The current hospital / A&E crisis

https://www.boards.ie/discussion/comment/120067567#Comment_120067567

What does that mean?

You stand in a third world country and you would realise how incredulously stupid it is to say we are “plunging towards” one.

Xander10

https://www.boards.ie/discussion/comment/120067525#Comment_120067525

Just don't hire the shower building the children's hospital.

We will be dead before they are finished

Cordell

Stopping graduates from leaving is not the right solution, making the jobs so attractive that they don't feel the need to leave is. I don't want to be treated by doctors and nurses who feel trapped in their jobs.

whisky_galore

https://www.boards.ie/discussion/comment/120067578#Comment_120067578

Shur twill be grand. It'll sort itself out. No queues, no trollies, nothing to see here move along.

Wash rinse and repeat.

shesty

https://www.boards.ie/discussion/comment/120067616#Comment_120067616

Well this is the question.Incentivise seems wrong when so much money is already being pumped in unsuccessfully mind you.We simply have not got enough staff though and you can't improve working hours and stress unless you up staff numbers, and you can't up staff numbers without some way to attract people into a broken system.It's a chicken and egg, some way has to be found to break that cycle because what we re doing isn't working.There is a new consultant's contract being negotiated and consultants are up in arms about 300k contracts that don't allow them to work private clinics (and make extra money) among other things.If those contracts are a problem, what on earth can you offer that is more attractive?? For graduates, structured hours and enough staff to cover the wards is the only other thing besides money I suspect (proper facilities would obviously help too), but how can you make that offer without enough staff as it stands and everyone leaving??

Doctors may already feel trapped if the only way they see out is to emigrate.Maybe many would like to stay here but just can't.

I am simply throwing out points for discussion here really.We all know the horror stories, but what are the ideas for improving the situation??As it stands I wouldn't be recommending to any of my kids to consider medicine as a career.

whisky_galore

https://www.boards.ie/discussion/comment/120067269#Comment_120067269

Even a broken clock is right twice a day.

https://www.boards.ie/discussion/comment/120067674#Comment_120067674

Are coming on this thread just to type silly things and wind people up?

Cordell

https://www.boards.ie/discussion/comment/120067660#Comment_120067660

I'm a simple man so here's a simple solution: look at the health systems they emigrate to and copy them. Money is not a problem, Ireland already spends a lot on healthcare and there are enough resources to spend even more.

sekond

https://www.boards.ie/discussion/comment/120067164#Comment_120067164

Yes, we've had a few good saves from the local pharmacy over the years too. Minor enough stuff, rashes, earaches etc. Usually a case of "try this, and if there isn't any improvement in X days, then go to the GP". In almost all cases the pharmacist was right, and a GP visit was avoided, and when they weren't we were also able to go in to the GP and say we'd spoken to the pharmacist and tried X, Y, Z and it hadn't worked, which meant the GP was able to move onto other options.

Geuze

HSE staff headcount

https://www.hse.ie/eng/staff/resources/our-workforce/workforce-reporting/national-reports.html

Dec 2019 and Nov 2022 data, three years apart, all WTE data

Doctors - medical consultants, up from 3250 to 3861, an extra 611 or 19% more in three years

All doctors/dentists, from interns to consultants, up from 10,857 to 12,658, an extra 1,801 or 16.6% in three years

Nurses up from 38,205 to 43,374, up by 5,169 or 13.5% in three years

19% more consultants in three years seems like strong growth to me?

Floppybits

https://www.boards.ie/discussion/comment/120067616#Comment_120067616

The reason why the graduates leave is that they see the state of the healthservice and the hours people have to put in just to keep the lights on and the ongoing mess in A&E, ask yourself who in their right mind would want to work in a system like that? Lets face most of us if we worked in job where the management/organisation was as poor as the HSE is and your were constantly overworked because of understaffing then I would bet you would leave that company to find somewhere better? I know I would. Fair play to all the medical staff who do stay and work in that chaotic system.

Floppybits

https://www.boards.ie/discussion/comment/120067687#Comment_120067687

I agree I don't the issue is the money or incentives, well maybe at certain levels, but I think the main issue as I said above is the conditions that the medical front line staff in the HSE are expected to work in. Improvements in the conditions would go along way towards making people want to say in the services. Lets face it most people if they worked for an employer that is as badly run and mismanaged as the HSE we would be out door as fast as our two legs can carry us.

I see the new head of the HSE is keeping their head down, I'd say he was left some mess to sort out.

Deeec

The management and planning of A & E also needs to be looked at.

Last year I had to take my elderly mum to A & E. It was a friday about 7pm and she had a severe earache - GP closed for weekend and out of hours doc couldnt see her so I was advised to take her to A & E given the severity of the pain. Luckily for us A & E was pretty quiet. Triage seen her immediately - I asked should she not have been given a blood test there and then and was told no need. Despite being quiet very few patients were seen - eventually after a few hours she got to be examined. Doctor said she needed a blood test - had to wait then for someone to take the blood and then we were told we would have to wait for the results ( about 1/2 hr we were told). We were left in a cubicle right beside the admin/nurses station. The nurses/doctors gathered here chatting, laughing and eating cake. Very little attention was given to patients at all - it seemed they were on a Friday night buzz. After being left there for 2 hours I went and asked was the blood results not back - doctor immediately checked and said oh they are back. Examined again - then doctor had to go and consult with another doctor he so we were just left waiting again. Eventually we got out with a referral and antibiotics. That night the doctors and nurses were not working efficiently or to the best of their ability. If they had have been we could have been in half the time. Why couldnt the triage nurse have done a blood test so the results would have been there when my mum was examined? Its something that could make a difference - better triage services and somebody actually managing staff and the treatment of patients. That night I also spoke to an old man in another cubicle who asked for my help - he was left so long ignored he thought the staff forgot about him.

I can understand why A & E is slow when there is alot of patients attending but that night it was actually quiet. Efficiency really needs to be looked at also.

Cluedo Monopoly

https://www.boards.ie/discussion/comment/120067886#Comment_120067886

Who would want to be a Junior doctor in Ireland?

Junior doctor pay issues due to payroll system - IMO (rte.ie)

'Demoralising' issues for junior doctors caused by payroll system - IMO

Non-consultant hospital doctors, or junior doctors, are having difficulties getting paid, due to having to join new payroll systems every time they start at a new post, according to the Irish Medical Organisation.

Chairman of the non-consultant hospital doctors committee at the IMO Dr John Cannon said junior doctors rotate hospitals in Ireland every six to 12 months as part of their training programme.

Speaking on RTÉ's Morning Ireland, he said that when they change hospital, even though they remain in Health Service Executive employment as their main employer, "they actually technically change employer as well at a local level.

"So that means every time they go to a new hospital, even though they're still working for the HSE, they have to join a new payroll system as all the payroll systems in the HSE are siloed, there's no national payroll system," he added.

Dr Cannon said that this often results in doctors going on to emergency tax, being put on the wrong pay point on the scale, missing hours that they are due in their pay, and, in some cases, not even getting paid at all.

'Bonkers' overtime worked by junior doctors causing burnout and risks for patients (thejournal.ie)

'Bonkers' overtime worked by junior doctors causing burnout and risks for patients

Junior doctors in Ireland worked 2.8 million recorded overtime hours last year, according to figures from the HSE.

EXCESSIVE OVERTIME WORKED by junior doctors is causing burnout and unsafe working conditions, doctors say.

Junior doctors are regularly working hours far beyond what should be acceptable in Irish hospitals, doctors have told The Journal, to the detriment of patients and staff.

mumo3

https://www.boards.ie/discussion/comment/120065204#Comment_120065204

The problem with the current privatized set up, is the doctors are double jobbing with the HSE...that needs to be knocked on the head.

I'm lucky (and I know I am) to have private insurance and I will always head there with the kids.... the most its ever cost me, was €185 for a broken bone and that was including xrays, cast and boot... but I was in and out in an hour, sure it would have cost me €100 to sit in public A&E for what 10-14 hours

Cluedo Monopoly

Health system an 'endless cycle of crisis' - IMO (rte.ie)

Health system an 'endless cycle of crisis' - IMO

No additional beds in northwest in three years.

The Chief Executive the Saolta Hospital Group, which includes six hospitals in the northwest and west, has said the group has not received any additional beds in the last three years.

Speaking on RTÉ's Morning Ireland, said if additional beds had come on stream it would improve the situation currently.

sekond

https://www.boards.ie/discussion/comment/120067927#Comment_120067927

I think this story shows one of the major problems with the health service here (and to be fair, I have experienced a similar issue overseas also) - you need a significant amount of agency and capacity to be able to navigate it. In your case, your Mum had you there to follow up on the blood tests etc - without that, how many more hours might she have been waiting.

Me being able to investigate and find out about the local minor injuries unit (after one or two eye wateringly expensive visits to Swiftcare etc), investigate alternative options when GP was unavailable, have enough prep done why I take my kids to the GP that I can ask the right questions, know what specialists are out there, know to ask for referrals and when to press for something to be done by the GP, know who and when to follow up on things.

I've got family with medical backgrounds, have worked briefly in the past as a receptionist in a Drs surgery and am used to dealing with complex systems. So I usually have the capacity and energy to do all that. Not everyone does. Which means they maybe end up in the wrong place and get frustrated.

(It's also not the only part of the system that works like that - certain parts of the education system need a similar level of capacity to untangle knots and work out options).

Cluedo Monopoly

https://twitter.com/DrHaroldNews/status/1610703097801711616

Enda Kenny promised in 2007 to end the trolley crisis. 16 years later it's worse than ever.

He also promised to reform the Seanad.

Wanderer78

https://www.boards.ie/discussion/2058278103/the-current-hospital-a-e-crisis

...we re clearly experiencing a catastrophic systemic collapse, and its probably never gonna be resolved, period!

joe40

https://www.boards.ie/discussion/comment/120067943#Comment_120067943

And yet medicine is still a very competitive course to get into both here and the UK. Pupils need very high LC snd HPAT scores. Nursing is also very competitive.

I think that is a worrying aspect of these type of crisis, and all the negative commentary. Will the bright hardworking young people eventually move away from health care careers?

Wanderer78

https://www.boards.ie/discussion/comment/120068095#Comment_120068095

...our educational system is effectively defunct in regards preparing participants for our needs, so its a very poor indicator for these needs....

yup, many younger participants are preparing to leave the sector, and/or leave the country, we ve rightfully fcuked this one up also....

shesty

https://www.boards.ie/discussion/comment/120067687#Comment_120067687

I absolutely agree. So let's take a look at a few of those systems (correct me if I get things wrong here anybody) vs some of the unique quirks of the Irish system.

The UK and Australia seem to be the main focus. Do you have a system in either country where you pay tax to fund public hospitals, but you also have private health insurance "just in case", to "skip the queues"? Quite often the queue skipping is to have procedures done by private consultants who are also working public hours, being paid privately by you and also funded by your tax to be paid by the Government, and using public facilities such as operating theatres, surgeries, in public hospitals, thereby taking time away from the system that your tax funds.....??? I don't think that is a thing in either of those countries.

Take the consultants here - private/public set up. The contract that they are so up in arms about, 300k for public only work. Is there a health system in the UK/Australia that has a set up like this? I highly doubt it, I suspect if you are in the public health system, that's where you are. Probably being paid less in those countries. So straight up, that is one problem that is attempting to be addressed and Consultants are furious about it. But somebody needs to stand up to them and say tough.

More beds? Our hospitals are for the most part cramped and old. Ancient, in some cases. We attempted to build a new children's hospital - medical opinion swayed it to a site in Dublin City Centre with poor access for cars, no room for expansion and (I believe) no helipad. We are trying to relocate a maternity hospital - fighting going on for years over who owns the land, who is on the Board, who controls the hospital. Jebus, just pick a greenfield site around the M50 belt and build a hospital. Are we only ever going to build new hospitals co-located on the grounds of old ones, because consultants say so? Is that the future of the Irish Health system? How we will ever achieve the numbers of beds we need?

More staff - we train quite a large number of doctors every year. I will have to find the stats but I believe it is among the highest in OECD countries. How many of those are non-EU, fee paying and returning to their own countries? Should we make more places available to Irish students? And how do we retain them in hospitals - pay is one thing for nurses and the rest but for many it seems to be coming down to having enough staff to cover patients during a shift, and having staff on duty 24/7 to discharge patients efficiently. Numbers, basically - bums in seats, so to speak. How do we achieve that without either an incentive or penalty system in place for a period of time, to ensure graduates stay in the system for a number of years, to try and build up the staffing levels and improve the working conditions for all??

I am trying to make people think here. Realise that we should not have a public health system but also "need" health insurance. There is no way we should be allowing public consultants also work privately.The public do though, have to come to the realisation that they should not need health insurance, and that seems to be quite hard for some people to understand. I understand it's a security of sorts against endless waiting lists, but part of the reason those are there is because of how things are set up. We can keep complaining about individual aspects of the system, but it needs a wider approach.

Oh one other thing. The NHS and the Australian system have patient numbers to my knowledge - where you move through the health system with one unique number and a centralised IT system so medical personnel have access to your history no matter where you are. Our hospitals can't communicate between each other by email as far as I can see, and as for the idea of introducing a patient number - we all saw the public reaction to that when it was floated as a plan....

We have to help ourselves out here as a nation too.Can't keep pointing the fingers at those in charge.

https://www.boards.ie/discussion/comment/120068108#Comment_120068108

Defunct in what way?

Wanderer78

https://www.boards.ie/discussion/comment/120068208#Comment_120068208

...show us where it effectively and appropriately prepares people for adulthood and the working world?

Joseph101Ryan

Speech and language therapists, now being asked to work 7 days a week in public hospitals.

They have always been Mon-Fri only and had their hours cut (restored) to pre-recession levels of 35 hours payable a week from 39 in Q3 of 2022.

The same number of SLTs expected to work 4 hours less a week each, it is no surprise they are now chronically understaffed.

This all comes at a time with the highest number of available SLT job postings suggesting uptake in the profession in Ireland is a worrying low.

Crazy short term thinking going on and now left with a situation where more SLTs will without doubt leave for private work or even emigrate to the UK/Australia.

spaceHopper

https://www.boards.ie/discussion/comment/120066640#Comment_120066640

I've had lots of dealings with the public health for my mother and I've alway found if ask nicely you will get somewhere but I'm always ready to get though if needed. Sorry it happened you you. If it ever happens again you say "is this a safe discharge from hospital" the hospitals have social workers that deal with this all the time but you need to push them. Or you say how do I make a formal complaint and what is your name. A GP visit card or long term illness card is as good. Also the medical card isn't necessary you've paid PRSI for this kinds of service. They use it as gatekeeper to push back but you are very much entitled to the care.

https://www.boards.ie/discussion/comment/120068218#Comment_120068218

Why are you expecting the education system to be responsible for preparing your children for adult life and the workplace? Surely the parents and the way in which our kids mature as they get older play a more significant part.

I didn’t expect the school to prepare my kids for adulthood/working, I expected the school to educate them and prepare them for state exams.

Wanderer78

https://www.boards.ie/discussion/comment/120068388#Comment_120068388

...so our educational system hasnt been responsible for these needs thus far?

...and by any chance are younger generation parents being effectively forced to enter the workforce, in order to try meet life requirements, mortgage requirements etc, thus not providing them with the resources, in particular the time required, in order to prepare their kids for this reality?

....also baring in mind, the 'teaching to test', rote learning method has been well proven to be a truly dreadful method in teaching, of which our educational system is ultimately based on....

https://www.boards.ie/discussion/comment/120068472#Comment_120068472

Back to the thread, nurses/Doctors etc spend a considerable amount of time in hospital departments during their training to prepare them for their working environment. Why you would think a school would be able to, or expected to prepare a future health professional for working in a hospital, is beyond comprehension.

Wanderer78

https://www.boards.ie/discussion/comment/120068488#Comment_120068488

....and you d wonder why we are where we are, with this kind of thinking!

....and by any chance does our educational system partly already do this?

https://www.boards.ie/discussion/comment/120068278#Comment_120068278

As a public servant I was told that my class of payments didn’t cover such service, that was back in 2017, I just didn’t have the fight in me, I had a fever, dizzy etc.

What had happened was I was already discharged from hospital after 11 days, mostly in HDU. Bowel obstruction & leakage, large hernia repair; cardiac complications after they forgot to give painkillers -doctor responsible personally apologised& said she clean forgot about my existence as a patient on her list. Attended GP nurse to get stitches removed, the wound opened up wide and infection was evident. GP phoned hospital, was sent over in taxi where surgeon removed dead tissue and dressed over wide open wound. She phoned a social worker re getting a visiting nurse, social worker checked PPS and said I wasn’t entitled to public nurse visiting and would have to make own private arrangements. GP came up with a discount for me to cover a few weeks attention.

I could of course have availed of VHI “Hospital at home” service, but apparently this is arranged if you have been discharged as a private rather than a public patient. I had this service afforded to me on another occasion to get me out of the Beacon, so that a drain could be attended by a calling nurse 3 times daily. I literally fell between two stools after having been in a public hospital.

AdrianG08

Always confused when I hear of a lack of GPs in Ireland. I'm probably completely ignorant to the realities they face and I apologise for this in advance if this is the case.

They usually work sociable enough hours 9-6pm, its pretty well paid. I completely understand that its hard to fill positions where its front line work like an A+E, emergency department doctor etc.. but surely the GP would be cushy enough in the grand scheme of things no?

https://www.boards.ie/discussion/comment/120068500#Comment_120068500

Leaving aside healthcare, which no school can prepare you for, does any professional look back and think “well my teachers in school let me down by not preparing me for working in this office, or for my lack of maturity”? No. There are many other influencing factors including your parents, rate of maturity, personality, experience etc. Saying our educational system is to blame is passing the buck for bad policy by the Dept of Health and our ministers.

Our healthcare education system prepares graduates as for working in healthcare, but like every other profession, it is only part of their development, interns are for the most part still training when they begin work after graduation, the number of times senior nurses help Drs might surprise many. But they learn with experience, experience that can only come with working in a hospital. To say our education system didn’t prepare them for adulthood, or working in the hospital, is just dumb.

Chiparus

https://www.boards.ie/discussion/2058278103/the-current-hospital-a-e-crisis

The crisis is not people who don't need to be there , they get lower triage scores and wait the longest, the crisis is that people who do need to be there cannot get a hospital bed and block the rooms in the emergency department so that no one else can get in.

Chiparus

https://www.boards.ie/discussion/comment/120065951#Comment_120065951

Do that and you will be reported by the patient Doctor in Waterford did that the a patient who did not need to be there - got his name in the media.

https://www.irishexaminer.com/news/munster/arid-40793256.html

mumo3

https://www.boards.ie/discussion/comment/120068654#Comment_120068654

I think (now don't hold me too it) a GP is an additional couple of years training, in hospital settings because you are not specialising in any specific speciality. So you could become a consultant get a cushy contract with the HSE and open your own private practice alongside that and just watch the money roll in, or you can continue to study, open a GP practice with all the over heads and get paid €9 per month per medical card and €60 per private patient.... They are also obligated to take a minimum number of medical card holders(whether medical card holders are there 2 or 20 times a month its still only €9)

My GP retired last year and he is still unable to get another Doctor to cover his practice, its absolute carnage at the minute in his clinic. But my advice people, is always, always, be kind to receptionist, no matter how nosey you fell they are being, they are the ones giving you cancellations or squeezing you in between appointments.

joe40

How are health systems in other countries coping with winter illnes and hospital overcrowding. I know from news reports the NHS is under severe pressure but how are other European countries doing. Do they have similar issues?

hotmail.com

About a third of those going into a and e shouldn't be there.

It happens all the time. Hypochondriacs.

Those being interviewed about their terrible hospital experiences are the ones that don't need to be there. Nothing wrong with them. That's why the nurses ignore them.

spaceHopper

https://www.boards.ie/discussion/comment/120068541#Comment_120068541

That's rough, next time don't let them discharge you unless a care plan in place. My father has the same, he was semi state and the consultant in St james told him that it was his choice to go private or public it made no difference to him and he's get the same care. That was after I'd gotten him moved from the Beacon Private hospital to James for rehab after a similar illness to yours. I was told it was impossible to get him move to a public hospital and to send him to a nursing home. Unfortunately he was to far gone for that and died of complications. He'd been mis diagnosed by his GP and the hospital in Drogheda.

spaceHopper

https://www.boards.ie/discussion/comment/120068863#Comment_120068863

Forget about who should or shouldn't be there, 700 to 900 people are there and were seen by a Dr who wants to admit them to the hospital for more care. So we know they should have gone to A&E and the problem is in the floors above A&E, if they were moved out of A&E and onto wards then the A&E staff would have less to do and be able to look after everybody better.

Blaming people for going to A&E is a way of shifting the blame away for the Dept of Health and the Minister.

joe40

https://www.boards.ie/discussion/comment/120068806#Comment_120068806

All Doctors have to do a 5 or 6 year medical degree and then complete a year as an intern. Then they go into speciaity training including GP training. A consultant will have to complete a minimum of 8 years speciality training maybe longer before they can apply for consultant posts. Durng this training period they are fairly well paid but takes a good while to get to consultant level.

shesty

https://www.boards.ie/discussion/comment/120068654#Comment_120068654

My GP surgery is 8.30 to 6, 5 days of the week.I have no clue how many patients they have - hundreds, I would guess. They have 4 doctors there, and at times like this there are no appointments.There are also 2 nurses.There are 3-4 receptionists at the desk all the time (they take turns on hours, I don't think any of them work 9-5 4 days a week).Piles of post gets opened every morning (have seen it) and you are often waiting 30-40 minutes past your time to see the doctor as they are delayed by the patients ahead of you.

The surgery has lost 3 doctors in the last 18 months due to the stress and the hours of the place.The doctors that are there, 1 is Irish - the "original" GP and the other 3 are non EU.This can be complicated with language barriers.They somehow manage their appointment system better than other GPs around here in that you stand a chance of a cancellation most days, whereas more local surgeries just say outright nothing for the next 5-10 days.

Unless something changes in the country, or a GP found a much quieter area to work, I wouldn't be volunteering for that job myself.

Goldengirl

https://www.boards.ie/discussion/comment/120067817#Comment_120067817

Did you look at how many left those jobsand how many mkre people they have had to treat ie population growth, in those 3 years?

https://www.boards.ie/discussion/comment/120069000#Comment_120069000

Sorry to hear about your Dad, an awful thing to have happened.

I worked almost 40 years in a public service job 5 days per, Mon, Tue, Wed, Thu, Fri/Sat (alternating), Mon & Wed were late shifts, 12.30 - 20.30, the other days normal office type shifts. I would have swapped this for GP surgery hours any time. My job requires a lot of lifting, moving about, assembling things, unix system admin work, desk work, payroll, accounting, database search & management, cleaning messes when public has “accidents” in the building. There were creative elements too. At least I have the modest pension, but had no option but to work shifts which could be changed any time at management’s behest.

In the name of goodness, some people don’t realise how lucky they have it. GPs have a responsible job which some of them are good at, others not, but if the job is now thought too much work, people have gone soft. IMO, of course.

Gregor Samsa

https://www.boards.ie/discussion/comment/120068830#Comment_120068830

Here's an article about that very topic from December

https://www.theguardian.com/society/2022/dec/14/a-ticking-time-bomb-healthcare-under-threat-across-western-europe

a snippet:

In France, there are fewer doctors now than in 2012. More than 6 million people, including 600,000 with chronic illnesses, do not have a regular GP and 30% of the population does not have adequate access to health services.

In Germany, 35,000 care sector posts were vacant last year, 40% more than a decade ago, while a report this summer said that by 2035 more than a third of all health jobs could be unfilled.

Facing unprecedented hospital overcrowding due to “a severe shortage of nurses”, even Finland will need 200,000 new workers in the health and social care sector by 2030.

In Spain, the health ministry announced in May that more than 700,000 people were waiting for surgery, and 5,000 frontline GPs and paediatricians in Madrid have been on strike for nearly a month in protest at years of underfunding and overwork.

Goldengirl

https://www.boards.ie/discussion/comment/120068207#Comment_120068207

I don't disagree with your points.

We do need to look at other countries.. Nkt the UK it is a basket case for the last few years and most are leaving for Canada and Australia.

Nurses have better pay and conditions in both these countries. Smaller workloads set hours, more staff basically. Why because of better conditions. Doctors also, are never expected to work more than their rostered hours except voluntarily and for a lot of money.

Why should intelligent and socially motivated young people choose to go into some of the most difficult careers with no prospect of financial incentives and good working conditions where you can do your job well, including your paperwork and handover your patients safely within your rostered hours?

Not a lot to ask for is it, but for most unless working in a very quiet backwater it is only an occasional treat.

I along with many of my ex colleagues dreaded the phone ringing those days off over Christmas or New Year, if you were lucky enough to get it off.

Always a call to duty because of short staffing due to increased pressure or sick leave. Eirst of all bei g called in onChristmas Day or for New Years Eve night . I have often worked bits of both despite being rostered off originally, especially when my kids were older. But you get there and everyone is so glad to see you there and you forget while you are busy working.

And as for consultants.. Some are swinging the system only working minimum public hours and seeing private patients first, totally.

But others are amazing, clever people who work through the night when they have to, for any patient and teach everyone they come in contact with. They would have no problem making an excellent living in private practice only and some do. But the ones still working the Public/Private contract we are generally lucky to have and want them to stay. Some of the newer consultants in the Public only contract are ready to walk from those 300k contracts you are talking about and thats before Donnelly came out with his 7 day week scenario. They train for 10 to 14 years before they can even be considered for a consultant posts. They come to an Irish hospital from senior jobs abroad where they are given everything they need to do their jobs and are thriving, and within a couple of years here I have seen them ready to leave because of the long hours and constant stress and hassle from management and disillusionment

Totally demoralised and ground down with all their altruism thrown back in their faces.

I know many will look at their salaries and say fvck them, but if we do they can walk to any private facility or any other country so it is our health system that is the loser.

There is no way around it.. More staff and thus better conditions. And better management with LESS managers, too many useless clipboard people.

Politicians are getting how much money for very little return to the taxpayer?

Lets get real here.. Its the politicians taking the pvss!

We need to be looking at how much value a person gives the taxpayer, how valuable that role is in the current market and reward them accordingly and / or ensure they have the best conditions to do their jobs.

https://www.boards.ie/discussion/comment/120069473#Comment_120069473

How many times per day during the last 40 years have you been responsible for the treatment of sick and dying people?

Goldengirl

https://www.boards.ie/discussion/comment/120068274#Comment_120068274

Yeah . Whose bright idea was that ?

Like having an SLT working 7 days will help in the current crisis? Will that ensure patients are discharged sooner ?

https://www.boards.ie/discussion/comment/120068806#Comment_120068806

GPs do the same 6 years in uni , one year as an intern( junior hospital trainee doctor) , and can either apply to do GP rotation ( general medicine , working with GP and in community public health , midwifery and basic paediatrics) for the next few years when other non consultant hospital doctors ( nchd) are doing medical or surgical rotations to become medical or surgical registrars ( senior nchds ) .Following this they do more exams to get Membership for medicine or general practice , for Fellowship ,if a surgeon and gain more experience working in the area before they can or become eligible to have their own practice . 10 or 12 years at least . More for consultants . And then more doing research and writing up work ,usually while travelling working , and having families as would be in their 30s by then . But GPs are by definition general . Consultants are usually very highly trained and experienced and often have done research and are published in their field . Some GPs are very specialised in some areas too . They all do continuing professional development courses to keep their membership / fellowship,practice up to date .

Nurses, and other allied health professionals all do continuing professional development courses as well. Some are required but many are doing extra courses for their own professional development . Nurses who have years of experience and want to progress further but stay working clinically ie. with patients , can go further and become Clinical Nurse Specialists , or Advanced Nurse Practitioners. These nurses are qualified in their chosen field to lead nurse led clinics and within a defined area manage their own group of patients, with reference to a consultant as necessary.

I agree re the receptionist . They are doing as instructed guided by their GP employer , and are in effect triaging patients , when they know what they are doing. Ideally it should be the practice nurse doing this but they too are up to their eyes in work.

Goldengirl

https://www.boards.ie/discussion/comment/120067850#Comment_120067850

Bernard Gloster , formerly CEO of TUSLA, another well run organisation 👀