The health service - most damning report yet

BrianD3

Unplanned (i.e. through A&E) care in 9 hospitals in 2018/2019 has been reviewed. The findings should be shocking, but umm, they aren't for anyone with direct experience of our death, sorry health service.

https://www.rte.ie/news/health/2022/0404/1290134-health-review/

No clear understanding of who was providing the patients' care.

"Safari rounds" ( I think that means walking around hospitals looking for patients scattered around the hospital)

Harm introduced through non specialist care.

Hospitals not operating a 24/7 care model

Problems at weekends

Not appearing to provide safe and effective care

Hospital staff didn't know who was in charge

Unsafe

etc.

The HSE didn't want the report published as they claim it is no longer relevant due to changes being made since. Absolute bull, of course it is relevant. I await the spin about how the problems in the health service are mainly due to Covid and how it was out of their control. Now everyone wear a mask and keep your distance.

As for the strategy to shift demands to the community - care in the community, from homecare to physiotherapy to public health nursing to nursing homes - shambolic.

Also, re: the 9 hospitals reviewed, IME there are even worse hospitals out there such as the Eye and Ear and Mayo General.

A few years ago, two of my close relatives died after attending A&Es in different public hospitals for conditions that while needing urgent attention, would not normally be expected to result in death in a modern health system. I suppose they were just "unlucky".

That's two in one small family, There must be thousands of others who have experienced similar, the death toll from this may well dwarf the death toll from Covid.

And yet, six figure salaries and fat pensions will still be paid. The HSE is in existence since 2005, that should have been our "NHS moment" but 17 years later, here we are. How much has been paid to a succession of Ministers, Dept of Health officials and HSE senior people in those 17 years. This serpent has many heads.

"

The HSE response is at the bottom of the linked article.

“In opting not to publish the report in 2020, the HSE told the Department of Health that the benefit of releasing the report has significantly diminished in that its principle recommendation was to accelerate the implementation of the Capacity Review of 2018 and that many measures had been put in place since.

HSE Chief Operations Officer Anne O'Connor told the Department of Health that the review had been conducted at a particular point in time, during 2019 and "prior to the impact of the learning from winter 2018/2019".

She said the findings of the review were largely predictable and reflective of work already under way, including shifting demand to the community.

Ms O'Connor said that the relevance and usefulness of the findings of the review had been considered in the context of the accelerated improvements made to deal with Covid-19.

"Therefore, the HSE has taken a decision not to proceed to finalisation and publication of a report that no longer has relevance," she told the Department of Health.”

cnocbui

I am emigrating, and the HSE and Irish health care system would be quite high on my list of reasons for doing so. I doubt ireland is capable of fixing it as facing and dealing with uncomfortable facts isn't an Irish thing.

blanch152

https://www.boards.ie/discussion/comment/118878942#Comment_118878942

Unfortunately you could be correct in that we are incapable of fixing it.

The HSE has been bedivilled by poor work practices protected by intransigent unions and stupid pay deals such as the one that created nursing management grades and promoted nurses who were actually good at nursing into a management job they weren't good at, therefore making both the nursing and management grades worse.

There are also societal issues. 75% of the people who turned up at A&E didn't need to be admitted and could have been treated in the community. Why are people turning up like that? It is madness. That isn't on the HSE, that isn't on the nurses, that isn't on local management or A&E Departments, it is on the people who turned up and the GPs who sent them.

cnocbui

https://www.boards.ie/discussion/comment/118878995#Comment_118878995

The problems are top to bottom and start with GP's and that whole system which is slow, paper based and stupidly inefficient. The whole mess starts with the education system where the medical profession have been allowed to control the whole mess and have used it to restrict the number of doctors who are educated. My local general practice is so overloaded they don't take on new patients and the turnover of Doctors seems quite high.

In other countries, it's possible for patients to directly access specialists, that isn't the case here, and it's just so inefficient, costly and time wasting.

I remember moving into my current house in 2002, and listening to the news while in the kitchen and hearing about patients on trolleys at Limerick regional. 20 years later and every year in between, it's still the norm. Other countries I can think of wouldn't tollerate that and the governments would have realized a need for greater capacity and would have provided it.

The HSE attitude to the report is typical - sweep it under the caprpet while saying no need to worry, that's all in the past, the problems have been solved, thing aren't like that now. Same sort of nonsense that's characterized how Catholic church attrocities have been dealt with by sweeping them under the carpet.

blanch152

https://www.boards.ie/discussion/comment/118879111#Comment_118879111

We spend huge amounts of taxpayer money per capita on the health service. It isn't a case of money, it isn't a case of politicians being able to fix it either, no legislation or Ministerial direction will change the poor quality of nurse management and poor practices on the ground by frontline staff, neither will it stop idiots turning up at A&E on a Friday night, just needing to sleep off drink and drugs.

cnocbui

https://www.boards.ie/discussion/comment/118879135#Comment_118879135

Absolutely. Ireland has one of the highest expenditures on healthcare in the OECD and the worst outcomes. Everyone knows that a large portion of the money is just a torrent of € going into the pockets of the HSE management layer that is hugely overpopulated and mostly unnecessary, but it's one of those generally known uncomfortable truths Ireland can't mentally deal with or openly and publicly acknowledge .

In Australia they would have been made redundant two decades ago. Here? - not a chance. The government can't get it's head around the civil sector being over financed compared to what is delivered, when compared to the norm in the EU or OECD.

Ireland doesn't do 'consequences'. I will always remember a few years ago a newspaper article about the national childrens hospital mess, where the minister for health said something like 'there needs to be an enquiry into matters, but it's important that a core element be that no individuals are to be identified, reported on or actioned.'

Hopeless - I'm off.

Ireland second-highest OECD health spending, poorest outcomes

blanch152

https://www.boards.ie/discussion/comment/118879195#Comment_118879195

With a problem that big, no Ministerial direction or legislation can solve it.

A lot of it comes from organisational behaviour, a culture of poor performance that permeates the health service right down to the frontline.

recode the site

https://www.boards.ie/discussion/comment/118878995#Comment_118878995

I got into a minor Twitter spat sone time ago when I responded to a Tweet that went like this: woman who had attended GP (who didn’t seem to attempt to fix her problem or refer her to a specific outpatient centre) said “if you are uncomfortable go to A&E”. Which she did. She registered in, saw triage nurse, waited 6 hours and left in protest. Seems she got better without further attention toon. But the Tweet was protesting at the fact she was sent a bill for attending, and wasn’t seen to before she got fed up. I replied that A&E is for people who are really too unwell to be able to walk out at their convenience.

A male tweeter retorted in this fashion: “ very unfair of you to say that, I have to fit in my A&E visits between collecting children from school”. Again I countered that he should be attending his GP for stuff that can be slotted into a time frame if his convenience and that attending A&E in that fashion, taking up space and walking out because you have done where else to go, really is not appropriate and part of the problem of A&E overcrowding.

kirk.

https://www.boards.ie/discussion/comment/118878995#Comment_118878995

People are turning up at a+e because of the GP issues, delays getting appointments

Also the out-of-hours service is scaled down and it's simply handier to present at a+e out-of-hours ,here a+e is much nearer destination

Also the docs on the out-of-hours tend to refer you to a+e for minor stuff anyway as a precaution so it was simpler to bypass them anyway

There's a couple of reasons anyhow plus the hypochondriacs with medical cards

kirk.

Has Donnelly even said anything about solutions aside from hiding behind covid

I really don't recall him saying much of substance on the hse

Ubbquittious

How hard do they need to damn before something gets done about it?

Fandymo

https://www.boards.ie/discussion/comment/118878995#Comment_118878995

Where do you go in the community after 6pm or on a weekend if something happens??

blanch152

https://www.boards.ie/discussion/comment/118879416#Comment_118879416

Two excellent examples of the problems I am talking about. If someone is able to collect their kids from school, they don't need to be in A&E.

recode the site

There’s a certain “illness culture”, more particularly among women (I am a woman btw, I’ll get my coat now 😂) that is of the belief that if you imagined you were sick enough to attend hospital then you must be taken very seriously. In some people’s minds it’s an “upgrade” in how others will view the importance of your suffering.

An example from some time back. Somebody I worked with was telling me about her daughter’s visit to A&E. I expressed due concern and hoped she was ok etc, and asked what was the matter. She had diarrhoea after eating something that was out of date. Now most people will stay at home beside their bathroom, take dioralyte, or Imodium from the medicine drawer or nearest pharmacy, stop eating for a bit or take light food.

There was no blood loss or extraordinary pain in her case. Just an unpleasant episode. I diplomatically enquired why she might not have taken care of it at home, the reply was that she “would surely need a drip”. Instead this extremely fit & healthy twenty something year old girl brings what could have been highly contagious Norovirus into a hospital of much sicker people who are undergoing surgeries etc and could be doing without that added misery.

Dyr

https://www.boards.ie/discussion/comment/118878942#Comment_118878942

If there's an Irish national charectaristic it's complacency, so long as the next lad is getting rode like you, it's all fine.

Dempo1

https://www.boards.ie/discussion/comment/118878915#Comment_118878915

Anne O Connor asked that this report not be released but shortly after it was it followed by an announcement she's heading off to the VHI to become Managing Director.

Paul Reid spoke of her wonderfulness generally and offerred a glowing analysis of her time in the Health sector.

Former Director of Mental Health 🙄

National Director of Community Based Health & Care 🙄

I'll leave others to decide how those assignments went.

Anne Led the Spin operation throughout the Pandemic very efficiently, one wonders who Paul Reid will have holding him up after she leaves.

https://www.irishexaminer.com/news/arid-40844015.html

Only in Ireland is Abject failure rewarded so handsomely

Dempo1

https://www.boards.ie/discussion/comment/118879563#Comment_118879563

I don't ever recall him saying anything of Substance, ever 😏

c.p.w.g.w

https://www.boards.ie/discussion/comment/118878995#Comment_118878995

Well if I need a GP appointment, I will typically be waiting 6-15 days for an appointment, they don't open weekends, close for 2.5 hours for lunch...

That's were the issue lies, also many GP's and primary care facilities use Covid19 to reduce access to services from my experience

babyducklings1

The system is so broken that people are being turned away when they try to register with a gp!

blanch152

https://www.boards.ie/discussion/comment/118879960#Comment_118879960

That only proves my point that throwing more money at the HSE and hospitals isn't the solution.

Developing community care and reducing the numbers of nurses in hospitals is a better solution.

Dempo1

https://www.boards.ie/discussion/comment/118880018#Comment_118880018

That's primarily because of the Lack of Gp"s rather than the system being broken but I do agree the system is broken.

It amazes me that after decades and multiple billions given to the Health Service, the same annual excuses given.

It's not lack of funding thats the problem it's how that funding is being managed or more likely miss managed.

The Pandemic shown a bright light on the Senior Management Team at the HSE and some of the stuff they spun was simply beggar's belief.

blanch152

https://www.boards.ie/discussion/comment/118880137#Comment_118880137

It is not just the senior management team, the culture of non-performance goes right through the organisation down to the bottom, with the first-line and middle managers probably the worst of all.

cuttingtimber22

https://www.boards.ie/discussion/comment/118879195#Comment_118879195

Does that expenditure include private health insurance?

Dempo1

https://www.boards.ie/discussion/comment/118880145#Comment_118880145

I absolutely agree with Middle management a serious problem . They seem to be incapable or more likely unable to make day to day decisions.

[Deleted User]

https://www.boards.ie/discussion/comment/118879960#Comment_118879960

Just because they are closed to appointments for 2.5 hours does not mean they are at lunch

Strumms

I’d like to see reports done regarding a&e attendances whereby we find out what percentage of people turning up, quite simply don’t need to be there…I doubt the HSE would be forthcoming with that info, there’d be war…

https://www.mater.ie/patients/emergency-department/

https://www.boards.ie/discussion/comment/118879960#Comment_118879960

All GPs will see an ill patient. If you can wait 6-15 days, you’re not ill. Doctors are still working when they’re officially closed. Ringing patients, reviewing blood and other test results.

Then at weekends there’s the out of hours service, here in Clonmel, Caredoc.

blanch152

https://www.boards.ie/discussion/comment/118880603#Comment_118880603

It is in the report, 75% of those who turned up at A&E didn't need to be there. No wonder they are under pressure.

Fasano

Every single function of this state is broken, be it Health, justice or Education. Yet somehow the heads of those functions all earn over €200,000 per year.

With regards Health, we have the head of the Department on a self appointed €292k and the head of the HSE on €411k and yet last night, over 500 people spent the night on trolleys or temporary beds because there were no beds available.

This will never be sorted out, because it is so deeply ingrained in the public sector here, short of a dictator coming in and ripping up the rule books, any politician who even tries to address this will fail miserably.

BrianD3

https://www.boards.ie/discussion/comment/118883177#Comment_118883177

It goes beyond normal public sector incompetence. Every HSE senior executive, hospital consultant, DOH official, Minister for Health, GP etc is practically guaranteed to have private health insurance for themselves and their families. And not basic plans either.

PHI won't necessarily help them in an emergency situation but it does insulate them from much of the rest of the sh1tshow that is our public health service.

Salaries will be paid unless they kill someone directly. Indirectly killing thousands of people through inaction - no consequences.