Sick of this country

Igotadose

https://www.boards.ie/discussion/comment/121569250#Comment_121569250

Non-idiot, new, better administrators? Paid for by reduction in overpaid, underperforming administrator staff?

elperello

https://www.boards.ie/discussion/comment/121569725#Comment_121569725

It's not really a mad scheme.

They have extra capacity in NI and the students will commit to working for the HSE.

Not the full answer to shortages but a step in the right direction.

https://www.bbc.com/news/uk-northern-ireland-65876585

AndrewJRenko

https://www.boards.ie/discussion/comment/121570068#Comment_121570068

The overall IT services and cyber security services in the HSE were underfunded for decades, which is why we've made very slow progress on digitising patient records. Cyber security has been beefed up since the HSE hack, but with a heavy dependence on external consultants, because experienced cyber security experts would be earning double or treble the HSE salary levels in the open market.

But if you think the answer is to get rid of the existing staff who are keeping the whole thing going, you could be in for a nasty shock.

maninasia

https://www.boards.ie/discussion/comment/121564616#Comment_121564616

Primary healthcare is dogshit, can't even get a GP in many areas of Dubln. Even if you are with a long standing GP they often have two week waiting lists . Some don't even have phone appintments for days.

Delusional statement. Problem is much bigger than just A&E.

Igotadose

https://www.boards.ie/discussion/comment/121570842#Comment_121570842

So, 2 years on from the hack and it's still held together with elastic bands and sticky tape? In the meanwhile, the administrative load keeps going and simple things like backups, restores, audits, nothing changes.

This is just one dimension of what a wreck the HSE is. They protect HSE employees at all costs - even the "doctor" that killed Savita Halappanavar is still working for the HSE. The hiding of results like in the case of Emma Mhic Mhathuna, where the failings that cause her death due to telling the known (but hidden) results, again, no one in the HSE loses their jobs. Mental health care for children in Kerry? Nope, can't do anything to fix the quality of the service provided, but there's lots of money to pay off the victims and their families.

And on, and on. Throw money it is always what the HSE does. As long as there's money to pay off the poor victims, nothing will change, and there's no serious effort to improve the quality of the service or those that provide it.

AndrewJRenko

https://www.boards.ie/discussion/comment/121571128#Comment_121571128

Yes, when you underfund IT services for decades, and you still can't recruit expert staff directly, you don't get to wave a magic wand and fix an environment with over 100k users and thousands of seperate systems within two years. That's reality.

It's not true to say 'nothing changes' at all.

NSAman

https://www.boards.ie/discussion/comment/121570842#Comment_121570842

Jaysus Andrew, every suggestion has been met by you on this thread with defending the indefensible.

Systems managers are required. Programmers, IT Professionals.

Basically the IT in the HSE is a joke at this stage. With the BILLIONS being spent on health, with every single nurse sitting in front of a computer instead of having a portable tablet (most hospitals have no wifi) entering information on the go, yet you say there are changes?

Health underfunding of basics like IT is indefensible. Imagine people loosing transfers of information between hospitals and health clinics/doctors, files going missing etc. it happens daily. It causes mayhem extra work and backlogs not to mention being dangerous for the patient.

Slow these days is not going to cut it. There is NO excusing the lack of planning, implementation and non-expertise of the HSE in Ireland.

AndrewJRenko

https://www.boards.ie/discussion/comment/121571391#Comment_121571391

I recall seeing a presentation from the then HSE CIO Richard Corbridge about five years talking about their rollout of tablets to the maternity hospital in Cork, and the Cork midwife who threw the tablet back at him on the first day, and then told him that she couldn't work without it once she got used to it a week later.

https://www.thecork.ie/2019/08/15/paperless-hospital-cork-university-maternity-hospital-becomes-first-fully-digital-hospital-in-ireland/

THis isn't new, lads.

But they still have nothing near the level of resources that they need to roll out the digital records to the 100k+ staff members across the HSE.

Podge_irl

https://www.boards.ie/discussion/comment/121571391#Comment_121571391

Obviously the HSE digital infra needs investment and upgrading.

It just seems silly to acknowledge that and simultaneously bemoan the level of administrative staff in the HSE (without ever providing evidence of same).

Igotadose

https://www.boards.ie/discussion/comment/121571812#Comment_121571812

Well, there's a freeze because of too many administrative staff hired (not the world's best written article imo):

https://www.thejournal.ie/hse-admin-staff-industrial-action-6188365-Oct2023/

'not be working?' WTF?

And, a few years earlier, this juicy bit:

https://www.independent.ie/regionals/herald/blame-untouchables-for-health-service/27875939.html

And this (unfortunately I can't find Dr. Handley's article):

""To put this in context, in 2013 the Irish Hospital Consultants Association pointed out that the ratio of managers and administrators to Consultants in Britain’s NHS is 3.1, a level regarded as excessive. Here in Ireland the equivalent ratio stood at 6.2 and no-one batted an eyelid."

https://www.askaboutmoney.com/threads/ratio-of-administrators-to-consultants-in-the-hse-is-6-2-to-1.202215/

NSAman

https://www.boards.ie/discussion/comment/121571812#Comment_121571812

Missing files from last week? One example from my mother personally. Prescriptions not sent over, mass confusion between doctor hospital and pharmacy. Have spent the past week chasing, administrators (who I have to say in the ward was excellent) but infrastructure that doesn’t work. I actually feel so sorry for many staff in the hospitals who have to work in a system that is broken completely.

another example? Waiting in A&E for 18 hours only to find the admittance file was lost, then when I complained, security threw me out. Security also threw out a family waiting beside for 18 hours when their sons leg was broken for the same reason….being told (and I quote) “you’ll be seen when you are **** seen”, really gives one confidence in our system!

Podge_irl

https://www.boards.ie/discussion/comment/121572135#Comment_121572135

This is not evidence of an overabundance of administrative staff?

Not sure what point you are trying to make. I agree the digital infrastructure is outdated and needs investment. That requires a huge investment in "non frontline" staff and services. The kind of thing people rail against.

https://www.boards.ie/discussion/comment/121571048#Comment_121571048

Actually a large part of A&E queues are due in part to lack of available GP services, or GPs referring people to A&E for some stuff they should be able to deal with themselves.

An example (some time ago mind) was a work colleague’s daughter who developed severe diarrhoea after eating some coleslaw, she was caring for her young children along with her husband. A very healthy young woman too, just got a dose of food poisoning, no bleeding or anything. Called out of hours doctor, he told her to go to A&E. Chemist was closed at this time, and I don’t think she had dioralyte or equivalent in medicine cupboard, so it seems doctor told her to go to A&E. she was left for hours and her mother, my colleague was furious that she wasn’t attended to quickly. By the time she saw a doctor the symptoms had stopped, as typical with a short sharp staph food poisoning. That was a completely silly referral imo, GP should have advised to use light dilute soup or something in the kitchen cupboard to replace lost salts.

jackboy

https://www.boards.ie/discussion/comment/121572135#Comment_121572135

The missing files thing is absolutely widespread and no improvements in recent years. When something so basic and obvious is not being fixed that is strong evidence that those in charge have zero motivation to improve things.

Podge_irl

https://www.boards.ie/discussion/comment/121572348#Comment_121572348

This is a chronic problem and the issue is not "motivation". The idea that if some senior people just cared more it would be fixed is ridiculous. It requires massive investment of time, energy and resources.

HSE data management is an absolutely collosal system.

jackboy

https://www.boards.ie/discussion/comment/121572374#Comment_121572374

Maybe your right. It's just staggering how files can be lost and misplaced all the time in this day and age.

Hypnotic86

Anyone wants to hang out ? This is a boring country with cold distant people

A good time back I opened a thread on medical records, and basically what a lot of posters indicated was that GDPR is one big fly in the ointment such that trying to reconcile a lot of the data into an amalgamated system is problematic.

At the MS seminar in September I queried medical consultants about the entire scenario and how I try to gather all my medical records and put them into my cloud storage etc. Consultant said that was a very good idea. I have had big problems regarding transferring records between hospitals private-public, as have consultants I have attended. They were very glad when I sent them digital copies of reports. I also try and keep CD records of radiology/imaging.

At the seminar I also queried with a lovely radiologist who is doing AI diagnostic research for his PhD in relation to precisely mapping MS lesions, asking him why some very obvious errors are apparent in the records I have obtained, eg “normal diameter colon” when I don’t actually have a colon!! He have me an honest answer, one reason he is doing his project is that radiologists don’t have enough time to focus sufficiently on the scans they are reporting on and tend to see what they are expecting to see rather Han what is in actually evident in front of them. AI, he determines, hugely assists radiology reporting but isn’t welcomed by some old school types.

That wasn’t the only example in my case. Two reports by the very same radiologist in a short space of time pointed out an incidental abnormality in one report and “no abnormality” in a slightly earlier report. The second report prompted a surgical investigation as the observed abnormality suggested early cancer. It wasn’t, but accounted for by adhesions from a previous surgery.

Podge_irl

https://www.boards.ie/discussion/comment/121571898#Comment_121571898

Who regards the level in the NHS as excessive? There is a constant issue with the level of managerial and administrative staff in the NHS that results in frontline staff doing far too much administrative work.

for example

https://www.nhsconfed.org/long-reads/nhs-overmanaged

https://www.bmj.com/content/380/bmj.p681/rr#:~:text=NHS%20doctors%20spend%20far%20too,medical%20scribes%20and%20personal%20assistants

I feel like this is one of those tropes - we have had the same in regards policing. It is an easy political showpiece to say we are investing in frontline and not admin, but all it does is leave the frontline to spend a chunk of their time on admin.

The very fact people are here bemoaning the admin cost of the heath service is part of the problem anyone faces in trying to fix it as it will invariably involve a shitload of non-frontline investment.

marno21

https://www.boards.ie/discussion/comment/121569725#Comment_121569725

Ah. That explains all the empty champagne bottles I saw outside the Western Australia Dept of Health headquarters this morning.

crusd

https://www.boards.ie/discussion/comment/121571048#Comment_121571048

You confuse the words "compare favourably" with "perfect". We compare favourably with lots of countries on GP numbers. That doesn't mean it couldn't be better. It means there are lots of places where it is far worse. Developed countries. Even Austrailia and New Zealand, which everyone seems to think are perfect places relative to here, have the same problems we do and virtually the same number of doctors per capita

https://ceoworld.biz/2023/08/25/revealed-countries-with-the-best-health-care-systems-2023/

maninasia

I've never experienced anything worse than the GP situation in Ireland .....and it's shocking to see how badly it's gone downhill over the last 20 years not only for me but for my elderly parents who desperately needed to see them but nobody available ....always a sad search for some to find something worse to compare to save face .

Healthcare system in Ireland is poor to very poor by many metrics, accessibility , cost of primary care, huge waiting lists for consultations , crazy A and E waiting times and complete lack of a national digital health system. They don't even provide weekend services in hospitals .

Enough of the compare favourably waffle already we don't need to see a silly list (CEO world? ) to see know and experience the issues first hand in Ireland.

Podge_irl

Yeah. Who needs people methodically researching health systems across dozens of countries to try and analyse who is doing what well and how we compare when we can just rely on vibes.

The health system has significant problems. Many of them are similar to problems faced in other western countries globally. A lot of it has to do with increasingly older populations. This is not unique to Ireland.

arctictree

https://www.boards.ie/discussion/comment/121569725#Comment_121569725

This is what I dont get. We are proposing to pay another state to train doctors for us. Why cant we just do it ourselves? And then the politicians present this as some sort of win?

maninasia

It's absolutely ridiculous yet I didn't see the 'journalists' even question the government why is this ?

Half of the medical students in Ireland are foreign nationals who almost all just head straight home after graduation . Much of the other half (Irish students subsidised up to 50k a year for education fees) head straight to Australia after graduation .What a mess.

Bet you that list above doesn't take that into account !

Podge_irl

https://www.boards.ie/discussion/comment/121577459#Comment_121577459

No one is subsidising students 50k a year for their studies. Which is a large part or why universities rely on non EU students paying exorbitant fees to top up their funding.

maninasia

Yes they are.

I've checked the estimated cost for medical student education in Ireland and it's up to 50k per person.thst it would cost if the government didn't cover it. Educating and training medical students needs a lot more resources than other courses.

And foreign students pay up to 57k a year for courses in Ireland.

Stop allowing our HIGHLY subsidised graduates to jet off to another country immediately upon graduation.so easily. The current situation is a travesty.

Podge_irl

https://www.boards.ie/discussion/comment/121577521#Comment_121577521

And the government don't pay 50k per person, which is why they rely on foreign students to make up the shortfall.

Any other courses you suggest should result in being blocked from leaving Ireland? This isn't something other countries seem to need to resort to.

maninasia

Other countries aren't as fucked up as Ireland.

Our problem isn't the money, we need doctors to stay in Ireland and work in Ireland for a few years.

You seem to think that is unreasonable which I why I believe you have skin in the game yourself.

Peter Flynt

https://www.boards.ie/discussion/comment/121570094#Comment_121570094

Students being forced to "commit" to work for the state after they graduate is outrageous. Does this happen with accountants destined for KPMG or PWC? Somehow I think not.