What is wrong with the health service, HSE

AndrewJRenko

listermint wrote: »

So 4 of the decision makers were consultants, What was the make up of the rest of the committee.

Intrigued.

Two expert planners, one architect, one hospital CEO
https://health.gov.ie/blog/press-release/announcement-of-the-composition-of-the-review-group-into-the-national-paediatric-hospital/

theguzman

The time has come to Privatise the operation of the Healthcare system in Ireland, get rid of the unions and the thousands of unnecessary administrative, management and clerical positions. The HSE like the rest of the Public sector is a dumping ground for the failed careers of Fianna Fail crony hacks. HSE property to remain state-owned, Private Healthcare to be PRSI deductable, let the Private companies in and watch a real proper system be delivered. There is too many vested interested sucking from the teat of the sacred cow that is the HSE.

oscarBravo

theguzman wrote: »

...get rid of the unions...

I don't understand why people espouse views like this and expect to be taken seriously. I mean, I have my issues with trade unions, but I would never argue that they should be gotten rid of - unless I was actively trying to come across as some sort of parody account.

It's one of those proposals that, frankly, indicates a lazy unwillingness to think through the consequences of what you're proposing. And if you couldn't be bothered putting even a hint of effort into thinking about your proposed solution, why should anyone else?

FreudianSlippers

Unionism itself isn't the problem necessarily, but it impedes or perhaps prevents any meaningful reform of the system. If you had the silver bullet to fix the HSE tomorrow morning, you wouldn't be able to implement it because of the unions. I don't think there is anyone who could seriously claim otherwise.

I have no problem with union representation of front-line workers - of course nurses need a union.

James Brown

theguzman wrote: »

The time has come to Privatise the operation of the Healthcare system in Ireland, get rid of the unions and the thousands of unnecessary administrative, management and clerical positions. The HSE like the rest of the Public sector is a dumping ground for the failed careers of Fianna Fail crony hacks. HSE property to remain state-owned, Private Healthcare to be PRSI deductable, let the Private companies in and watch a real proper system be delivered. There is too many vested interested sucking from the teat of the sacred cow that is the HSE.

How many civil servants or the HSE policy and decision makers are unionised I wonder?

Unions are often the only protection workers have. They are not there to stymie progress but to ensure any changes do not unduly effect their membership. They are not the tax payers representatives and have no remit to protect the interests of anyone but their members.
Unions are a necessity. Even if you are not a member it's likely you benefit in some way from the institution.

The idea that public owned entities can't be run as efficiently as any private one is a nonsense. The problem could very well be that any official, political or politically appointed might not be so eager to address problems if favouring privatisation. Contracts mean deals and our politicians like dining out on them.

The unions are not responsible for the farcical children's hospital cost over run.

Tell me how

Matt Barrett wrote: »

How many civil servants or the HSE policy and decision makers are unionised I wonder?

Unions are often the only protection workers have. They are not there to stymie progress but to ensure any changes do not unduly effect their membership. They are not the tax payers representatives and have no remit to protect the interests of anyone but their members.
Unions are a necessity. Even if you are not a member it's likely you benefit in some way from the institution.

The idea that public owned entities can't be run as efficiently as any private one is a nonsense. The problem could very well be that any official, political or politically appointed might not be so eager to address problems if favouring privatisation. Contracts mean deals and our politicians like dining out on them.

The unions are not responsible for the farcical children's hospital cost over run.

The point in bold is not necessarily the case in my opinion. The WRC is accessible for any Irish worker and does not require Union membership.

The "unduly affect their membership" is where I have a problem with a lot of how unions seem to operate in Ireland in the 21st century.

One mans interpretation of being unduly affected is another mans interpretation of adjusting to meet market realities. Unions (seem) to be focused on maintaining inefficient practices within certain industries and while they can justifiably say they are doing so because that is their purpose, the end result seems to be public sector organisations which are top heavy in management and administration and are therefore hampered from delivering efficient services due to in part to the mass of bureaucracy which exists.

James Brown

Tell me how wrote: »

The point in bold is not necessarily the case in my opinion. The WRC is accessible for any Irish worker and does not require Union membership.

The "unduly affect their membership" is where I have a problem with a lot of how unions seem to operate in Ireland in the 21st century.

One mans interpretation of being unduly affected is another mans interpretation of adjusting to meet market realities. Unions (seem) to be focused on maintaining inefficient practices within certain industries and while they can justifiably say they are doing so because that is their purpose, the end result seems to be public sector organisations which are top heavy in management and administration and are therefore hampered from delivering efficient services due to in part to the mass of bureaucracy which exists.

You've a problem with:

Unions are often the only protection workers have. They are not there to stymie progress but to ensure any changes do not unduly effect their membership

When is it not the case? Can you show where unions are stopping progress and not looking after the interests of their members?

Your following elaboration states some possible/likely side effects of looking after members interests. This happens for sure, Irish Press workers etc.
The point is they are not in existence to merely retard progress but it can be an effect of looking after their membership in some circumstances.
Unions have a vote, the majority view is their stance and therefore the 'one mans' debate doesn't come into it. It's on the government to argue the case for the tax payer and hopefully come to a mutually beneficial agreement.
Simply writing off unions or calling to 'get rid' of them suggests it's all a one way street and everything publicly ran would go off without a hitch and we could fix the HSE without bothersome unions. When you look at Irish Water, housing, education, e-voting and a myriad other jacked up state enterprises, it's apparent to me that as with the HSE (and children's hospital cost over run for that matter) although convenient, blaming unions for looking after their members can not be looked to as the bigger problem. For instance what measures have been suggested to 'fix' the HSE that unions are stopping? I don't even see anything of much on the table other than bringing in consultants and bitching about over worked nurses taking due holidays at unverified inappropriate times.

And again, how many civil servants or the HSE policy and decision makers are unionised?

Tell me how

Matt Barrett wrote: »

You've a problem with:



When is it not the case? Can you show where unions are stopping progress and not looking after the interests of their members?

Your following elaboration states some possible/likely side effects of looking after members interests. This happens for sure, Irish Press workers etc.
The point is they are not in existence to merely retard progress but it can be an effect of looking after their membership in some circumstances.
Unions have a vote, the majority view is their stance and therefore the 'one mans' debate doesn't come into it. It's on the government to argue the case for the tax payer and hopefully come to a mutually beneficial agreement.
Simply writing off unions or calling to 'get rid' of them suggests it's all a one way street and everything publicly ran would go off without a hitch and we could fix the HSE without bothersome unions. When you look at Irish Water, housing, education, e-voting and a myriad other jacked up state enterprises, it's apparent to me that as with the HSE (and children's hospital cost over run for that matter) although convenient, blaming unions for looking after their members can not be looked to as the bigger problem. For instance what measures have been suggested to 'fix' the HSE that unions are stopping? I don't even see anything of much on the table other than bringing in consultants and bitching about over worked nurses taking due holidays at unverified inappropriate times.

And again, how many civil servants or the HSE policy and decision makers are unionised?

Black bolded point - I didn't suggest getting rid of unions. I believe they do serve a function but that their motivation is not best motivated in improving the service offering which their members are providing in conjunction with serving those members needs. And this goes for groups which are unions in practice if not in name as much as it does the traditional interpretation of the role.

Red bolded point - Why have we consistently heard about top heavy structures (and I include the number of nursing managers in that) but not seen any change in this area. Who is preventing the numbers in such roles being reduced when contracts expire or people retire and leave? Maybe we are not 'hearing about such measures' because it is known that they are a dead duck because of the groups (unions) which have negotiated, such as the time of the creation of the HSE that no role would be abolished.

Blue bolded point - The Healthcare budget has increased by more than double in 17 years within which was the greatest global financial crash in nearly 100 years. I'd say that's a pretty significant lump on the table.

James Brown

Tell me how wrote: »

Black bolded point - I didn't suggest getting rid of unions. I believe they do serve a function but that their motivation is not best motivated in improving the service offering which their members are providing in conjunction with serving those members needs. And this goes for groups which are unions in practice if not in name as much as it does the traditional interpretation of the role.

Red bolded point - Why have we consistently heard about top heavy structures (and I include the number of nursing managers in that) but not seen any change in this area. Who is preventing the numbers in such roles being reduced when contracts expire or people retire and leave? Maybe we are not 'hearing about such measures' because it is known that they are a dead duck because of the groups (unions) which have negotiated, such as the time of the creation of the HSE that no role would be abolished.

Blue bolded point - The Healthcare budget has increased by more than double in 17 years within which was the greatest global financial crash in nearly 100 years. I'd say that's a pretty significant lump on the table.

Never said you did. My post was in response to another saying we should get rid of unions. Then you commented on that post and asked questions. I answered referencing my reasoning for saying what I said.
You can't step into the chain of conversation and expect the previous posts on discussion be ignored especially when making queries on a response to a previous post. That said you are rewording what I've already conceded to.

I don't believe unions are the major problem. Treating workers with respect is important. Are you suggesting there are no moves to fix the HSE because with unions and union like entities, what's the point, (dead duck)? I think that's a cop out and not one I've even heard Harris or Varadkar use.
If a clear idea of how to proceed is put to the public and explained, if it's deemed fair and useful not some mish-mash of looking after our own or another quango, I can't see anyone holding it up. Even the unions. Health is everybody's business and we've all got an interest.

It's an exercise in can kicking not a solution.

Tell me how

Matt Barrett wrote: »

Never said you did. My post was in response to another saying we should get rid of unions. Then you commented on that post and asked questions. I answered referencing my reasoning for saying what I said.
You can't step into the chain of conversation and expect the previous posts on discussion be ignored especially when making queries on a response to a previous post. That said you are rewording what I've already conceded to.

I don't believe unions are the major problem. Treating workers with respect is important. Are you suggesting there are no moves to fix the HSE because with unions and union like entities, what's the point, (dead duck)? I think that's a cop out and not one I've even heard Harris or Varadkar use.
If a clear idea of how to proceed is put to the public and explained, if it's deemed fair and useful not some mish-mash of looking after our own or another quango, I can't see anyone holding it up. Even the unions. Health is everybody's business and we've all got an interest.

It's an exercise in can kicking not a solution.

First bolded point - Calm down, no need to instruct me on how to use boards at this point. I was ensuring there was no ambiguity about my position.

Second bolded point - Why do you think the imbalance in staff numbers in terms of administration/medical staff still exists? Do you think Harris or Varadkar would publicly suggest unions are a problem even if they thought they were?

We have a series of very qualified or politically experienced people hold the position of Minister for health (from at least 3 of the major political parties) over the last 20 years. Why have the problems persisted (grown) in your view?

Do you think they are all trying to maintain the same quangos?

James Brown

Tell me how wrote: »

First bolded point - Calm down, no need to instruct me on how to use boards at this point. I was ensuring there was no ambiguity about my position.

Second bolded point - Why do you think the imbalance in staff numbers in terms of administration/medical staff still exists? Do you think Harris or Varadkar would publicly suggest unions are a problem even if they thought they were?

We have a series of very qualified or politically experienced people hold the position of Minister for health (from at least 3 of the major political parties) over the last 20 years. Why have the problems persisted (grown) in your view?

Do you think they are all trying to maintain the same quangos?

Explaining isn't getting over excited. If you had read the post I was responding to all would have been clear.
You continue to talk on unions like I don't see any issues with them. I do not believe policy makers are reluctant to suggest genuine ideas on fixing the HSE because unions might kick off no. If it were true it would show a reluctance to do their job and said policy makers should be replaced.
You're forgetting Varadkar was a health minister and now Harris. Hardly two fine examples. Health is often jokingly viewed as the dud department nobody wants. The last one to show any enthusiasm was Harney and I believe she had ulterior motives in the way of privatising piece by piece.
IMO, I don't think the will is there. I believe they would rather someone else looked after it. If there were privatisation and/or contracts in the offing they'd be all over it. Currently 'there's no money in it, so why bother?'. That's my take. I don't think unions could depend on public support if they stood in the way of any genuine progress.
Again this line of discussion was to counter making it all about unions. It certainly is not.

blanch152

Matt Barrett wrote: »

And again, how many civil servants or the HSE policy and decision makers are unionised?

Not sure of the situation in the health service, as it is the only one I haven't worked in.

In the civil service the grades of Assistant Principal and Principal Officer are represented by the AHCPS.

http://www.ahcps.ie/

Lower grades are now represented by Forsa, up until about two years ago, there was a multiplicity of unions:

https://www.forsa.ie/about-forsa/


The higher grades of Assistant Secretary General, Deputy Secretary General and Secretary General, who are the real decision-makers in the Civil Service don't have a union per se. Most are members of an association, but I don't think it has union status. Actually, just found their website, they are not a union.

https://scsa.ie/

AndrewJRenko

theguzman wrote: »

The time has come to Privatise the operation of the Healthcare system in Ireland, get rid of the unions and the thousands of unnecessary administrative, management and clerical positions. The HSE like the rest of the Public sector is a dumping ground for the failed careers of Fianna Fail crony hacks. HSE property to remain state-owned, Private Healthcare to be PRSI deductable, let the Private companies in and watch a real proper system be delivered. There is too many vested interested sucking from the teat of the sacred cow that is the HSE.

How's that approach working out for people in the States?

FreudianSlippers

AndrewJRenko wrote: »

How's that approach working out for people in the States?

Classic confusing of privatisation with access to insurance.

AndrewJRenko

FreudianSlippers wrote: »

Classic confusing of privatisation with access to insurance.

There's no confusion. The lack of socialised healthcare in the States is why gofundme is covered with fundraisers for people seeking treatment for cancer and other basic medical care services.

FreudianSlippers

So you're claiming that people with insurance are doing this to afford healthcare?

AndrewJRenko

FreudianSlippers wrote: »

So you're claiming that people with insurance are doing this to afford healthcare?

I'm claiming that the lack of socialised healthcare in the States is why gofundme is covered with fundraisers for people seeking treatment for cancer and other basic medical care services.

FreudianSlippers

AndrewJRenko wrote: »

I'm claiming that the lack of socialised healthcare in the States is why gofundme is covered with fundraisers for people seeking treatment for cancer and other basic medical care services.

Which is... somehow... proof that privatised hospitals are bad how?

AndrewJRenko

FreudianSlippers wrote: »

Which is... somehow... proof that privatised hospitals are bad how?

It shows that a privatised system leaves many people exposed without health care.

FreudianSlippers

AndrewJRenko wrote: »

It shows that a privatised system leaves many people exposed without health care.

Again, you're confusing private hospitals with private insurance.

Tell me how

FreudianSlippers wrote: »

Which is... somehow... proof that privatised hospitals are bad how?

I think the point is that the absence of a public health system of any worth is detrimental to many within that society.

There were reports (which were somewhat questionable) that over 600k annually go bankrupt because of medical bills in the US. The

Even if it is only 365K (which is probably conservative) that is still 1,000 people a day.
That's a pretty harsh indictment for healthcare strategy in the "greatest country in the world".

FreudianSlippers

Tell me how wrote: »

I think the point is that the absence of a public health system of any worth is detrimental to many within that society.

There were reports (which were somewhat questionable) that over 600k annually go bankrupt because of medical bills in the US. The

Even if it is only 365K (which is probably conservative) that is still 1,000 people a day.
That's a pretty harsh indictment for healthcare strategy in the "greatest country in the world".

I'm not debating the fact that a lack of publicly funded health insurance is a problem; I support the ACA. Do you have statistics on the number of forgiven bills/debt from private hospitals or how many people are saved from life-threatening conditions due to the cutting edge healthcare from private hospitals in the US?

Again - and I can't be more clear about this - private hospitals and private health insurance are very different animals.

Tell me how

FreudianSlippers wrote: »

I'm not debating the fact that a lack of publicly funded health insurance is a problem; I support the ACA. Do you have statistics on the number of forgiven bills/debt from private hospitals or how many people are saved from life-threatening conditions due to the cutting edge healthcare from private hospitals in the US?

Again - and I can't be more clear about this - private hospitals and private health insurance are very different animals.

First bold point - No. Do you?

Second bold point - Not disputing that (even though both have an impact on healthcare strategy at a governmental level) but also confused as to why you feel it is such an issue in this discussion.

FreudianSlippers

Tell me how wrote: »

First bold point - No. Do you?

Are you debating the truth of the statement or do you just want me to google something for you?

Second bold point - Not disputing that (even though both have an impact on healthcare strategy at a governmental level) but also confused as to why you feel it is such an issue in this discussion.

I'm not the one who brought up US healthcare is an indictment on private hospitals am I?

Tell me how

FreudianSlippers wrote: »

Are you debating the truth of the statement or do you just want me to google something for you?


I'm not the one who brought up US healthcare is an indictment on private hospitals am I?

Come on now. If you want to enter a point in to the discussion, it is incumbent on you to provide evidence. That is debating 101.

Or do you want me to spend half an hour researching this so you can tell me you meant 'other' evidence?

FreudianSlippers

Tell me how wrote: »

Come on now. If you want to enter a point in to the discussion, it is incumbent on you to provide evidence. That is debating 101.

Sorry... you cherry-picked an irrelevant statistic in your earlier post in relation to insurance (which you ignored that I said is not what I'm discussing). I'm simply asking whether you (i) researched any other statistics or (ii) are debating the veracity of my claim.

If you are, in the case of the latter, I'm happy to go provide the evidence for you; I just don't see the point in doing so until you answer my question (and I don't see the relevance to the discussion of private hospitals).

Or do you want me to spend half an hour researching this so you can tell me you meant 'other' evidence?

You know very well that's not what I'm suggesting. I'm asking you to answer a simple question before I go off and provide evidence for something I know to be true.

Let's be fair here for a second and not make people waste their time.

Tell me how

FreudianSlippers wrote: »

Sorry... you cherry-picked an irrelevant statistic in your earlier post in relation to insurance (which you ignored that I said is not what I'm discussing). I'm simply asking whether you (i) researched any other statistics or (ii) are debating the veracity of my claim.

If you are, in the case of the latter, I'm happy to go provide the evidence for you; I just don't see the point in doing so until you answer my question (and I don't see the relevance to the discussion of private hospitals).


You know very well that's not what I'm suggesting. I'm asking you to answer a simple question before I go off and provide evidence for something I know to be true.

Let's be fair here for a second and not make people waste their time.

First bolded point - What did I cherry pick which was irrelevant. I responded to a point relating to the absence of a public health system with evidence of same?

Second bolded point - Why would I pick statistics other than the point I was referring to? Should I also research the comparable qualifications and experience amongst staff in public/private hospitals? Or maybe the patient to staff ratio in same?

Third bolded point - if you know it to be true, it shouldn't take you that long. Not sure what point you think it proves though.

You seem to fighting a non-existent slur aimed at private hospitals when the focus of the conversation was about the impact the absence of a public health system can have on a society. (I also think you misconstrued one of Andrews points above but so be it).

FreudianSlippers

Tell me how wrote: »

First bolded point - What did I cherry pick which was irrelevant. I responded to a point relating to the absence of a public health system with evidence of same?

As I said, private insurance is a totally different topic.

Are you debating the veracity of the claim I made, or are you trying to get me to go provide evidence for no reason?

Second bolded point - Why would I pick statistics other than the point I was referring to? Should I also research the comparable qualifications and experience amongst staff in public/private hospitals? Or maybe the patient to staff ratio in same?

If you're making a claim that there is a significant difference in the US as to those matters, then yes of course.

Third bolded point - if you know it to be true, it shouldn't take you that long. Not sure what point you think it proves though.

You know it's true, I know it's true... if you don't I will get it for you, but I don't see the point in doing so for the sake of doing so. Do you?

You seem to fighting a non-existent slur aimed at private hospitals when the focus of the conversation was about the impact the absence of a public health system can have on a society. (I also think you misconstrued one of Andrews points above but so be it).

Are we talking about privatisation of healthcare in terms of the hospitals or in terms of scrapping the social benefit of health insurance?

I don't think the two necessarily need to be related and I don't think I misconstrued Andrew's point at all; in fact, I'd submit he (presumably) has smashed the two issues rather clumsily together.

I'm happy to go and provide evidence, but I fear (as I said above) that it's a fools errand as it's not relevant to the point at hand: private hospitals ≠ private insurance.

I'm not sure how else you could take up that point?

AndrewJRenko

FreudianSlippers wrote: »

Again, you're confusing private hospitals with private insurance.

Two cheeks of the same arse.

Geuze

FreudianSlippers wrote: »

Again, you're confusing private hospitals with private insurance.

Yes, some countries have private provision, but with 100% coverage.

The aim of Obamacare is to increase insurance coverage.