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Do we pay too much tax for crappy services?
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Still no reply on EHCI. Cherry picking is your random synthetic WHO report.OK. So do you have a response on EHCI? Because the report you provided is a purely academic exercise with no value in this discussion. EHCI is a fairly authoriative and widely accepted report, and most importantly clearly measures indicators important for us, the public, the consumers.
I sort of expected you would mention UK with regards to trolleys, but I naturally exclude UK as I'm coming from a continental perspective and I don't think UK should be the country to evaluate Ireland against (even though I have a personal experience with the UK and do take it into account in comparison). NHS isn't the best public healthcare system in the world as the British believe. It has several areas of speacilisation where it excels due to the sheer amount of resources (including academia), but taken as a whole and overall it's a poor system and lags behind almost all Northern, Western and even Central European systems. I can point you to EHCI here as well where UK isn't doing that well as the Brits would like everyone to believe i.e. it's not even top 10 what to speak of number 1.
And I insist that trolleys aren't normal thing top half of the European healthcare systems and that the occurence of this issye in Ireland is certainly not an indicator of a successful "upper quartile" healthcare system. How can you maintain that HSE is first class public service is beyond me. I'd say that vast majority of lay people and experts agree on HSE being sub-standard in the "top league" at least, let's narrow it down to Western/Northern Europe.
And also, care to comment on whether your POV is a Dublin-centric or not? Are you assessing Ireland based on Dublin? That wouldn't be exactly accurate.
So you've excluded the NHS which is one of the oldest public health systems in Europe and for a variety of reasons the most comparable to Ireland. Any other countries you'd like to include from your data set? Poland for example? Of are you just cherry picking your data to be the best health services in Europe? As I stated, health news rarely travels borders (other than UK) but the idea of no issues elsewhere is perplexing and not plausible. There are issues in every EU country.
I also note that you've moved from "everything is ****" to focusing on A&E in Ireland. I specifically said the top 50% or in some cases the top quartile in delivering public services within the EU. You have changed to goal posts to health care among the top five countries on the planet (outside of Japan and South Korea).
I've already commented twice that Ireland has one of the lowest population densities in Europe. We aren't the Netherlands and have a preponderance of one off housing. That has an impact delivering any form of services but especially public transport. This was and continues to be a choice of the Irish electorate.
Again my point is, Ireland is up there with some of the best services in the world. Stating that Ireland is "totally behind most of the EU" or "terrible" is manifestly untrue. And the reason I say that is that you can then have a rational discussion about how you improve services based on data and not on anecdote.
Also no reply if you are coming from Dublin centric POV.
Care to respond?
Finland, Norway, Sweden and Estonia have lower density than Ireland, the former three are also quite large so much more difficult to govern, yet their public services and governance are first class.
And I insist that NHS is not a good system to gauge health care system against. Look at France, Spain, Belgium, Austria, Netherlands, I won't even mention the Nordic countries because they are two leagues ahead.
Your goal of top 50% in the EU (which is 13/27 in other words) doesn't match with the Irish PR of "we're one of the best developed countries in multitude of indicators globally". You mentioned it repeatedly. So are you climbing down now?0 -
The problem with the Irish health system is public consultants allowed to make money on private work in public hospitals
When they should be working to clear public waiting lists
If you want private care, use a private hospital0 -
Yes, the EHCI reports raise this issue as well, parallel economy (separate private practises of public doctors, under the table payments etc).beggars_bush wrote: »The problem with the Irish health system is public consultants allowed to make money on private work in public hospitals
When they should be working to clear public waiting lists
If you want private care, use a private hospital
And also more importantly that waiting list is a wrong concept which only decreases accessibility and makes situation progressively worse (because it had in UK, Ireland, Sweden which all heavily rely on lists).1.1.2 No correlation between accessibility to healthcare and money spent
It is inherently cheaper to run a healthcare system without waiting lists than having waiting lists! Contrary to popular belief, not least among healthcare politicians, waiting
lists do not save money – they cost money! Healthcare is basically a process industry. As any professional manager from such an industry would know, smooth procedures with a minimum of pause or interruption is key to keeping costs low!
In the EHCI 2017 there were some surprising newcomers among countries having no or minimal waiting lists in healthcare. Tiny Montenegro has achieved a similar improvement
to what Macedonia did in 2013 by introducing a national real time e-referral system. In 2018, only Switzerland scores “All Green” on Accessibility. Frequently, there is a negative bias in Patient Organisation responses on Waiting Times and a positive bias in officialnational data.
Serbia, having bought a license for the Macedonia system, is a bit slower in the implementation than their smaller neighbours, but is on course to eliminating waiting lists.
If countries with limited means can achieve virtual absence of waiting lists – what excuse can there be for countries such as Ireland, the UK, Sweden or Norway to keep having
waiting list problems?0 -
Why? Do you want consultants removed from the public system to just work in private ran hospitals? That's not going to help public waiting lists.beggars_bush wrote: »If you want private care, use a private hospital0 -
Just thought I’d jump in here. I live craughwell galway.
Our bin company used to take direct debits from us every month to take away our trash (fare enough,) but recently I received a letter from them saying from now on they want all there customers to pay a whole year in advance (which is crazy!!!.)
I mean it’s not like we have a choice to change what company takes our trash away or anything, they have a captive audience so to speak, and I’m just finding out, can basically charge any amount they want, or if it be weekly, monthly or yearly. And there’s absolutely nothing you can do about it.
I care for my partners autistic son, and my partner also has a long term disease so she can’t work either. I have to scrabble around now and find the money somehow and on benefits it isn’t an easy task at all.
The actual amount for the year hasn’t gone up, it’s the same, but when at the end of each week your emptying the loose change jar to by milk, how the hell we can afford a whole years payment, it’s ridiculous!!
If they haven’t put the money up but are now asking for yearly payments instead of monthly I can only presume its because they themselves are looking to expand there business into a new area, and they need a fat chunk of paper at the start of the year be able to get a loan from the bank big enough to do it.
Can’t do anything about it, I have to pay, I’m just sick to death of it.
The railway here has only one track so there’s like 3 trains a day, leaving at times of the day nobody needs to travel.
It’s as overpriced as hell to go anywhere anyway so nobody does.
The busses that go to Galway from here come from Dublin so there always late and also overpriced.
Were the hell is the sanity0 -
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Just thought I’d jump in here. I live craughwell galway.
Our bin company used to take direct debits from us every month to take away our trash (fare enough,) but recently I received a letter from them saying from now on they want all there customers to pay a whole year in advance (which is crazy!!!.)
I mean it’s not like we have a choice to change what company takes our trash away or anything, they have a captive audience so to speak, and I’m just finding out, can basically charge any amount they want, or if it be weekly, monthly or yearly. And there’s absolutely nothing you can do about it.
I care for my partners autistic son, and my partner also has a long term disease so she can’t work either. I have to scrabble around now and find the money somehow and on benefits it isn’t an easy task at all.
The actual amount for the year hasn’t gone up, it’s the same, but when at the end of each week your emptying the loose change jar to by milk, how the hell we can afford a whole years payment, it’s ridiculous!!
If they haven’t put the money up but are now asking for yearly payments instead of monthly I can only presume its because they themselves are looking to expand there business into a new area, and they need a fat chunk of paper at the start of the year be able to get a loan from the bank big enough to do it.
Can’t do anything about it, I have to pay, I’m just sick to death of it.
The railway here has only one track so there’s like 3 trains a day, leaving at times of the day nobody needs to travel.
It’s as overpriced as hell to go anywhere anyway so nobody does.
The busses that go to Galway from here come from Dublin so there always late and also overpriced.
Were the hell is the sanity
You can bring your recycling and rubbish to council centre for much less than the bin companies charge
We let our recycling build up (its all washed, stacked and separated, then go every few months.0 -
munstermagic11 wrote: »Why? Do you want consultants removed from the public system to just work in private ran hospitals? That's not going to help public waiting lists.
Neither is consultants using the long waiting lists to drum up business for private clinics.0 -
True, but it doesn't answer the question I asked.Matt Barrett wrote: »Neither is consultants using the long waiting lists to drum up business for private clinics.0 -
munstermagic11 wrote: »True, but it doesn't answer the question I asked.
No I don't want consultants removed from hospitals :rolleyes:
They should not be able to dangle a private option over a patients head after giving them a wait time of several months in public.0 -
The problem I see with hospitals is that they are completely inefficient, I’ve been in an Irish hospital twice since I’ve been here, once for a gaping wound on my hand that was extremely painful and didn’t get seen even for pain killers for over 8 hours, second time was because of a trapped nerve in my back, which was extremely painful and was calling out repeatedly to any nurse that would listen to please give me a pain killer but was still left there on a stretcher, in the hallway, writhing in agony for at least 4 hours before someone gave me a paracetamol, it was a joke. My partner has a long term illness that could actually eventually kill her and she refuses to go to hospital now, and she takes the terrible pain and toughs it out cause she doesn’t want to be waiting for 12 hours or more, like the last few visits.
Hospitals are supposed to be hassle, it’s why mums don’t take there kids there with grazed knees, but it’s ridiculous.
Nurses should be trained to the level that they can take care of the easy cases themselves, without a doctor. So the more serious cases can be seen faster.0 -
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Totally consistent with my experience, experience virtually everyone I know and the EHCI reports. Yet micosoft insists Irish services are in the first league comparable to Western & Northern Europe. Which is very rich.The problem I see with hospitals is that they are completely inefficient, I’ve been in an Irish hospital twice since I’ve been here, once for a gaping wound on my hand that was extremely painful and didn’t get seen even for pain killers for over 8 hours, second time was because of a trapped nerve in my back, which was extremely painful and was calling out repeatedly to any nurse that would listen to please give me a pain killer but was still left there on a stretcher, in the hallway, writhing in agony for at least 4 hours before someone gave me a paracetamol, it was a joke. My partner has a long term illness that could actually eventually kill her and she refuses to go to hospital now, and she takes the terrible pain and toughs it out cause she doesn’t want to be waiting for 12 hours or more, like the last few visits.
Hospitals are supposed to be hassle, it’s why mums don’t take there kids there with grazed knees, but it’s ridiculous.
Nurses should be trained to the level that they can take care of the easy cases themselves, without a doctor. So the more serious cases can be seen faster.
It's not only the hospitals that are inefficient, the bigger issue is the HSE itself, the structure is so convoluted that it leads to massive ineffeciencies, corruption and waste. Ireland pays one of the highest per capita healthcare costs in OECD yet this is the result.
I had several personal shocking experiences with public Irish health care both from admin and medical point of view.
It escapes me how anyone can dispute this despite all the evidence.
By the way, Is there any efficient government agency in Ireland? Revenue PAYE probably.0 -
The problem I see with hospitals is that they are completely inefficient, I’ve been in an Irish hospital twice since I’ve been here, once for a gaping wound on my hand that was extremely painful and didn’t get seen even for pain killers for over 8 hours, second time was because of a trapped nerve in my back, which was extremely painful and was calling out repeatedly to any nurse that would listen to please give me a pain killer but was still left there on a stretcher, in the hallway, writhing in agony for at least 4 hours before someone gave me a paracetamol, it was a joke. .
I don't mean to belittle your experience but a large part of the problem is people turning up to A&E instead of going to their GP first. Your GP would have at least given you pain medication.0 -
I didn't say you did. The question wasn't even directed at you. Relax.Matt Barrett wrote: »No I don't want consultants removed from hospitals :rolleyes:0 -
This is an issue in all EU countries by the way. Maybe the degree of it is higher in Ireland but I have no data for that.jimmycrackcorm wrote: »The problem I see with hospitals is that they are completely inefficient, I’ve been in an Irish hospital twice since I’ve been here, once for a gaping wound on my hand that was extremely painful and didn’t get seen even for pain killers for over 8 hours, second time was because of a trapped nerve in my back, which was extremely painful and was calling out repeatedly to any nurse that would listen to please give me a pain killer but was still left there on a stretcher, in the hallway, writhing in agony for at least 4 hours before someone gave me a paracetamol, it was a joke. .
I don't mean to belittle your experience but a large part of the problem is people turning up to A&E instead of going to their GP first. Your GP would have at least given you pain medication.0 -
munstermagic11 wrote: »I didn't say you did. The question wasn't even directed at you. Relax.
It's not a yes or no solution. I'm pretty chill thanks.
Regarding people going to the A and E instead of the GP, that's for the A and E to sort out. Stop treating them they'll not come back.
If you wander into the A and E on a whim and get treated you'd be almost foolish not to avail of it as you fancy. Anyway I'd rather stick the pain and wait until the doctor opens than go to an A and E.0 -
Matt Barrett wrote: »It's not a yes or no solution. I'm pretty chill thanks.
Regarding people going to the A and E instead of the GP, that's for the A and E to sort out. Stop treating them they'll not come back.
If you wander into the A and E on a whim and get treated you'd be almost foolish not to avail of it as you fancy. Anyway I'd rather stick the pain and wait until the doctor opens than go to an A and E.
Big believer in personal responsibility I see :rolleyes:
They can't not treat them and it is on people themselves to stop being either selfish, misguided or whatever it is that drives them to go to A&E when they shouldn't.0 -
Big believer in personal responsibility I see :rolleyes:
They can't not treat them and it is on people themselves to stop being either selfish, misguided or whatever it is that drives them to go to A&E when they shouldn't.
Can they not advise seeing a local GP as that's accident and emergency?
Well you wait on people to do whats best for the HSE over and above themselves. Let me know how you go.0 -
jimmycrackcorm wrote: »
I don't mean to belittle your experience but a large part of the problem is people turning up to A&E instead of going to their GP first. Your GP would have at least given you pain medication.
The night before I went to hospital I was sitting on the sofa and had the same pain. Like very intense muscle spasms slowly building up then giving and burst of excruciating pain, I couldn’t move anywhere.
First thing we did was ring west doc, in an attempt to get it seen to rather than going to hospital, first of all they didn’t want to come out, but my partner rang them back and practically begged them to come so they did. They gave me an injection of some kind and everything stopped almost straight away.
That night I went to bed ok, and went to the toilet during the night ok, but when I woke up the next morning it was back with a vengeance more intense than before. My partner rang west doc again and they flatly refused to come out so my partner rang the ambulance.
I was dreading going there but I just thought if they were to give me another one of those injections that west doc had given me the night before maybe I would be alright and could wait then for the doctor, or maybe leave the hospital and make an appointment with my local gp.
They left me in the corridor screaming in agony for what felt like hours with no medication what so ever.
I begged every nurse that walked by and a couple of them did say they would go find a doctor but they disappeared, and never came back.
Finally a nurse did give me paracetamol, but it didn’t stop it.
After being there all day in complete agony the evening came and still nobody.
Long and short of it is that I never actually got to see a doctor at all, the pain eventually subsided and as soon as it did I got a lift home from a friend.0 -
You don't come across that way.Matt Barrett wrote: »It's not a yes or no solution. I'm pretty chill thanks.
Again, the question was directed at you.0 -
Totally consistent with my experience, experience virtually everyone I know and the EHCI reports. Yet micosoft insists Irish services are in the first league comparable to Western & Northern Europe. Which is very rich.
It's not only the hospitals that are inefficient, the bigger issue is the HSE itself, the structure is so convoluted that it leads to massive ineffeciencies, corruption and waste. Ireland pays one of the highest per capita healthcare costs in OECD yet this is the result.
I had several personal shocking experiences with public Irish health care both from admin and medical point of view.
It escapes me how anyone can dispute this despite all the evidence.
By the way, Is there any efficient government agency in Ireland? Revenue PAYE probably.
Revenue is efficient. Why? Because they have to be. They are in the business of making money. I work for a government agency. My job is very technical and esoteric. I'm sometimes asked to school colleagues a grade or two above me. And that's ok but recently I've begun to question my raison d'etre. You see there are people there on better salaries than me who "perform" menial tasks. Admin roles, secretarial roles, HR type roles. These are handy jobs. I spend days sometimes parsing legal texts while trying to problem solve and present a solution to my boss. Meanwhile, there's some jobs worth in charge of licking stamps and filling out forms. So, it's really not worth my while performing in my current role. I'm better off vegetating with the cabbages. And that's my goal now. The general attitude across the public sector is not too dissimilar. Take the handy number, do the bare minimum and achieve the optimum remuneration package for your output.
This is a true ineptocracy.0 -
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I think this would be the case in most European civil services, to be be fair. But my observation is that the Irish government structures, organisation and management is overly convoluted. It's a cultural thing I guess.Mongfinder General wrote: »Totally consistent with my experience, experience virtually everyone I know and the EHCI reports. Yet micosoft insists Irish services are in the first league comparable to Western & Northern Europe. Which is very rich.
It's not only the hospitals that are inefficient, the bigger issue is the HSE itself, the structure is so convoluted that it leads to massive ineffeciencies, corruption and waste. Ireland pays one of the highest per capita healthcare costs in OECD yet this is the result.
I had several personal shocking experiences with public Irish health care both from admin and medical point of view.
It escapes me how anyone can dispute this despite all the evidence.
By the way, Is there any efficient government agency in Ireland? Revenue PAYE probably.
Revenue is efficient. Why? Because they have to be. They are in the business of making money. I work for a government agency. My job is very technical and esoteric. I'm sometimes asked to school colleagues a grade or two above me. And that's ok but recently I've begun to question my raison d'etre. You see there are people there on better salaries than me who "perform" menial tasks. Admin roles, secretarial roles, HR type roles. These are handy jobs. I spend days sometimes parsing legal texts while trying to problem solve and present a solution to my boss. Meanwhile, there's some jobs worth in charge of licking stamps and filling out forms. So, it's really not worth my while performing in my current role. I'm better off vegetating with the cabbages. And that's my goal now. The general attitude across the public sector is not too dissimilar. Take the handy number, do the bare minimum and achieve the optimum remuneration package for your output.
This is a true ineptocracy.0
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