Health system

ted1

So taking a break from the main GE thread I thought we’d start a separate health thread and see how we fix the system

I’m Currently paying about 2,500 a year so 5,000 before tax for private health insurance for myself , wife and three kids.

Don’t have day to day , so spend and additional 600 euro cash on doctors a year.

So the question is, if there was a good health system would you be willing to pay an extra 2 thousand ( per family, say700 for an individual) in taxes for a proper system as opposed to our current system ?
And if so would that fix the system ?

dwmcdos

Absolutely, but the money needs to be spent efficiently and intelligently.

somesoldiers

Should be no BIK on health insurance at least IMO

Markcheese

Is that going to be a chicken and egg scenario ??

As in you'd pay extra as long as the service was efficent now , but you're not going to pay both , and there's no guarantee they'll get the service running well on x time ..( or likely hood ever )
Then does everyone pay 2 grand extra ?

What if they've more or less got things running well in say cork and Galway ,but Dublin is still as clogged up as ever ? Would you pay then ?

Wanderer78

Health care systems are highly complex beasts, I'd imagine every system on the planet is problematic, and I'd say ours will always be problematic

Mantis Toboggan

Wanderer78 wrote: »

Health care systems are highly complex beasts, I'd imagine every system on the planet is problematic, and I'd say ours will always be problematic

Nothing will change as long as the HSE remains, it's not fit for purpose. Needs to be scraped.

Wanderer78

Mantis Toboggan wrote:

Nothing will change as long as the HSE remains, it's not fit for purpose. Needs to be scraped.

Scrapping a major body such as the HSE would probably introduce more chaos, it's very easy to say such a thing, but actually doing it.....

Mantis Toboggan

Wanderer78 wrote: »

Scrapping a major body such as the HSE would probably introduce more chaos, it's very easy to say such a thing, but actually doing it.....

Well then nothing will change, its a bottomless pit in terms of throwing money at it.

Wanderer78

Mantis Toboggan wrote:

Well then nothing will change, its a bottomless pit in terms of throwing money at it.

Very similar in other countries I'd imagine, keeping people alive seems to be important across the world

C0N0R

This may sound rather ignorant but I’m not currently in the country and don’t have any relations that are struggling to cope with the health service either patients or doctors/nurses, but what are the fundamental issues with the health service? And why can’t they be fixed, or how can they be fixed? An answer without it just saying people waiting on trolleys would be appreciated if possible.

Wanderer78

C0N0R wrote:

This may sound rather ignorant but I’m not currently in the country and don’t have any relations that are struggling to cope with the health service either patients or doctors/nurses, but what are the fundamental issues with the health service? And why can’t they be fixed, or how can they be fixed? An answer without it just saying people waiting on trolleys would be appreciated if possible.

Its hard to know where to begin, but adequate mental health and psychological supports effectively don't exist, but it's issues are long and complex, I don't think anyone knows what to do. Very long waiting lists, some for critical procedures

lisasimpson

We keep talking about more nurses and beds but we need more staff in other area. 2 examples of people close to me.1 in for pre op the day before having breast removed. Last part of pre op was a chest xray. As it was near 12 we were told go for coffee as the xray dep would be gone on lunch. No way should a dept fully close for lunch. In a previous job I worked in a dept where all the team couldnt go on lunch at the same time there had to be cover.
2. A friend needed a spinal tap done. Was suppose to have it on a thursday to be discharged after it. No one available and didnt get it done until the following monday. Spent all weekend in hospital as a bed blocker

BluePlanet

This thread is a waste.
We already have a plan called SlainteCare that all parties have backed in principle.
We just need the political will, and capital to implement over the next decade.

lisasimpson

BluePlanet wrote: »

This thread is a waste.
We already have a plan called SlainteCare that all parties have backed in principle.
We just need the political will, and capital to implement over the next decade.

Hello Roisin

Mantis Toboggan

Wanderer78 wrote: »

Very similar in other countries I'd imagine, keeping people alive seems to be important across the world

Yeah but our system is top heavy, too many chiefs and not enough Indians. People in offices on huge salaries twiddling their thumbs with little to no qualifications. Drafted in from the old health board system.

Outdated technology, poor systems and a lack of joined up thinking. A unionised workforce who resist change on a daily basis. Nothing will change as long as the current system remains.

Wanderer78

Mantis Toboggan wrote:

Outdated technology, poor systems and a lack of joined up thinking. A unionised workforce who resist change on a daily basis. Nothing will change as long as the current system remains.

You can be damn sure, it won't be solved on boards, nobody knows what to do here

is_that_so

Mantis Toboggan wrote: »

Nothing will change as long as the HSE remains, it's not fit for purpose. Needs to be scraped.

Harris and Reid agree with you. It is being scrapped in its current form. New version will be up and running next year, subject to government approval.

RobAMerc

I worked for the HSE for 3 years - what a total basket case, everyone bar non front line staff need to go and the whole organisation be rebooted
I watched as senior managers literally spent the whole day txting friends and drinking tea. Other senior managers hired multiple "aides" in order to use up budget and then left the aides watching youtube all day coz there was nothing for them to do.
I met an old acquaintance who was a senior manager in the Health Board, she told me she had never been removed when the HSE came in just replaced ! She was left in her post ( pretty much doing nothing )

What people may not understand is the HSE is simply a layer of management smeared over a bunch of fairly autonomous organisations based mainly around specialties. Each of those has in turn its own management structure, and internal organisational structures ( HR, IT etc ) and every one of those (without fail) have one purpose - keep themselves in a job by keeping the HSE out. The patient first ? My hole.

The HSE has 0 control over them and only really has the ability to gain some control when they have some leverage over them - such as a crisis.

Slainte Care is a pipe dream.( designed to line the pockets of the consultancies who helped define it ) The HSE will achieve nothing until the whole organisation is disbanded and a government with balls tackles the whole poisonous lot.

Wanderer78

Wanderer78 wrote: »

Health care systems are highly complex beasts, I'd imagine every system on the planet is problematic, and I'd say ours will always be problematic

What are you talking about?

The services offered by the private hospitals like the Beacon or the Mater are excellent.

votecounts

A lot of the problem is there too much middle management and they won't be touched without the unions going beserk.
Another problem is that how many times so you see in the news, that there is a facility built, eg a Hospice in Waterford but no money for staff.
Cardiac Care is 9-5 Monday to Friday in a lot of places, so don't dare have a heart attack outside these hours or you're fcuked
Public waiting lists for hip replacement and cateracts are way too long and this is why you had Indepedent TDs orgaising buses to belfast from cork/kerry.
I won't even start on the joke that is the care for people with disabilities, mental health issues and the elderly.

Graces7

Excellent appraisal. As anyone who has ever tried to get a serious formal complaint processed will attest. Myself included. Head meet multiple brick walls. Patient care ? They have never heard of it.

RobAMerc wrote: »

I worked for the HSE for 3 years - what a total basket case, everyone bar non front line staff need to go and the whole organisation be rebooted
I watched as senior managers literally spent the whole day txting friends and drinking tea. Other senior managers hired multiple "aides" in order to use up budget and then left the aides watching youtube all day coz there was nothing for them to do.
I met an old acquaintance who was a senior manager in the Health Board, she told me she had never been removed when the HSE came in just replaced ! She was left in her post ( pretty much doing nothing )

What people may not understand is the HSE is simply a layer of management smeared over a bunch of fairly autonomous organisations based mainly around specialties. Each of those has in turn its own management structure, and internal organisational structures ( HR, IT etc ) and every one of those (without fail) have one purpose - keep themselves in a job by keeping the HSE out. The patient first ? My hole.

The HSE has 0 control over them and only really has the ability to gain some control when they have some leverage over them - such as a crisis.

Slainte Care is a pipe dream.( designed to line the pockets of the consultancies who helped define it ) The HSE will achieve nothing until the whole organisation is disbanded and a government with balls tackles the whole poisonous lot.

If there is a grand coalition that they're talking about it might be an opportunity to dismantle the HSE..

ChikiChiki

RobAMerc wrote: »

I worked for the HSE for 3 years - what a total basket case, everyone bar non front line staff need to go and the whole organisation be rebooted
I watched as senior managers literally spent the whole day txting friends and drinking tea. Other senior managers hired multiple "aides" in order to use up budget and then left the aides watching youtube all day coz there was nothing for them to do.
I met an old acquaintance who was a senior manager in the Health Board, she told me she had never been removed when the HSE came in just replaced ! She was left in her post ( pretty much doing nothing )

What people may not understand is the HSE is simply a layer of management smeared over a bunch of fairly autonomous organisations based mainly around specialties. Each of those has in turn its own management structure, and internal organisational structures ( HR, IT etc ) and every one of those (without fail) have one purpose - keep themselves in a job by keeping the HSE out. The patient first ? My hole.

The HSE has 0 control over them and only really has the ability to gain some control when they have some leverage over them - such as a crisis.

Slainte Care is a pipe dream.( designed to line the pockets of the consultancies who helped define it ) The HSE will achieve nothing until the whole organisation is disbanded and a government with balls tackles the whole poisonous lot.

Ard you saying the HSE does not have standardised HR and IT systems/processes?

ChikiChiki

Wanderer78 wrote: »

Health care systems are highly complex beasts, I'd imagine every system on the planet is problematic, and I'd say ours will always be problematic

This is a myth. I hate this defeatist attitude that is constantly trotted out.

all about the mane

Wanderer78 wrote: »

Health care systems are highly complex beasts, I'd imagine every system on the planet is problematic, and I'd say ours will always be problematic

Nothing that a few pre-election empty promises can’t fix!

kevthegaff

Would u believe I'd work more at childrens/adults eating habits, fast food, drinking. Sport should be really pushed, big problem I read one day alot of young parents are overweight prob due to both working, long commutes and fast food. Societal changes are needed which would reduce lifestyle issues which burden the healthcare system

Snow Garden

Mantis Toboggan wrote: »

Yeah but our system is top heavy, too many chiefs and not enough Indians. People in offices on huge salaries twiddling their thumbs with little to no qualifications. Drafted in from the old health board system.

Outdated technology, poor systems and a lack of joined up thinking. A unionised workforce who resist change on a daily basis. Nothing will change as long as the current system remains.

Correct. I worked in the HSE for just under 2 years and it's bloated management team were completely useless and obsessed with milking expenses. Many of their roles added zero value. The waste of money is staggering. Total bureaucracy. Very difficult to get any process improvements done.

quodec

So how did SF think they'd solve the health crisis then?

all about the mane

[Deleted User] wrote: »

If there is a grand coalition that they're talking about it might be an opportunity to dismantle the HSE..

It’s the only way it could be done. All parties buying in and taking the battle on. Never going to happen.

all about the mane

quodec wrote: »

So how did SF think they'd solve the health crisis then?

They didn’t but it sounds good.

Rodin

No discussion about health should start without addressing the health of the nation.

People need to do their bit. And they're not.

Obesity and lack or exercise are the biggest challenges facing the health service.

If you're not doing your bit to not be a burden on the system, you've no right to criticise waiting times/lists.

screamer

No absolutely not, as my extra money would just be swallowed by the hole that is the HSE rather than being reformed.
HSE needs to be reverted to health boards and tackled one at a time. Outlaw unions, it’s the only way. Cut out the unnecessary admin and ancillary staff, ask the purchasing managers to get aggressive with buying to identify savings and we need more frontline staff. It will tKe years and so I’ll keep paying for my own health insurance.

byhookorbycrook

Recently spent time in a private hospital, two beds in my room, a few 4 beds on the floor too. The place was spotless . MRI ordered at 6pm on Sunday , done at 9am on Monday . The nurse to patient ratio seemed to be good and the food was pretty good too.

Contrast that to a relation in a public hospital . Minimum 6 patients per room . Litter on the floor - stayed there until one of the visitors picked it up after 2 days . Again, not sure of the nurse to patient ratio but definitely much worse than the private hospital. The public hospital was much bigger , so economy of scale should have been in its favour , as well .

Which begs the question, that if a private hospital run as a profit-making business can make money , how on earth can a public hospital be such a mess , considering that many of the patients there were covered by VHI or similar which was billed for those patients ?

the-island-man

I was born in the late 80's and growing up I remember having all the regional health boards in existence.

Anyone else see the irony in the fact that Slaintecare seems to be veering back to that model with the "health areas"?!

Anyone here of an older vintage know what the issue with the health boards was? Why did they create the HSE?

sameoldname

byhookorbycrook wrote: »

Recently spent time in a private hospital, two beds in my room, a few 4 beds on the floor too. The place was spotless . MRI ordered at 6pm on Sunday , done at 9am on Monday . The nurse to patient ratio seemed to be good and the food was pretty good too.

Contrast that to a relation in a public hospital . Minimum 6 patients per room . Litter on the floor - stayed there until one of the visitors picked it up after 2 days . Again, not sure of the nurse to patient ratio but definitely much worse than the private hospital. The public hospital was much bigger , so economy of scale should have been in its favour , as well .

Which begs the question, that if a private hospital run as a profit-making business can make money , how on earth can a public hospital be such a mess , considering that many of the patients there were covered by VHI or similar which was billed for those patients ?

According to this article from RTE, only €650 million a year comes in from private heath insurance to public hospitals. Government spending on health this year is €18.3 billion so it's a fairly small proportion overall.
Also, people on lower incomes who don't tend to have health insurance also tend to have more health complications than those in higher income brackets. Private hospitals don't generally deal with hundreds of pissheads every weekend either, etc, etc.

Graces7

Rodin wrote: »

No discussion about health should start without addressing the health of the nation.

People need to do their bit. And they're not.

Obesity and lack or exercise are the biggest challenges facing the health service.

If you're not doing your bit to not be a burden on the system, you've no right to criticise waiting times/lists.

Ah the " blame the patient" tactic. :rolleyes::eek: Anything but face the reality.

Snow Garden

the-island-man wrote: »

I was born in the late 80's and growing up I remember having all the regional health boards in existence.

Anyone else see the irony in the fact that Slaintecare seems to be veering back to that model with the "health areas"?!

Anyone here of an older vintage know what the issue with the health boards was? Why did they create the HSE?

The reason the health boards were amalgamated into the HSE was that it would reduce costs and increase efficiency by ending duplication across the country. However there were supposed to be large scale redundancies as part of the plan. At the last minute, in order to protect votes, Harney decided there could be no redundancies. It meant there were thousands of idle people with no value add roles. The HSE subsequently made up roles for those people and created a massive unwieldy bureaucracy. It was a disaster from the start and has only gotten worse.

Paulzx

byhookorbycrook wrote: »

Which begs the question, that if a private hospital run as a profit-making business can make money , how on earth can a public hospital be such a mess , considering that many of the patients there were covered by VHI or similar which was billed for those patients ?

.............because a Private Hospital can cherry pick areas of health and medical procedures that are profitable.

..............because a Private Hospital only has patients that are paying for the priviledge of being there.


There is still no excuse for the basket case that is the HSE but it is unfair to compare it to a private hospital which has no obligation to treat and provide healthcare for every person and ailment that appears at its doors.

For example, some private hospitals that have self styled A and E's will ring 999 for an emergency public ambulance when a patient presents with a serious condition that they can't or don't want to deal with. They will of course bill the patient for the assessment but then pawn the treatment and patient off to the public system in a publicly funded 999 ambulance.

There are defintely lessons the public system can learn from private hospitals but they are 2 different animals.

JohnnyFlash

Graces7 wrote: »

Ah the " blame the patient" tactic. :rolleyes::eek: Anything but face the reality.

What reality?

Hellrazer

The health service needs to be run as a business and that goes down to individual contracts of the consultants as in my opinion they are the ones causing the majority of the hold ups in the system.

In what other business can you

1.Decide to show up for work whenever you feel like it. Clinic starts at 9.00 - consultant arrives at 9.00,f**ks off for a coffee,comes back at 10.00 and then starts to see patients. Same at 11.00 and then off for lunch for 2 hours.Disappearing halfway through a clinic for no reason. They are not being held accountable. In the last 3 months I have personally experienced this on 3 separate occasions.

2. Decide to work for your competitor ie a private hospital. Cancel your public clinic with no notice yet the patient can get an appointment the same day or the next by paying you 200 + euros. Again leaving the patients waiting. Again Ive experienced this in the last couple of months. This is an absolute disgrace.

3.Decide when you feel like working. Not bothering to show up when a clinic is supposed to be open without any reason whatsoever.

So how would I suggest fixing it?


Make sure they actually show up on time - introduce a clock in system so they are accountable.
Do away with dual contracts. They either work for the public or private but not both.
If they decide to stick with the public system then they work a 35 hour week. Starting at the start of their clinic time,taking a realistic lunch break and finishing when all the patients have been seen.

In other words make them work like any other employee.

AndrewJRenko

salonfire wrote: »

What are you talking about?

The services offered by the private hospitals like the Beacon or the Mater are excellent.

It's easy to offer excellent services if you can cherrypick the services you offer and who you offer them too.

byhookorbycrook wrote: »

Recently spent time in a private hospital, two beds in my room, a few 4 beds on the floor too. The place was spotless . MRI ordered at 6pm on Sunday , done at 9am on Monday . The nurse to patient ratio seemed to be good and the food was pretty good too.

Contrast that to a relation in a public hospital . Minimum 6 patients per room . Litter on the floor - stayed there until one of the visitors picked it up after 2 days . Again, not sure of the nurse to patient ratio but definitely much worse than the private hospital. The public hospital was much bigger , so economy of scale should have been in its favour , as well .

Which begs the question, that if a private hospital run as a profit-making business can make money , how on earth can a public hospital be such a mess , considering that many of the patients there were covered by VHI or similar which was billed for those patients ?

Why would you assume that many of the patients in a public hospital are covered by VHI? Again, it's easy to run a nice, clean service when you cherrypick the services that you provide and who you provide them to.

AndrewJRenko

Hellrazer wrote: »

The health service needs to be run as a business and that goes down to individual contracts of the consultants as in my opinion they are the ones causing the majority of the hold ups in the system.

In what other business can you

1.Decide to show up for work whenever you feel like it. Clinic starts at 9.00 - consultant arrives at 9.00,f**ks off for a coffee,comes back at 10.00 and then starts to see patients. Same at 11.00 and then off for lunch for 2 hours.Disappearing halfway through a clinic for no reason. They are not being held accountable. In the last 3 months I have personally experienced this on 3 separate occasions.

2. Decide to work for your competitor ie a private hospital. Cancel your public clinic with no notice yet the patient can get an appointment the same day or the next by paying you 200 + euros. Again leaving the patients waiting. Again Ive experienced this in the last couple of months. This is an absolute disgrace.

3.Decide when you feel like working. Not bothering to show up when a clinic is supposed to be open without any reason whatsoever.

So how would I suggest fixing it?


Make sure they actually show up on time - introduce a clock in system so they are accountable.
Do away with dual contracts. They either work for the public or private but not both.
If they decide to stick with the public system then they work a 35 hour week. Starting at the start of their clinic time,taking a realistic lunch break and finishing when all the patients have been seen.

In other words make them work like any other employee.

Where specifically are these abuses happening?

Wanderer78 wrote: »

You can be damn sure, it won't be solved on boards, nobody knows what to do here

Ah, hold on now, surely you're not suggesting that the fixing something as complex as the health service might require people who actually know something about running health services?

Sure that's no fun - can't we continue to have people with no clue post their in-depth conclusions that arise from having walked past an outside wall once in 1992?

We should do this for all professions - to hell with professional qualifications, let's get the lads on boards tell us how to win court cases, design buildings, sell products etc. The next time I'm due for surgery, I'll definitely ask the lads on boards how to do the surgery. I'm so sick of bloody experts.

mikep

No plan will work until the two big beasts are controlled, HSE and Unions.

Recently there was talk about how reforms were blocked, it seems that there was a pilot project introduced to bring in the position of "theatre assistants" which would work in tandem with nurses etc keeping things running in the operating theaters. Common in most modern health systems..

Blocked by the unions so dropped despite the fact that it would have made conditions better...


Also there is a rumour that for each new nursing post thwere has to be a "manager" appointed, backed by the union..

Big problems there..

mikep

RobAMerc wrote: »

I worked for the HSE for 3 years - what a total basket case, everyone bar non front line staff need to go and the whole organisation be rebooted
I watched as senior managers literally spent the whole day txting friends and drinking tea. Other senior managers hired multiple "aides" in order to use up budget and then left the aides watching youtube all day coz there was nothing for them to do.
I met an old acquaintance who was a senior manager in the Health Board, she told me she had never been removed when the HSE came in just replaced ! She was left in her post ( pretty much doing nothing )

What people may not understand is the HSE is simply a layer of management smeared over a bunch of fairly autonomous organisations based mainly around specialties. Each of those has in turn its own management structure, and internal organisational structures ( HR, IT etc ) and every one of those (without fail) have one purpose - keep themselves in a job by keeping the HSE out. The patient first ? My hole.

The HSE has 0 control over them and only really has the ability to gain some control when they have some leverage over them - such as a crisis.

Slainte Care is a pipe dream.( designed to line the pockets of the consultancies who helped define it ) The HSE will achieve nothing until the whole organisation is disbanded and a government with balls tackles the whole poisonous lot.

Have you ever thought of approaching a journalist with this so this could get into the public arena...

mlem123

I think a lot of these middle management types are the "lifers" that are slowly being retired out. A lot of posts in the admin side aren't being replaced when someone leaves

AndrewJRenko

mikep wrote: »

No plan will work until the two big beasts are controlled, HSE and Unions.

Recently there was talk about how reforms were blocked, it seems that there was a pilot project introduced to bring in the position of "theatre assistants" which would work in tandem with nurses etc keeping things running in the operating theaters. Common in most modern health systems..

Blocked by the unions so dropped despite the fact that it would have made conditions better...


Also there is a rumour that for each new nursing post thwere has to be a "manager" appointed, backed by the union..

Big problems there..

How exactly were the theatre assistants being blocked?
https://www.businesspost.ie/health/cork-university-hospital-hires-theatre-assistants-to-ease-staffing-shortages-68161f64

Is there any chance that we could base our discussions on something more than 'rumour'?

mikep

AndrewJRenko wrote: »

How exactly were the theatre assistants being blocked?
https://www.businesspost.ie/health/cork-university-hospital-hires-theatre-assistants-to-ease-staffing-shortages-68161f64

Is there any chance that we could base our discussions on something more than 'rumour'?

I can't access the rest of that article but this was resisted before and if you look at the link you posted it states that that their introduction has been resisted by the INMO.

Let's see if it actually happens...

1641

For the amount of money we put in we should have an excellent health service.
More money is not going to help - it needs massive reform. But whoever takes power I am very pessimistic that they will be strong enough and determined enough to take on all the vested interests involved. This includes the unions who all want who shout for better services but resist any structural changes that impact their members - and who look at proposals for change as an invitation to improve their own pay and conditions. Of course they will all shout about what others must do but not themselves.

Any real reform is going to demand change from all involved. No matter what the unions say now, just see how they will squeal and resist when their own sector is impacted. This applies to all union groupings - doctors, nurses, paramedics, care staff, administrative, etc, etc, etc, (but some are more powerful than others).

Also, watch how local communities are mobilised when rationalisation and quality improvement threatens a low grade and inefficeient local service. These are "well paid secure jobs" that they are not going to give up easily. In is sometimes revolting to see and hear protesters looking to keep a crap service by pretending to care about patients/residents when it is the jobs and money "up the road" that is the concern.

piplip87

I still think less smaller hospitals, with centres of excellence dotted around the country is the way to go.

There's too many smaller hospitals that specialise in nothing but offer nothing than a place to go until you can get transferred to Dublin.

Close smaller hospitals while buildinglarge super hospitals around the country. That specialise in everything.

Provide taxbreaks for all healthcare workers and recruit internationally.

Move chemo, infusions and other day treatments to primary care centres locally and staff these as required. My OH has to travel to Dublin every month for a two hour infusion that could be given locally. This will free up rooms in hospitals.

Smaller hospitals are great to have in a town but in reality they are just places to go until your transferred but governments won't touch them due to the backlash but resources would be better spent elsewhere.

There's too many hospitals offering the same thing 20 super hospitals outside Dublin would see large parts of the country under an hour from a hospital if strategically placed.

jmayo

ted1 wrote: »

So taking a break from the main GE thread I thought we’d start a separate health thread and see how we fix the system

I’m Currently paying about 2,500 a year so 5,000 before tax for private health insurance for myself , wife and three kids.

Don’t have day to day , so spend and additional 600 euro cash on doctors a year.

So the question is, if there was a good health system would you be willing to pay an extra 2 thousand ( per family, say700 for an individual) in taxes for a proper system as opposed to our current system ?
And if so would that fix the system ?

The worry I would have is that you pay even more into a central pot and it is wasted in the whole public health system and you are screwed when you get to hospital anyway because you are now in the public system.

The whole health system from top to bottom needs to be overhauled.

You have people with medical cards going to the doctor unnecessarily simply because it costs nothing.
Charge 10 euros a pop if unnecessary visit.

Also then you have GPs just playing it safe and sending people unnecessarily to A&E clogging up that.

Also A&Es half full with junkies and drunks wandering around, which should immediately garnish a charge for time wasting.

The HSE and indeed all public hospitals (the voluntary ones) appear to be cesspit of yokels whiling away their time until ultimately tax free lump sum and nice pension, often in unnecessary duplicated roles, consultants acting as a law onto themselves and nurses doing more management than actual front line care.
There is often quoted myth about nurses spending all their time being up to their elbows in human excrement and blood, but the truth is a lot of this is now done by nursing aids and nurses don't do that stuff anymore.
But it plays better to keep the myth going when you are chasing pay rises.

joseywhales

I am confused by this free visit situation, is that actually true?

There a missionary hospital I'm hanging out in in India for the past while they charge people in poverty, and I mean eating scraps having a share of a goat poverty, and they charge them some nominal fee like 50c or e1, which is a big deal for them but the hospital does it so that they value the time and the medication. I would have thought this was a simple concept.