Ireland's PR-STV voting system is also starting to come into its own in the last few decades. For the early decades of the state, it weirdly managed to have a two-party system in a structure that should have really eliminated that. Now, at least you're seeing a situation developing where the government is far more about consensus building in the Dail. A lot of legislation is being started in cross-party committees and there's much more of a need to bring everyone on board to do things than there was in the past.

That's definitely not doing us any harm as I think the days of FF / FG politics ruling the roost are long gone and you're actually now getting something that's genuinely proportional, which is really always how the system was supposed to work.

Sceptic Orwellian

realdanbreen wrote: »

If you were critical of the Government in your country you would be locked up so just relax and enjoy your stay here.

Citizens in my country of birth have little to complain about because the Government takes very good care of all its citizens, in terms of education, healthcare, and infrastructure. Nevertheless, there are many flaws in all three areas and more and the issues that plague Ireland also plague my nation.

And I can assure you, no one will be "locked up" simply because of "being critical of the Government". My tertiary education and my brother's education here in the Republic is entirely being funded by my Government, just like the millions of other citizens both in the country and all over the world. My nation is by no means "rich", like I said, it is a third world country, and "poor" compared to Ireland. So why Ireland does not provide the healthcare that its citizens deserve is a paradox to me.

EdgeCase

It's largely down to an incompetent system that's been allowed to just spiral out of control for quite a long time. It is absolutely not a badly funded system, but it just creates endless bottlenecks and problems that shouldn't happen in the first place.

One of the things that has always shocked me about the Irish hospital system for example is that there's nobody really coordinating your care. If you've a complex problem, you're often bounced from consultant to consultant as if they're not colleagues at all. There's no single point of contact and your GP's often not really in the loop either.

I know I've relatives in the public system getting extremely good care for cancer, and access to drugs that would be unavailable elsewhere (seriously expensive stuff) but, they're often just left kind of to fend for themselves and nearly manage their own case.

You'd think there'd be some kind of individual assigned to manage your care i.e. a "Super GP" type role in a hospital, but there isn't. So you're left battling with administrators and bureaucracies and trying to endlessly chase things up.

Another example is a relative of mine who has bilateral cataracts (i.e. two eyes) and they put each eye on a different waiting list !?!?!
I mean how does that even make sense? The outcome will be worse due to the gap between the two operations and all the pre-op assessments now need to be done twice. It both causes the patient a load of inconvenience and costs the HSE more.

We also had the experience of my grandmother being called in for appointments, and waiting around for hours and hours (as an immune-compromised cancer patient with a very bad leg and back) and then you'd discover that they either just wanted to meet her her for a chat, or on two occasions had lost her file and had no idea why they'd called her in in the first place. It was a BIG deal to drag her into hospital for the day and exposed her to all sorts of risks of infection and so on. These things could have been handled by a GP, a community nurse or over the phone. Yet, they just kept dragging her in again and again.

I don't think we actually have healthcare "system". We have hospitals, doctors and nurses and nobody really coordinating anything properly.

I just always get the impression it's a bunch of usually well intentioned people running around in circles and management isn't management, but rather it's unthinking administration and bureaucracy.

I would agree with the OP, the system is a spectacular disaster and an absolute joke. It's largely down to complete and utter incompetence of the system rather than corruption and it does need to be declared a national emergency and put beyond politics.

I would advocate that there's a national crisis healthcare committee set up in the Dail on a cross party basis and that it be given powers to drive reform, investigate, hold organisations to account and so on until the mess is cleaned up.

Sceptic Orwellian

EdgeCase wrote: »

It's largely down to an incompetent system that's been allowed to just spiral out of control for quite a long time. It is absolutely not a badly funded system, but it just creates endless bottlenecks and problems that shouldn't happen in the first place.

One of the things that has always shocked me about the Irish hospital system for example is that there's nobody really coordinating your care. If you've a complex problem, you're often bounced from consultant to consultant as if they're not colleagues at all. There's no single point of contact and your GP's often not really in the loop either.

I know I've relatives in the public system getting extremely good care for cancer, and access to drugs that would be unavailable elsewhere (seriously expensive stuff) but, they're often just left kind of to fend for themselves and nearly manage their own case.

You'd think there'd be some kind of individual assigned to manage your care i.e. a "Super GP" type role in a hospital, but there isn't. So you're left battling with administrators and bureaucracies and trying to endlessly chase things up.

I am happy to hear that citizens are getting good care for a condition as horrible both physically and mentally as cancer. This is how it should be for all citizens, for all conditions, all the time.

The reason why I say "citizens" is because they should always be the priority in any country. They have contributed the most. I know it sounds a bit "right-wing", but that is how I think it should be. And I like how I could not get my long-term visa here without showing proof of private health insurance. This is how it should be in all countries. I say this because my brother has been telling me of the many problems of "health tourism" in the UK, where people who have contributed nothing into the system are using it for free.

James Brown

EdgeCase wrote: »

Petitions in favour of family and friends aren't on, but there are actually arguments about constituency service here going too far too i.e. clientelism.

We've two issues:

1. TDs can set themselves up as the local 'fixer' and that can create issues where they create an impression that they're getting people things that they are already entitled to. I've seen plenty of things where people were thankful to TDs who put a phone call in that they / anyone could have put in to find out some information or because they helped them fill in a form.

2. TDs can become so locally focused that major issues of national policy become totally distorted. We see that a lot here with health. Try reforming the local hospital system for example and centralising acute services into specialist centres and you'll have small towns going crazy demanding that they have services that are extremely difficult and even dangerous to support on a small scale.

I've always thought that Ireland could do with a version of a "mixed member" system where you'd a % of TDs elected from bigger constituencies that take in whole regions as well as the local ones.
This is what they do in Germany to counterbalance the tendency for everything to focus on local. You need a balance between everything being local and a need for some kind of serious national debate on issues.

Ireland's PR-STV voting system is also starting to come into its own in the last few decades. For the early decades of the state, it weirdly managed to have a two-party system in a structure that should have really eliminated that. Now, at least you're seeing a situation developing where the government is far more about consensus building in the Dail. A lot of legislation is being started in cross-party committees and there's much more of a need to bring everyone on board to do things than there was in the past.

That's definitely not doing us any harm as I think the days of FF / FG politics ruling the roost are long gone and you're actually now getting something that's genuinely proportional, which is really always how the system was supposed to work.

Have you told them? the fact they are in cahoots, is political protectionism and nothing to do with governance.

It was put forward we don't really have corruption because money is seldom seen to change hands. I was saying hard cash need not change hands for it to be corruption. Board appointments, contracts etc. etc.

Putting in a call to inquire on delays or issues to the correct authority, is part of their job. It's when they benefit personally, that it crosses the line.

EdgeCase

Sceptic Orwellian wrote: »

I am happy to hear that citizens are getting good care for a condition as horrible both physically and mentally as cancer. This is how it should be for all citizens, for all conditions, all the time.

The reason why I say "citizens" is because they should always be the priority in any country. They have contributed the most. I know it sounds a bit "right-wing", but that is how I think it should be. And I like how I could not get my long-term visa here without showing proof of private health insurance. This is how it should be in all countries. I say this because my brother has been telling me of the many problems of "health tourism" in the UK, where people who have contributed nothing into the system are using it for free.

They largely get cancer care, cardiac care and a few other areas very right because they were completely reformed and rebuilt over the last decade or so with major strategies that were driven though quite effectively. There was a very significant programme to create a number of regional centres of excellence for cancer, cardiology, renal etc.. and high tech and complex medicine in general.

The problems are pretty much ALL the other areas that they haven't reformed and many of them are non-critical care, but they can be the difference between a pleasant life and misery i.e. a lot of elective surgeries : cataracts, joint replacement.

The access to things like cochlear implant surgery here is abysmal. There's one centre in Beaumont and there should be one in Cork etc but there isn't. The result is that a lot of kids are going way past the age where they could have had hearing restored in time to deal with speech and language development.

Sceptic Orwellian

EdgeCase wrote: »

They largely get cancer care, cardiac care and a few other areas very right because they were completely reformed and rebuilt over the last decade or so with major strategies that were driven though quite effectively.

The problems are pretty much ALL the other areas that they haven't reformed.

One of the most important systems in any nation is its public healthcare system, without it and when it comes to things like managing chronic conditions, people who can contribute to the economy but don't have the means to access other forms of care, be it private or overseas, will end up simply not working and quite possibly disabled because of the potential complications. So not only will the individual suffer, but the State will lose out as well.

The reform must come sooner rather than later.

EdgeCase

Matt Barrett wrote: »

Have you told them? the fact they are in cahoots, is political protectionism and nothing to do with governance.

It was put forward we don't really have corruption because money is seldom seen to change hands. I was saying hard cash need not change hands for it to be corruption. Board appointments, contracts etc. etc.

Putting in a call to inquire on delays or issues to the correct authority, is part of their job. It's when they benefit personally, that it crosses the line.

In terms of raw numbers, things have changed a lot.
The combined vote for FF and FG has fallen and other parties have grown.

If you look back to 1937, as in the foundation year of this version of the state, Fianna Fail were in power for the vast majority of the time 21 out of 32 governments (many of the FG led governments didn't last a full term so the total time in office is actually a much higher %) I don't have the time to add up the exact % of time in office for FF but, it was extremely high to the point that Ireland had a default "party of Government". It was almost a 1 and a half party state for much of its existence.

It was a bizarre situation, when you consider that the voting system is setup specifically to be extremely proportional. You'd expect a political landscape more like what we have now. It just underlines how homogenous Ireland was and also how the civil war played a huge role in defining voting patterns for a considerable chunk of the state's existence.

We are seeing a plurality of parties in the Dail and a much more formidable opposition, all of which is positive and has been having very positive effects.

We've also radically improved our anti-corruption laws, which were virtually non existent or so weak that they might as well have been non existent as recently as the 1990s.

EdgeCase

Sceptic Orwellian wrote: »

One of the most important systems in any nation is its public healthcare system, without it and when it comes to things like managing chronic conditions, people who can contribute to the economy but don't have the means to access other forms of care, be it private or overseas, will end up simply not working and quite possibly disabled because of the potential complications. So not only will the individual suffer, but the State will lose out as well.

The reform must come sooner rather than later.

Yeah, it undoubtedly does have profound impacts and if the A&E and other continuous crises aren't dealt with, it will impact foreign direct investment as it's a significant infrastructural snag.

I would wonder about how this feeds into areas like people being on long-term disability benefit due to perhaps inadequate access to services like mental health, which is generally abysmal in the public system. For example, if you were on a low paid job and dependent on the HSE, and got cataracts, in the current system you could end up losing your sight entirely in the waiting list and probably end up registered as legally blind, which is ludicrous and extremely expensive if someone's still of working age.

They would eventually get to you, but that could end your career.

I know, for me anyway, healthcare is probably my biggest concern when it comes to any election. The problem is that I don't really see any great alternatives being proposed. FG had notions of a single tier public health system being rolled out and seem to have done absolutely nothing to achieve that and FF presided over a complete fiasco of a system for years. So, it doesn't leave me with all that many good options.

I also think that there's an attitudinal problem in Ireland when it comes to healthcare because it's two tier.

The two-tier system effectively morphed out of the old 19th century poor law hospital system where public health was seen as a charitable thing, not a public service. Those same charities (mostly, but not exclusively religious) formed the basis of what is now our public health system while those who could pay for insurance, are in a quasi-separate system.

That apartheid also has resulted in a situation where the most influential people don't really see how bad the public system is, as most will only have fleeting experiences of it. There are some exceptions, like maternity services which are increasingly totally public, but there are a lot of issues with how things are structured.

If the NHS screws up, everyone's impacted - from the cleaning lady to the solicitor who uses their services. In Ireland, the cleaning lady gets in line and the solicitor disappears of to some private hospital and thinks everything's lovely. That means that political pressure doesn't come on in the way it might otherwise do.

Also, the % of people with private insurance in Ireland is quite high, 46% are covered by private insurance of some sort. So, almost half the population don't interact with the public system very much at all and I think there's still a mentality that public healthcare is a 'charity' rather than a paid-for public service funded by social insurance contributions.

Sceptic Orwellian

EdgeCase wrote: »

Yeah, it undoubtedly does have profound impacts and if the A&E and other continuous crises aren't dealt with, it will impact foreign direct investment as it's a significant infrastructural snag.

I would wonder about how this feeds into areas like people being on long-term disability benefit due to perhaps inadequate access to services like mental health, which is generally abysmal in the public system. For example, if you were on a low paid job and dependent on the HSE, and got cataracts, in the current system you could end up losing your sight entirely in the waiting list and probably end up registered as legally blind, which is ludicrous and extremely expensive if someone's still of working age.

They would eventually get to you, but that could end your career.

I know, for me anyway, healthcare is probably my biggest concern when it comes to any election. The problem is that I don't really see any great alternatives being proposed. FG had notions of a single tier public health system being rolled out and seem to have done absolutely nothing to achieve that and FF presided over a complete fiasco of a system for years. So, it doesn't leave me with all that many good options.

What about the policies of SF and Labour? I do not know much about modern day Irish politics, but by talking to my Irish friends, it seems to me that when it comes to FG and FF, it is the lesser of two evils.

EdgeCase

Well, Sinn Fein has certain other legacy issues that put me off quite a bit and Labour managed to somehow destroy themselves during the last government, despite having pushed through some quite progressive policies that FG took credit for - especially things like marriage equality, which was something FG were never very progressive on until they noticed that public opinion was in favour of it.

Labour really needs to get its act together and make itself an decent alternative again. They really allowed themselves to become the 'mud flap' for the last government.

Sceptic Orwellian

EdgeCase wrote: »

Well, Sinn Fein has certain other legacy issues that put me off quite a bit and Labour managed to somehow destroy themselves during the last government, despite having pushed through some quite progressive policies that FG took credit for - especially things like marriage equality, which was something FG were never very progressive on until they noticed that public opinion was in favour of it.

Interesting. Yes, that seems to be the issue many people have with SF. It is depressing when you have no political party willing to push for a major reform. It makes you wonder if they are purposely pushing people to get private insurance.

EdgeCase

Well, the main proposal for a single-tier Irish healthcare system has been a universal cover using mandatory insurance model that would be funded using public and private payment to cover the bills.

Quite a few European public systems work on the basis of universal insurance, rather than the NHS model of direct state provision, and it might work, but I would just hope it didn't turn into a worst of both worlds.

All I know is the current system really can't go on.

Sceptic Orwellian

EdgeCase wrote: »

Well, the main proposal for a single-tier Irish healthcare system has been a universal, mandatory insurance model using public and private payment to cover the bills.

One thing that I do not quite understand, is Vhi state-owned or privatized?

EdgeCase

Sceptic Orwellian wrote: »

One thing that I do not quite understand, is Vhi state-owned or privatized?

It's a state owned company, much like the ESB or Irish Rail.
However, they opened the market to bring in other players. So, it behaves like a commercial company, even though it's state owned.

VHI could have provided the basis for a single tier healthcare system using a continental style state owned type insurance model, much like some of the French systems.

It's been around since 1957.

There's a concept of 'community rating' in the Irish health insurance system and also a number of balancing systems that require insurers to cross subsidise each other depending on their risk loading e.g. VHI might have more older / sicker customers and some of the new entrants have relatively low risk portfolios so there are balancing structures there to even that loading out.

Franz Von Peppercorn

munchkin_utd wrote: »

The irish dont like paying taxes, and wont vote for politicans who would suggest that stuff costs money, because patently thats just a lie. Stuff like transport and water and medical systems just fund themselves by magic.

Local taxes were abolished because that was an evil tax, and it won the party suggesting it the general election.
Water charges had to be abandoned because that'd be double taxation

Yet, everyone wants more stuff, and lower taxes.
It is bonkers.

In Germany theres a small extra tax/ insurance for old age care, extra tax/ insurance for medical system, extra tax for the pension - beyond general social insurance, but that'd never work in Ireland because stuff should be free and funded by magic / someone else

We have one of the highest marginal rates of taxation in the world. And it comes in at the lowest level.

Blaming the tax payer is victim blaming.

EdgeCase

Franz Von Peppercorn wrote: »

We have one of the highest marginal rates of taxation in the world. And it comes in at the lowest level.

Blaming the tax payer is victim blaming.

Also, if people could trust the public system, they wouldn't need all of this private insurance. Effectively we're being taxed twice for health. Paying rather a lot for a service than most of us end up paying for separately anyway.

MayoSalmon

Don't want more stuff just lower taxes please.

More than happy to pay for my own stuff if the government stop thieving 40% of my wage

Sceptic Orwellian

EdgeCase wrote: »

It's a state owned company, much like the ESB or Irish Rail.
However, they opened the market to bring in other players. So, it behaves like a commercial company, even though it's state owned.

VHI could have provided the basis for a single tier healthcare system using a continental style state owned type insurance model, much like some of the French systems.

It's been around since 1957.

That sounds like it could be a solution. Ireland has a population of a little below five million, so the problems facing the NHS in the UK should not be facing the HSE. But that is exactly what is happening, if not worse.

A single payer system is not the solution, the NHS in the UK is crumbling, with Virgin Care and other companies eyeing its facilities. I agree and I think that an insurance type model is the way to go.

Franz Von Peppercorn

EdgeCase wrote: »

If the NHS screws up, everyone's impacted - from the cleaning lady to the solicitor who uses their services. In Ireland, the cleaning lady gets in line and the solicitor disappears of to some private hospital and thinks everything's lovely. That means that political pressure doesn't come on in the way it might otherwise do.

Also, the % of people with private insurance in Ireland is quite high, 46% are covered by private insurance of some sort. So, almost half the population don't interact with the public system very much at all and I think there's still a mentality that public healthcare is a 'charity' rather than a paid-for public service funded by social insurance contributions.

No true at all. Most of us go to public hospitals. Most hospitals are public.

EdgeCase

Well, as it stands a lot of the public hospitals are effectively private trust anyway, other than direct-owned HSE hospitals, many of the acute 'public hospitals' are actually owned by religious organisations or charities. They're just publicly funded.

What worries me a bit though is that there's an assumption that the market would remove the overspends and the bureaucracy, as the money would follow the patient and the patients would shop around, thus shaking out the inefficient providers.

The opposite could also end up being the case, and costs could be driven up.

Oafley Jones

Sceptic Orwellian wrote: »

The latter. This is my brother's account who has recently joined me here and is already utterly shocked by the stories I am telling him.

Of course. Setting up your own account is far too difficult for an international student such as yourself. That seems far more likely than some sock puppet who’s done a bad job of tracking their own BS.

Franz Von Peppercorn

EdgeCase wrote: »

Also, if people could trust the public system, they wouldn't need all of this private insurance. Effectively we're being taxed twice for health. Paying rather a lot for a service than most of us end up paying for separately anyway.

Yes. I pay higher marginal and as much tax in total percentage as I did in the U.K. I fund my own health care. Trust me I’d like the NHS system. If it could work here.