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Have NPHET lost the attention of people?
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The entire approach, with five levels, had been messed up by the “Level 3.5”, “Level 4+“, carry on
Too many people are trying to find loopholes in the regulations/guidelines, so I think it’s high time for some total clarity of what’s required of us, in crystal clear language with no faffing about. Instead of half baked language, simplicity.
Melbourne has got it sorted. So can we. More drip feed today from Simon Harris. Softening us up. FFS government, get a grip and get in the driving seat.0 -
Happydays2020 wrote: »Yes. Which has shown the mess that NPHET have been making for the last few weeks. Level 3 restrictions were working until they lost the run of themselves. They have lost the people.
I’m not sure what you mean. I follow government advice. If people don’t know that standing next to each other is not great in light of a global pandemic of an incredibly infectious disease then I don’t know what you or anyone expects. But i don’t think it’s some fault of nphet.
Nphet never had me. So they can’t lose me.
Droplet precautions existed before nphet. They’ll exist afterward. They even exist in other countries - quell surprise.0 -
Happydays2020 wrote: »Who are the people responsible for tracing? They sit on NPHET.
Who is responsible for acute hospital capacity? They sit on NPHET.
Who did nothing on these during the summer and wagged their fingers at the citizens? They sit on NPHET.
Tracing - HSE and HPSC (a sub function of HSE). An effective test trace system is not an excuse to not adhere to guidelines.
Capacity - DoH. If you can **** 3500 Acute beds at a cost of billions in a few months then you’re probably the worlds most sought after ceo. St james has about a 1000 beds. Not sure where you’re gonna get the other 3500. Regardless there’s capacity built up for about 2200 beds all around the country. Read the HSE winter plan before you spout ****e.
What would you know about what they did or didn’t do.0 -
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[Deleted User] wrote: »The entire approach, with five levels, had been messed up by the “Level 3.5”, “Level 4+“, carry on
Too many people are trying to find loopholes in the regulations/guidelines, so I think it’s high time for some total clarity of what’s required of us, in crystal clear language with no faffing about. Instead of half baked language, simplicity.
Melbourne has got it sorted. So can we. More drip feed today from Simon Harris. Softening us up. FFS government, get a grip and get in the driving seat.
How can you make the complex more simple. Melbourne locked down. You can have fully open and fully locked down. There is always layers of complexity in between that could only be implemented with people being reasonable and responsible and not finding loopholes for non compliance.0 -
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I’m not sure what you mean. I follow government advice. If people don’t know that standing next to each other is not great in light of a global pandemic of an incredibly infectious disease then I don’t know what you or anyone expects. But i don’t think it’s some fault of nphet.
Nphet never had me. So they can’t lose me.
Droplet precautions existed before nphet. They’ll exist afterward. They even exist in other countries - quell surprise.
Well - if the Government and NPHET are not seeing eye to eye then that drips down to the people. Communication and process is critical.0 -
Tracing - HSE and HPSC (a sub function of HSE). An effective test trace system is not an excuse to not adhere to guidelines.
Capacity - DoH. If you can **** 3500 Acute beds at a cost of billions in a few months then you’re probably the worlds most sought after ceo. St james has about a 1000 beds. Not sure where you’re gonna get the other 3500. Regardless there’s capacity built up for about 2200 beds all around the country. Read the HSE winter plan before you spout ****e.
What would you know about what they did or didn’t do.
This is the not the first rodeo the HSE has had winter after winter with euro after euro given to them. The winter plan should have been started in June. We knew what the problems were then. I think people who have experienced the disorganisation first hand know the mess it is in and has been in for years. And we have been funding it.0 -
Happydays2020 wrote: »Well - if the Government and NPHET are not seeing eye to eye then that drips down to the people. Communication and process is critical.
Of course they’re not seeing eye to eye. One provides public health advice. The other governs.0 -
Happydays2020 wrote: »This is the not the first rodeo the HSE has had winter after winter with euro after euro given to them. The winter plan should have been started in June. We knew what the problems were then. I think people who have experienced the disorganisation first hand know the mess it is in and has been in for years. And we have been funding it.
It was started in June. You do understand that the day the report is published is not the date that it was first considered or thought about.
No you haven’t been funding it for what it is you think you want. It’s been funded for what we currently have.
If you think there’s billions of slack in the health service then that’s delusional.
Take even a very small part of the health service - icu. To fund those 250 beds Previously identified would cost 1/4bn. Fine - increase taxes and pick out one small part of the health service. You don’t have to tell the rest of the health service that they can’t do without it just cos icu want more of the slice of cake.
Every year, every oireachtas committee on health and public accounts it’s the same thing. The HSE is not funded to meet the normal needs of an older and growing population. Yet more services are to be developed within that envelope.
The same people cry for more money for our docs and nurses yet won’t pay more tax.
The same people say there’s too many managers but never say that it only represents 1.5% of th health service and includes all hr finance and all those other enabling functions that are required. And that we have less admin that nhs and they’ve had reports suggesting that they need far more.
It’s amazing there’s any room left on the anti HSE bandwagon.0 -
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True. That brings back questions around the schools.
Well in my view - there’s only one way to get rid of the virus. A full and complete lockdown. I’m not even entirely sure that you can completely get rid of it. I’m not advocating that position - just a point in fact.
No restrictions is not an acceptable position. So clearly it’s a level of risk and exposure that’s tolerable to society.
I pick schools over pubs every day of the week. The responsibility is then on parents to do what they need to do to maintain droplets precautions.
All easier said than done.0 -
It was started in June. You do understand that the day the report is published is not the date that it was first considered or thought about.
No you haven’t been funding it for what it is you think you want. It’s been funded for what we currently have.
If you think there’s billions of slack in the health service then that’s delusional.
Take even a very small part of the health service - icu. To fund those 250 beds Previously identified would cost 1/4bn. Fine - increase taxes and pick out one small part of the health service. You don’t have to tell the rest of the health service that they can’t do without it just cos icu want more of the slice of cake.
Every year, every oireachtas committee on health and public accounts it’s the same thing. The HSE is not funded to meet the normal needs of an older and growing population. Yet more services are to be developed within that envelope.
The same people cry for more money for our docs and nurses yet won’t pay more tax.
The same people say there’s too many managers but never say that it only represents 1.5% of th health service and includes all hr finance and all those other enabling functions that are required. And that we have less admin that nhs and they’ve had reports suggesting that they need far more.
It’s amazing there’s any room left on the anti HSE bandwagon.
I have family members who have worked in the HSE and the health boards before them. They are even more scathing about this mismanagement and a culture of finding excuses. Where you have people within always moving in opposite directions what do you expect. I am not excusing the political side either and am fully willing to pay in my taxes once I get some value for money.
Anyway, my issue here is that I don’t think NPHET is fit for purpose in advising Government at this time. I also think there are opportunities now to make the necessary structural changes to the health service. And I have no problem paying for it - and most people will not be paying more given health insurance costs.0 -
Happydays2020 wrote: »I have family members who have worked in the HSE and the health boards before them. They are even more scathing about this mismanagement and a culture of finding excuses. Where you have people within always moving in opposite directions what do you expect. I am not excusing the political side either and am fully willing to pay in my taxes once I get some value for money.
Anyway, my issue here is that I don’t think NPHET is fit for purpose in advising Government at this time. I also think there are opportunities now to make the necessary structural changes to the health service. And I have no problem paying for it - and most people will not be paying more given health insurance costs.
What is NEPHET's purpose?0 -
NPHET can’t be let run the country. Think about it, would you like the Data Protection or Safety Office run your company? The media are part of the perception problem too, as they peddle a narrative that the government must unconditionally parrot NPHET’s advice. We are either living with the virus or following a zero COVID strategy, the latter doesn’t seem politically possible. Time to continue living following sensible and strict precautions.0
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There is no Zero covid strategy, nor has there been a zero covid strategy. The strategy is to keep the virus under control.NPHET can’t be let run the country. Think about it, would you like the Data Protection or Safety Office run your company? The media are part of the perception problem too, as they peddle a narrative that the government must unconditionally parrot NPHET’s advice. We are either living with the virus or following a zero COVID strategy, the latter doesn’t seem politically possible. Time to continue living following sensible and strict precautions.
Living with Covid is designed to strike a balance between living with the disease and not having major impact on the economy and health services.
Thing is not enough people have been living with the precautions. The opposite in fact. This is why further restrictions are required. To push the virus numbers down again.
NEPHET aren't 'running the country'0 -
Happydays2020 wrote: »I have family members who have worked in the HSE and the health boards before them. They are even more scathing about this mismanagement and a culture of finding excuses. Where you have people within always moving in opposite directions what do you expect. I am not excusing the political side either and am fully willing to pay in my taxes once I get some value for money.
Anyway, my issue here is that I don’t think NPHET is fit for purpose in advising Government at this time. I also think there are opportunities now to make the necessary structural changes to the health service. And I have no problem paying for it - and most people will not be paying more given health insurance costs.
This old anecdotal tripe
Well since your family members don’t seem to be the managers that you criticise then it’s not exactly an informed position from them. Even if it is true.
Sure I have loads of family members who said that the HSE is well run by management in the area that they work in.
Funny response - you’ll only pay taxes when it’s value for money. You won’t pay for the investment needed until the investment is already made by people other than you.0 -
There is no Zero covid strategy, nor has there been a zero covid strategy. The strategy is to keep the virus under control.
Living with Covid is designed to strike a balance between living with the disease and not having major impact on the economy and health services.
Thing is not enough people have been living with the precautions. The opposite in fact. This is why further restrictions are required. To push the virus numbers down again.
NEPHET aren't 'running the country'
Why do we even have this forum then?
The truth is that never in the history of the state has an unelected committee been given the level of access to the media and the national spotlight being on them daily with press briefings, leaks and all headed up by a highly political leader, i.e. Holohan....
.....experts are supposed to advise and politicians lead not the other way around...
I do hope that people get the full Level 5 that they think will control Covid19 and come back in a months time wondering why it's not worked or hasn't had the effect they thought it would...0 -
This old anecdotal tripe
Well since your family members don’t seem to be the managers that you criticise then it’s not exactly an informed position from them. Even if it is true.
Sure I have loads of family members who said that the HSE is well run by management in the area that they work in.
Funny response - you’ll only pay taxes when it’s value for money. You won’t pay for the investment needed until the investment is already made by people other than you.
They were managers. But you will have to take it as anecdotal as I will not be naming names here.
But the IMF, the EU Commission and the OECD have all been of the view that we are not getting bang for buck from our healths service.0 -
The truth is that never in the history of the state has an unelected committee been given the level of access to the media and the national spotlight being on them daily with press briefings, leaks and all headed up by a highly political leader, i.e. Holohan....
.....experts are supposed to advise and politicians lead not the other way around...
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A succinct and reasonable analysis. I make two pints in response
- there has never been such a challenge to the state in the history of the state.
- that is the role of the chief doctor in ireland. It is (I think) a legislative function. Even if nphet didn’t exist, he would still speak to the media and still advise the government but he also has a role on advising the public directly on what they need to do as per of public health. If he disagrees with government, then he has to say it to the public out loud as he is a doctor first and foremost. No more than Dr. Fauci in US. This is clearly a fine line, which is why you need a cmo who is a political animal to thread that line.
I’m not disagreeing with you, just offering a response.0 -
I think NPHET is going to destroy Ireland.
They are always going for level 5.
I think the health aspect is very important but also socio-economic aspects should also be considered
I think the current government is making a shambles of dealing with the pandemic.
Why could we not take an approach like New Zealand?
I think the „co- Taoiseach“ had lost the run of himself completely - he seems to undermine the Taoiseach at every opportunity.
The health minister does not instill confidence.
Simon Harris is a man That did great work during the start of the pandemic and he single handedly saved thousands of lives.0 -
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Happydays2020 wrote: »They were managers. But you will have to take it as anecdotal as I will not be naming names here.
But the IMF, the EU Commission and the OECD have all been of the view that we are not getting bang for buck from our healths service.
I will certainly be taking it as anecdotal. Because it is anecdotal.
And you’ve clearly missed my point, nor responded to it.
Looking forward to you providing the links for these assertions and seeing - if they do exist - how you’ve confused the point.
Perhaps you might give an example where these managers have not gotten bang for buck.
A quick glance at the OECD Health at a glance report, or the DoH NHQRS report, or the NOCA NAHM, IHFD, ICU reports, or the HIQA medication safety and HCAi reports, the sepsis report etc will clearly show that we get excellent bang for our buck.
Managers don’t set the system up as it currently is. Doctors, nurses (And their unions) and governments do. Sure why else were the hospital groups set up the way that they where. Why was the HSE changed by government from it’s set up in 2008 to the one adopted in 2011 to the one adopted in 2018. Even now there’s question marks that the new structure won’t be moved to.0 -
I will certainly be taking it as anecdotal. Because it is anecdotal.
And you’ve clearly missed my point, nor responded to it.
Looking forward to you providing the links for these assertions and seeing - if they do exist - how you’ve confused the point.
Perhaps you might give an example where these managers have not gotten bang for buck.
A quick glance at the OECD Health at a glance report, or the DoH NHQRS report, or the NOCA NAHM, IHFD, ICU reports, or the HIQA medication safety and HCAi reports, the sepsis report etc will clearly show that we get excellent bang for our buck.
Managers don’t set the system up as it currently is. Doctors, nurses (And their unions) and governments do. Sure why else were the hospital groups set up the way that they where. Why was the HSE changed by government from it’s set up in 2008 to the one adopted in 2011 to the one adopted in 2018. Even now there’s question marks that the new structure won’t be moved to.
You are an apologist for the mis-functioning HSE. Simples. Like the HSE blame everyone except themselves.0 -
Happydays2020 wrote: »You are an apologist for the mis-functioning HSE. Simples. Like the HSE blame everyone except themselves.
You’re a bang wagging jumping know-it-all who - ironically- knows nothing about the biggest organisation in the country that provides care for every citizen in this stage from cradle to grave.
All you can offer is anecdotal examples from ‘someone you know’. Any examples that you can offer seem to be relate to government policy rather than anything the HSE can do anything about. And the stuff that you could reasonably highlight relates to about 0.1% of what the health service offers. You’re also the type of person who says it’s all the managers fault yet administrative and managerial staff are only 1.5% of the service and include all HR, Finance, Comms etc. The HSE is made up of doctors, nurses, physios, OTs and a tonne of other clinical staff. But typically tripe - it’s all the managers fault.
You provide nothing to the conversation. You have no understanding of how health systems run anywhere else in the world, including our own one.
Maybe you should start a HSE gratitude journal. You can write down three examples of how you’re grateful for our national health service. You can even share them with us.
I’ll start.
- Childhood immunisation programme
- sepsis programme
- ODTI0 -
https://ec.europa.eu/info/sites/info/files/file_import/2019-european-semester-country-report-ireland_en.pdf
The Irish healthcare system faces a crisis of cost-effectiveness. Year after year significant overspends are recorded in healthcare, yet process and output measurements do not reveal an improvement in performance. Neither are the persistent deficits attributable to any major expansion in service provision.
Despite its relatively young population, Ireland is one of the highest per capita spenders on health in the EU and the ageing of the population is likely to lead to higher spending and fiscal sustainability concerns (see Section 4.1.1). Considerable scope exists for savings to be made (DPER, 2018e), potentially freeing up resources for ambitious reform plans.
The ‘Sláintecare’ ten-year plan for healthcare reform captures the holistic overhaul that the Irish health system requires. A Sláintecare Programme Implementation Office has been created, aiming to translate the 2017 cross-party Sláintecare Report into reality. There are serious implementation challenges to realising the original vision of universal entitlement, and investment needs remain in order to shift focus to primary and community care. Yet the costs of not implementing the Sláintecare vision would be much higher in the long run.
Ireland has the largest duplicate market across the EU. Its characteristic ‘duplicate insurance’ enables patients to jump the queue — providing faster private sector access to medical services where there are waiting times in the public system (OECD et al., 2018g). This creates perverse incentives in publicly-funded hospitals, where preferential treatment of privately-insured patients adds to doctors’ private revenues. It is the Sláintecare vision to ultimately remove private practice from public hospitals, but Ireland has so far proven unable to confront the powerful stakes of the enormous insurance market. An independent review is underway, albeit constrained by lack of data on private practice.
Access to some core health services is still not universal in Ireland. An outlier in the EU, only around 50 % of the Irish population are covered for the costs of general practitioner visits (OECD et al., 2018g; European Commission, 2018o), and general practitioners are reluctant to see both coverage and service provision expanded without a commensurate change in remuneration. Without the expansion of coverage under Sláintecare, patients will continue to use hospital services for conditions that should normally be treated in primary care settings (OECD et al. 2017; OECD 2018f). Strong investment needs remain in order to deliver care at its lowest point of complexity.
Budget management is weak across all levels of the health system. The framework of accountability for expenditure under the Health Service Executive (HSE) to parliament is highly complex (Houses of the Oireachtas, 2018) and the HSE has repeatedly struggled to effectively manage a budget and stay within it, despite subsequent annual increases in expenditure (DPER, 2018b).
Comprehensive planning and funding models are either non-existent, poorly functioning or unconnected locally and regionally. Governance and accountability are hampered by lack of data on health workforce and private practice. For 2019, the Department of Health plans Labour market, education and social policies to increase the budget allocation for the HSE while requiring it to avoid overspends.
Public hospitals constitute an area where the cost-effectiveness crisis is most acute. Over the 2014-2017 period expenditure increased by 17 % while outputs remained relatively flat and waiting times increased sharply (DPER, 2018b).
Compared with other EU countries, Ireland has the highest occupancy rate for one of the lowest numbers of hospital beds per 1000 population (32) (OECD et al., 2018g). Efforts to implement Activity-Based Funding, as well as Performance and Accountability Frameworks, have only had limited success so far (DPER, 2018b) and there has been little progress since the 2015 Flory Report, which stressed the need for hospitals to produce realistic annual efficiency improvement plans.
Ireland’s system of long-term care also faces challenges. Spending on long-term care is projected to increase much faster than the EU average, leading to fiscal sustainability concerns (European Commission et al., 2018q). There is currently no statutory entitlement to formal home care, with long waiting lists and government plans to introduce a statutory scheme having been delayed (see Section 4.1.1 and European Commission, 2018n). Investing in a more developed formal home care sector could help reduce exchequer costs — reaching about EUR 1 billion in 2016 — while relieving the burden on (mostly female) informal carers, thus enabling them to return to the labour market.
Short-term cost containment will be needed to make the full Sláintecare vision a reality in the long run. There are a number of examples. Savings could be made from a higher uptake of biosimilar medicines, where Ireland lags behind (DPER, 2017). Realistic budgeting that avoids recurrent overspends is a necessary condition for the Health Service Executive to effectively manage their expenditure. Staffing costs and skill mix are not being actively managed and represent a risk of budget overspends and crowding out of other health expenditure (DPER 2018c; 2018d).
Finally, good quality hospital performance data, through the planned deepening and extending of Activity- Based Funding, are necessary to get to the bottom of the budgeting and performance problems.0 -
You’re a bang wagging jumping know-it-all who - ironically- knows nothing about the biggest organisation in the country that provides care for every citizen in this stage from cradle to grave.
All you can offer is anecdotal examples from ‘someone you know’. Any examples that you can offer seem to be relate to government policy rather than anything the HSE can do anything about. And the stuff that you could reasonably highlight relates to about 0.1% of what the health service offers. You’re also the type of person who says it’s all the managers fault yet administrative and managerial staff are only 1.5% of the service and include all HR, Finance, Comms etc. The HSE is made up of doctors, nurses, physios, OTs and a tonne of other clinical staff. But typically tripe - it’s all the managers fault.
You provide nothing to the conversation. You have no understanding of how health systems run anywhere else in the world, including our own one.
Maybe you should start a HSE gratitude journal. You can write down three examples of how you’re grateful for our national health service. You can even share them with us.
I’ll start.
- Childhood immunisation programme
- sepsis programme
- ODTI
I have provided above a link to and extract from independent analysis from the EU Commission on the stage of the health service. And they are not an outlier.
I know it is complicated, I know that there are structural difficulties and I know there are vested interests.
But pretending all is great when we are being told that the reason we need to have a more severe lockdown than any other country in Europe is due to the capacity and capability of our healths service then yes I will be critical and yes taxpayers have a right to be critical.
And please no need to insult me either. This is an Internet forum - people will have opinions and you can disagree with them if you like.0 -
I think NPHET is going to destroy Ireland.
They are always going for level 5.
I think the health aspect is very important but also socio-economic aspects should also be considered
I think the current government is making a shambles of dealing with the pandemic.
Why could we not take an approach like New Zealand?
I think the „co- Taoiseach“ had lost the run of himself completely - he seems to undermine the Taoiseach at every opportunity.
The health minister does not instill confidence.
Simon Harris is a man That did great work during the start of the pandemic and he single handedly saved thousands of lives.
What approach did NZ take?
NPHET advise based on numbers.
If the numbers were manageable I doubt they'd be asking for greater restrictions.0 -
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The problem with NPHET is that they are advising the government on the virus and it's spread only, the economy is not on their minds at all.
In their ideal would we would stay at level 5 until we have a working vaccine.
How society and the economy functions they probably don't care about. The virus would be kept under control and they have done their job.
Vaccine around Jan, Feb, more than one by then. Social distancing to dissipate by next May.
Great point your making cause I take it Nphet prob would have us at level 5 by way figures are going at the mo. Government needs to be strong here, Jobs are going like leaf's off fckn trees at this stage. Peoples mental health is being affected. My mates bro, attends a day care center he works there, 45 has mental illness, place is closed just heard tonight he tried to top himself 3 times in past 6 weeks.0 -
Is there really going to be an effective and safe and widely distributed vaccine by January?? That seems so optimistic. These things usually take many months and i havent read anything about a vaccine arriving so soon.0
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Vaccine around Jan, Feb, more than one by then. Social distancing to dissipate by next May.
Great point your making cause I take it Nphet prob would have us at level 5 by way figures are going at the mo. Government needs to be strong here, Jobs are going like leaf's off fckn trees at this stage. Peoples mental health is being affected. My mates bro, attends a day care center he works there, 45 has mental illness, place is closed just heard tonight he tried to top himself 3 times in past 6 weeks.
Do people not see, that the way figures are going at the moment, our hospitals and our ICU's WILL be over run without intervention?
It's a tough balancing act but higher numbers mean more erstrictions or greater enforcement of restrictions are need to stop this having a devastating impact on our healthcare system and indeed our economy.0
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