The HSE is re-regionalising

Gatling

Already a thread on the matter

lawred2

Gatling wrote: »

Already a thread on the matter

Where?

Gatling

lawred2 wrote: »

Where?

https://touch.boards.ie/thread/2057997032/2/#post110707558

Eric Cartman

the problem with a 'free' healthcare system is somebody has to pay for it, and its the very point that we're arguing here. The doctors and nurses on the front line have a hard job and arent getting enough money, we're pouring too much money in and in the middle theres a bunch of useless oxygen thieves protected by the unions and I'm trying to figure a workable, legal solution to sack them all so that we can get a value for money healthcare system.

It will be nothing short of a calamity, too many middle managers effectively hiding out. Each region applying their own standard, muddying the waters somewhat i.e. if a second opinion was required in another hospital. Passing the buck when something goes awry, "well, there isn't a universal benchmark so we're not exactly culpable..." etc.

Eric Cartman

Deleted User wrote: »

It will be nothing short of a calamity, too many middle managers effectively hiding out. Each region applying their own standard, muddying the waters somewhat i.e. if a second opinion was required in another hospital. Passing the buck when something goes awry, "well, there isn't a universal benchmark so we're not exactly culpable..." etc.

Im just awaiting the relocation bonuses, retraining grants and defacto promotions a lot of them will get. Some of them will get 50k on top of selling their dublin gaf to go back down and live in tuam and work from the most expensive regional office ever constructed with half a million quid in the back burner and still raking in 70k+ a year waiting on that fat pension to kick in.

Spanish Eyes

salonfire wrote: »

Good to see you agreeing with me.

The HSE should not be required to treat everything, they are not capable in delivering in a cost-effective manner.

All the routine procedures should be tendered out and make the HSE much smaller.

Resulting in those paying through the nose for PHI going on a waiting list for their preferred consultant/private hospital you mean? Who gets priority there?

OK, back to UHI so. Sigh.

James Brown

Are we blaming decades of poor governance on the unions? There's negotiations every few years. Maybe we need better negotiators? Enda ignored the ball on this never mind dropping it when he took power.
Harris could use this revival of the old HSE model as a chance to rebuild the HSE but it's likely he'll be too busy looking for angles to introduce acceptable private elements, which I for one am thankful, the unions won't wear.

super_furry

Part of me wonders if this is a step towards full privatisation of healthcare in Ireland. It'll be much easier to see which areas are performing financially and which would be ripe for the plucking.

All this will do really is to create more layers of middle and upper management. Half the problem with the HSE is that when they health-boards went, no-one was made redundant so that there were far too many chiefs and bosses collecting a wage.

Eric Cartman

Matt Barrett wrote: »

Are we blaming decades of poor governance on the unions? There's negotiations every few years. Maybe we need better negotiators? Enda ignored the ball on this never mind dropping it when he took power.
Harris could use this revival of the old HSE model as a chance to rebuild the HSE but it's likely he'll be too busy looking for angles to introduce acceptable private elements, which I for one am thankful, the unions won't wear.

Were blaming the unions and a lack of government backbone over the years that has allowed them to get this far. We gave the civil service and their unions too much power. I think everyone can accept that the blame is shared among the civil servants, unions and successive governments as theyve all had a part to play.

Now is about solutions though. The only way this 're-regionalisation' plan could possibly work is a 'to hell or to connaught' model where you offer the dead weight positions in really awful places or to retire early / take redundancy. Unless the admin staff numbers are decreased by a quantifiable amount , then this will be an abject failure.

banie01

A step towards care commission committees couched in the guise of "placing the decision makers closer to the problem"

When in actuality it is more of a layer of plausible deniability for sitting ministers on budgetary and "local needs" decisions.

The HSE was a huge missed opportunity for streamlined purchasing and economy of scale.

That the vast majority of previous Health Board staff were subsumed into the HSE in the same roles, on the same terms of employ and then had the benefits of benchmarking with no actual effort by senior management to ensure increased productivity on the part of admin staff in particular.
Despite their growth in numbers.

The frontline staff are dealing with growth in patient numbers, decline in available beds and renewed growth in waiting lists.

A concerted effort to engage best practice, simple ideas but unfortunately complicated and expensive implementation such as electronic patient records, availy across all points of interaction. Elimination of the paper records.

The lack of consultant positions being filled across the country, is particularly galling.
That we can spend €16billion on a health service for less than 5million people and can not provide a truly World Class service at point of care is quite concerning.

On a practical note, we spend the equivalent of @€;3500 per person on the HSE per year.
Before any privately accounted for costs are taken into consideration.
Health is not cheap, it's not easy but it does seem that is Irish do love to involve layers of unnecessary administration and management into our care.

Spanish Eyes

I often wonder how a big country like France for instance has a top notch health system. Yes I know it is paid for by contributions, but it works very well.

And we know what the Unions are like in France too!

Send Simon to France on a jolly to see how they do it. Would be worth every penny IMO. Cannot understand how the French system (as an example) works so well as opposed to the obviously dysfunctional NHS and our own Public system. Probably higher contributions to the healthcare system. But at least it works. France is just an example FWIW. I am sure it is replicated elsewhere too.

James Brown

Eric Cartman wrote: »

Were blaming the unions and a lack of government backbone over the years that has allowed them to get this far. We gave the civil service and their unions too much power. I think everyone can accept that the blame is shared among the civil servants, unions and successive governments as theyve all had a part to play.

Now is about solutions though. The only way this 're-regionalisation' plan could possibly work is a 'to hell or to connaught' model where you offer the dead weight positions in really awful places or to retire early / take redundancy. Unless the admin staff numbers are decreased by a quantifiable amount , then this will be an abject failure.

Sounds to me like the unions are doing great at their job.
Enda had a chance to tackle such things in 2011, he didn't even try.

I hope he does. Harris might get something in the back door with this move but as I said I think the goal might be to work in some form of privatisation.
In the least they could be at, 'anyone who joins such a role from here on in has deal X'. My fear is they're more concerned with privatising than reform.

dudara

Duplicate thread merged into pre-existing thread

dudara

previousmass

How much of a pain is Dublin being split between multiple regions likely to be?

lawred2

previousmass wrote: »

How much of a pain is Dublin being split between multiple regions likely to be?

Not really. It's already split into three administrative councils. Reality is that's where the population is. Fingal probably has a similar population to Connacht.

previousmass

lawred2 wrote: »

Not really. It's already split into three administrative councils.

So there is going to be regional planning and management but I'm still going to be treated in the geographically closest treatment centre even if the centre for my region is the other side of the country. Or are they just going to locate all the specialist centers for the 3 zones on the east in Dublin.

whisky_galore

Spanish Eyes wrote: »

I often wonder how a big country like France for instance has a top notch health system. Yes I know it is paid for by contributions, but it works very well.

And we know what the Unions are like in France too!

Send Simon to France on a jolly to see how they do it. Would be worth every penny IMO. Cannot understand how the French system (as an example) works so well as opposed to the obviously dysfunctional NHS and our own Public system. Probably higher contributions to the healthcare system. But at least it works. France is just an example FWIW. I am sure it is replicated elsewhere too.

You can shovel as much money as you want into an already fűcked up system but it'll never fix it.

The HSEs woes go beyond simply needing more money.

end of the road

Eric Cartman wrote: »

the problem with a 'free' healthcare system is somebody has to pay for it, and its the very point that we're arguing here. The doctors and nurses on the front line have a hard job and arent getting enough money, we're pouring too much money in and in the middle theres a bunch of useless oxygen thieves protected by the unions and I'm trying to figure a workable, legal solution to sack them all so that we can get a value for money healthcare system.

you were given a way to reduce staff numbers.
a way which would avoid nonsense and pointless schemes which come across as being more about trying to cause trouble, and wanting to sack people for the sake of sacking them, then about reducing surplus staff.

Delta2113

Eric Cartman wrote: »

https://www.independent.ie/irish-news/health/redundancy-scheme-on-cards-as-fewer-health-staff-needed-38316582.html

How do we consistently allow this double and even quadruple jobbed hell hole to continue wasting money. There needs to be a serious cull in the HSE , have it completely gutted and reformed.

50 year old mary who cant use a computer - out the door
The 4 people stamping forms - out the door
Gut the rot out of it.

- So what if Mary is 50 years old - you support age discrimination?

Oops69

Siptu will still be in control whether it's split into 2, 10 , 20 or 100 regions -- waste of time , deal with SIPTu's stangehold on the HSE staff or this will have no effect.

Eric Cartman

Delta2113 wrote: »

- So what if Mary is 50 years old - you support age discrimination?

No, but anyone who works in IT or management will tell you usually that women of that age, especially ones expected to use computers are incredibly unproductive and cause more work for other people than they do themselves. We sit in a weird generational hinterland where its going to take us 20 years to phase out all the people in the civil service who have no idea how to use the one tool needed for their job and actively refuse to learn, if not even boast and compete with each other about how theyre 'not good with technology'

end of the road

Oops69 wrote: »

Siptu will still be in control whether it's split into 2, 10 , 20 or 100 regions -- waste of time , deal with SIPTu's stangehold on the HSE staff or this will have no effect.

siptu are not in control of the HSE nor do they have any stranglehold on HSE staff.

Eric Cartman wrote: »

No, but anyone who works in IT or management will tell you usually that women of that age, especially ones expected to use computers are incredibly unproductive and cause more work for other people than they do themselves. We sit in a weird generational hinterland where its going to take us 20 years to phase out all the people in the civil service who have no idea how to use the one tool needed for their job and actively refuse to learn, if not even boast and compete with each other about how theyre 'not good with technology'

someone of 50 now would have been 30 20 years ago when the internet was starting to become mainstream.
the amount of 50 year olds who either don't know how to use a computer or who refuse to use one are likely tiny in number.
so with respect i would suggest that this is nothing more then ps bashing with no real basis.

Calhoun

Time for a big cull, every time someone complains about the health service and how bad it is in Ireland think that it's in a bad shape partially because we have a very bloated admin staff that never got reduced in size when we merged the old regional setups.

Big concern here is will they now increase staff again ? What happens if another government gets in place ?

P2C

The constant cycle of change must be wearing on the staff. There has been a number of half arsed efforts over the last twenty years. This is more like a rebranding effort. Therefore if there are six new health authorities if any of them are underperforming it will take the heat of the rest of the services in the media. The HSE is a big monster and although there are some very good points there are also disasters. I have had to access services a number of times with my kids and can’t say enough about the service we have received and the care we received when my father passed away with a brain tumor two years ago today. That was free pubic health service and made me very proud of the care that was received. If there is not a redundancy scheme to clear out middle and senior management and the newly created corporate structure then this is a waste. It’s up to Paul Reid

purifol0

The problem with taking on public sector unions is the lack of support by the general public. The simplest & most effective way of undermining PS unions would be to simply publish payslips for all to see. Support would evaporate when the public sees just how much they are on (Nurses earning 100K+, porters earning mid 40's, admin on God knows). Ditto for PS pensioners. This is our taxes, we should be able to see where they're going (on the service or just on the staff?). Crazy? They do it in Norway - www.bbc.com/news/magazine-40669239

GDPR has already been used against the public to deny us the right to know how much our retired politicians are on, a slippery slope indeed.
Recent figures suggest the PS is earning 40% more than a private sector equivalent worker, except on top of that they have job security and a state backed (but unfunded) defined benefit pension. Contrast that with most in theprivate sector having no occupational pension, at all. Truly a two tier society not just health service.

Doc07

purifol0 wrote: »

The problem with taking on public sector unions is the lack of support by the general public. The simplest & most effective way of undermining PS unions would be to simply publish payslips for all to see. Support would evaporate when the public sees just how much they are on (Nurses earning 100K+, porters earning mid 40's, admin on God knows). Ditto for PS pensioners. This is our taxes, we should be able to see where they're going (on the service or just on the staff?). Crazy? They do it in Norway - www.bbc.com/news/magazine-40669239

I’ll give you a hand with some of your GDPR issues.
There are about 10 nurses in the country on 100k+

purifol0

There are a few nurses on 140k, which would have seen a pay rise if the unions strikes this year had been successful. They "low paid younger nurses" was a ruse, a soundbite that was a trojan horse to usher in pay rises for all nurse grades. Ingrid Miley wouldn't tell us that though, as RTE is very much in bed with PS unions.


My point stands, the public should be able to see where their money is going down to every publicly funded payslip. Otherwise we'll continue to be lied to by unions and sold out by vote-seeking politicians.

Doc07

purifol0 wrote: »

There are a few nurses on 140k, which would have seen a pay rise if the unions strikes this year had been successful. They "low paid younger nurses" was a ruse, a soundbite that was a trojan horse to usher in pay rises for all nurse grades. Ingrid Miley wouldn't tell us that though, as RTE is very much in bed with PS unions.


My point stands, the public should be able to see where their money is going down to every publicly funded payslip. Otherwise we'll continue to be lied to by unions and sold out by vote-seeking politicians.

A benefit to higher paid staff from an action fought on ground of helping the lowest paid could be true of several industrial relations actions. The full picture of IR battles rarely gets accurately depicted by the media.

Your point on transparency stands and is endorsed. I’d leave out the few 100+K nursing comments though. They are executive level managers, akin to CEOs of nursing and their pay can be challenged certainly but should be separate argument to non/management staff pay.
If it’s an argument about Garda pay I’d similarly leave out the chief commissioners pay. If it’s porters I’d leave out the hospital general manager. Again, the management/CEO pay can be challenged should be separated from ‘rank and file’ as it’s not helpful.

mariaalice

There are all kinds of professions in the HSE, some of them people have never heared off.

Yet every discussion abut the health services on boards ends up with an obsession, rage/rant about nurses its ludicrous.