Why can government consistently underfund hospitals?

coylemj

rock22 wrote: »

There is absolutely no benefit for the public system in the two tier system in place for the past 50 years

I choose to pay medical insurance on top of my taxes. This allows me to seek out medical expertise (consultants) and patient care (private hospitals) in the private sector. In doing so, I am relieving pressure on the public system. What's wrong with that? Even if the socialists got their single tier health system, people with money would still have the right to go outside the public system for treatment.

In the promised land which is the NHS in the UK, millions of people still pay medical insurance to the likes of BUPA. Why? Because when you give something to the people for nothing, you meet an insatiable demand which means longs queues for the service. It takes weeks to get a routine GP appointment in the UK and that's after you get grilled by the practice receptionist to make sure you really need to see a GP.

A single tier health system is a pipedream which will never happen. Because unless we adopt the North Korean model, where the state runs everything and private enterprise is banned, there will always be private hospitals and private consultants. And people prepared to pay for the service.

Good loser

rock22 wrote: »

There is absolutely no benefit for the public system in the two tier system in place for the past 50 years

The single tier system in the NHS seems to have them in dire straits. For sure the GP system there is poor.

Do you think a straight swop would be better for us? Seems to me the evidence is that NHS is moving towards privatising things.

The demand for healthcare is unlimited or limitless. Rationing thus is inevitable.

How to is the heart of the issue?

weisses

coylemj wrote: »

I choose to pay medical insurance on top of my taxes. This allows me to seek out medical expertise (consultants) and patient care (private hospitals) in the private sector. In doing so, I am relieving pressure on the public system. What's wrong with that? Even if the socialists got their single tier health system, people with money would still have the right to go outside the public system for treatment.

In the promised land which is the NHS in the UK, millions of people still pay medical insurance to the likes of BUPA. Why? Because when you give something to the people for nothing, you meet an insatiable demand which means longs queues for the service. It takes weeks to get a routine GP appointment in the UK and that's after you get grilled by the practice receptionist to make sure you really need to see a GP.

A single tier health system is a pipedream which will never happen. Because unless we adopt the North Korean model, where the state runs everything and private enterprise is banned, there will always be private hospitals and private consultants. And people prepared to pay for the service.

What the actual fukc does a one tier health system got to do with socialism ?

Geuze

We need to define exactly what people mean by "single-tier".

The extreme-left in Ireland want no for-profit h/c at all, it seems.

They do not want non-HSE hosps to exist.

Slaintecare does not mean that.

Slaintecare means that private activity would no longer happen within a public hosp.

Under Slaintecare, private hosps / insurance can all continue to exist, although of course they may be affected if the Slaintecare waiting times are met.

Brussels Sprout

Geuze wrote: »

The extreme-left in Ireland want no for-profit h/c at all, it seems.

You make it sound like a bad thing.

jimmycrackcorm

Brussels Sprout wrote:

You make it sound like a bad thing.

Having no private health care choice is a bad thing. You're assuming that if there was no private HC then automatically the pubic system would get better.

It wouldn't. Some of the top consultants we have either do private or mixed public work.
If you choose to take away that then they wouldn't choose to stay here.

It's like suggesting going back to the days before Ryanair when we only had Aer Lingus and £600 flights to London.

Would you suggest removing all private cars and insist on only pubic transport everywhere?

Geuze

Brussels Sprout wrote: »

You make it sound like a bad thing.

I would prefer a range of providers.

The HSE is associated with high costs / low productivity.

As stated in this thread, one consultant said he gets "twice as much done, in half the time" in a non-HSE hosp.

The head of HR in the HSE said : I have 2,000 staff, and need 800.

The HSE had (and maybe still has) 62 payroll offices.

My fear for Slaintecare is that it means more unions / more costs / more low productivity.

If we could get a rock-solid promise on the 12/13 week waiting times under Slaintecare, against the 18 months now, I'd be happier.

Geuze

JohnMcm1 wrote: »

It's beyond a joke at this stage, politicians on ridiculous salaries and constantly giving themselves raises for doing feck all.

This statement is false.

As has been repeated, over and over, TDs get exactly the same pay changes as other public servants.

Geuze

Brussels Sprout wrote: »

You make it sound like a bad thing.

I like the sound of the French and German systems, where everybody has access, but there are a range of providers.

I am interested in how UHI might work here. UHI = universal health insurance, like in FR, DE, etc.

UHI might combine two aspects:

(1) everybody is insured

(2) patients can choose from various providers, this should help maintain competition between providers.

noodler

seamus wrote: »

Well yes and no.

When you compare us to gold-standard countries for medical care, our per-capita public health spending is lower. In the EU area we're about average, but that just puts us above poorer countries and behind comparably wealthy countries.

In terms of health spending as a % of GDP we're quite far behind.

We are using our resources very inefficiently. But we're also not spending enough.

The problem is that those who are most affected by issues in the public system are those with the least power to do anything about it.

All of the people who make the decisions about health spending and the people who have their ear, can all rely on private healthcare. So there is no incentive to make it better.

%GDP will obviously make us seem lower.

We are a high health spend country, particularly for our relatively younger demographic.

coylemj

Geuze wrote: »

We need to define exactly what people mean by "single-tier".

The extreme-left in Ireland want no for-profit h/c at all, it seems.

They do not want non-HSE hosps to exist.

+1 When the extreme left talks about a single tier, they mean one tier only and that will be the public health system. No private medicine.

The practical effect of this should not be lost on people - it would mean that every newly qualified doctor or nurse will have a choice - sign up to become an fulltime employee of the HSE or emigrate.

The likes of Paul Murphy and Brid Smith call themselves socialists but they are unreconstructed communists, nothing less. They want to eliminate all private health care - that is what 'single tier' means in their agenda.

Geuze wrote: »

Slaintecare does not mean that.

Slaintecare means that private activity would no longer happen within a public hosp.

Under Slaintecare, private hosps / insurance can all continue to exist, although of course they may be affected if the Slaintecare waiting times are met.

A worthy cause but it's born not of practicality but of political ideology and it will have a disastrous effect on the public health system.

Will any consultant who currently works full time in the Beacon or the Hermitage (100% private) jack in their private practice and take a fulltime job on a fixed income in a public hospital if Slaintecare happens? They can do that today so of course not.

Will any consultant currently working in a public hospital move to the private sector if they can't do any private practice in their current job? You bet.

Geuze

coylemj wrote: »

+1 When the extreme left talks about a single tier, they mean one tier only and that will be the public health system. No private medicine.

The practical effect of this should not be lost on people - it would mean that every newly qualified doctor or nurse will have a choice - sign up to become an fulltime employee of the HSE or emigrate.

The likes of Paul Murphy and Brid Smith call themselves socialists but they are unreconstructed communists, nothing less. They want to eliminate all private health care - that is what 'single tier' means in their agenda.

Yes, correct, though they are careful never to explicitly say that.

Given that most people in Ireland know that when the Berlin wall came down, people were trying to leave communist east Germany for west Germany, not the other way around, then why do some Irish people vote for these communists?

Geuze

coylemj wrote: »

A worthy cause but it's born not of practicality but of political ideology and it will have a disastrous effect on the public health system.

Will any consultant who currently works full time in the Beacon or the Hermitage (100% private) jack in their private practice and take a fulltime job on a fixed income in a public hospital if Slaintecare happens? They can do that today so of course not.

Will any consultant currently working in a public hospital move to the private sector if they can't do any private practice in their current job? You bet.

I don't think Slaintecare means that a consultant can't do private practice.?

AFAIK, they won't be able to do it in the public hosp.

Fair enough, in many towns in Ireland, there is just one hosp, so S/care would have an impact.

S/care might mean consultants having contracts like they have today, combined public and private, say 80% public, but they do the 20% in a different place.

jmayo

Del2005 wrote: »

You missed the important bit. The HSE is well funded but there's too many admin/management people. We merged 8 health boards to form the HSE yet had zero redundancies, so at least 6 people have no jobs to do while still getting paid and getting incremental pay rises for doing nothing.

The level of duplication has been a joke.

As others have said the entire health system in Ireland is vested interest driver and riddled.

You had and still have religious orders involved, you have representative bodies for doctors/consultants, you have nursing unions, unions for all the other medical related professionals and then you have all the unions representing the admin staff, the technical staff.

And the politicians are scared for the most part to ever take them on.
And that is because there are so many employees of the health system, in other words a lot of votes.

How many people have relatives that are doctors, nurses, admin staff.
I would say nearly every family in Ireland has someone working in health system.

Anytime some dares rock the boat the sacred cows of say the nurses are wheeled out.

And yes some nurses do very hard and difficult jobs, but a hell of a lot of them are now effectively managers of some sort.

One would swear every nurse is swimming in shyte and blood.

It seems they sometimes forget about nurses aids.

And as for the nepotism in the consultancy profession where who you know still looms large.

Look at the long list of scandals, scandals that have cost lives, and not one single person has been found responsible.
All we ever hear is some shyte about it being systemic.

Look at the new childrens hospital, which became a battle between the major hospitals (and universities) in Dublin together with politicians greasing their own patch.
The Mater got it first and when planning finally scuppered that cockup, James got in their next.
Another awful location.

Of course Vincents and UCD got to have something so they get the new National Maternity hospital, nevermind that the site owners (or trustees) don't want to ever allow abortions.
It is all politics.
And who suffers in the end, the patients.

And it isn't just us, the NHS is not some great world leading system anymore.
It is at breaking point.
The HSCNI in the North appears to be almost a way of offering jobs to people that can't get them otherwise.

And then you have morons talking about unification.
Imagine adding the HSCNI to the HSE.

weisses

Ireland should adopt the Dutch model

salonfire

Thing about Health in Ireland is that it can improve somewhat by someone with a bit of backbone like Mary Hearney and closing small cancer treatment centres in favour of the Centres of Excellence. Likewise with the smoking ban.

This moving the deck-chairs on the Titantic won't achieve much unless the vested interests are tackled. Even in it's current form, the HSE could be a reasonably good model if someone was willing to tackle the unions and invest properly in IT , equipment and buildings other than giving into salary demands.