Leo Varadkar resigns as Taoiseach

jmayo

https://www.boards.ie/discussion/comment/121937971#Comment_121937971

Trust me if Hide and Seek was an event at the Olympics in Paris, Donnelly would win gold for Ireland.

blanch152

https://www.boards.ie/discussion/comment/121937995#Comment_121937995

Not what I said. Very happy to see largish towns built up. I would ban one-off housing in the countryside. The council could alternatively provide sites or buildings suitable for renovation instead within the existing environs of towns and villages.

That brings critical mass to villages and towns for services. As it is, those living in one-off housing frequently bypass the smaller villages and towns to head for the bigger places.

Podge_irl

https://www.boards.ie/discussion/comment/121936428#Comment_121936428

I mean, do you have stats that suggest things are worse now? It is generally very difficult to get funding in place for a replacement service while the existing service is still there, it is just the reality of politics.

I'm not trying to be flippant, but this is one of those areas where people assume having an A&E close by is by definition better and that is frequently simply not true. Could politicians do a better job of explaining this? Almost definitely. But again it just highlights that whatever people say, managing things such as the HSE is actually quite complicated. If you followed global best practices everywhere I suspect you would be deeply unpopular and lose your job. Such is the nature of politics.

jmayo

https://www.boards.ie/discussion/comment/121937958#Comment_121937958

Ah yes the politicians loved the creation of the HSE so that they could pass the buck unlike the old days when local politicians representing the political parties had to explain what they were doing on health boards.

Hospitals much like schools, much like prisons haven't kept pace with population increases.

Someone recently highluighted that we may now have less hospital beds than we had in 80s/90s.

And what has happened to our population.

Well for one it has increased despite how some think that immigrants don't add to it.

And secondly we are having a higher aging population.

Also as far as I know, someone can verify this, we have higher number of people per GP/doctor than other countries and a higher number of people per hospital bed.

But of course who cares about that we have a great many employed in the HSE/HIQA/Tusla bureaucracy.

It is sad that people try protect politicians, especially government ministers, and absolve them of blame for public sector fookups.

They obviously never subscribe to Harry Truman's old desk sign.🙄

skimpydoo

https://www.boards.ie/discussion/comment/121938035#Comment_121938035

If it's not been done before does not mean it can't be done. If this was the private sector heads would have rolled by now.

blanch152

https://www.boards.ie/discussion/comment/121938114#Comment_121938114

But we have the biggest ratio of nurses to population. Goes to show there isn't a simple answer.

Podge_irl

https://www.boards.ie/discussion/comment/121938114#Comment_121938114

Someone recently highluighted that we may now have less hospital beds than we had in 80s/90s.

Almost certainly, but we had too many beds then and they were not effective or efficient

And what has happened to our population.

Well for one it has increased despite how some think that immigrants don't add to it.

Of course immigrants add to the population. They generally have a far far lower impact on hospital admissions as they don't tend to either be chronically sick or be old. So they bring money to fund everyone else's hospital stay and provide a large part of the care system itself.

And secondly we are having a higher aging population.

Yes, this is the biggest problem.

Also as far as I know, someone can verify this, we have higher number of people per GP/doctor than other countries and a higher number of people per hospital bed.

Yes we are on the low end for hospital beds, though above places like Finland and Sweden which are not known for poor healthcare. We are above average in the OECD for doctors.

blanch152

https://www.boards.ie/discussion/comment/121938143#Comment_121938143

You need less hospital beds if you have efficient systems that discharge people effectively. Efficiency in Sweden and Finland means that they need less beds.

If our doctors and nurses worked as efficiently and effectively as those in Sweden and Finland, our bed numbers would be fine.

jmayo

https://www.boards.ie/discussion/comment/121938096#Comment_121938096

WTF has one off housing got to do with overcrowding in A&Es?

And people may try and play this as a Limerick only problem.

It is not.

I have an elderly relative through marriage that was left sitting in a major Dublin hospital A&E for about 10 hours after a fall earlier in the day.

And he wasn't the only one.

According to todays INMO trolley count

Date Hospital Region Trolley Total Ward Total Total

25/03/2024 Beaumont Hospital Eastern 13 0 13

25/03/2024 Children's University Hospital, Temple Street Eastern 6 0 6

25/03/2024 Connolly Hospital, Blanchardstown Eastern 18 0 18

25/03/2024 Mater Misericordiae University Hospital Eastern 19 0 19

25/03/2024 Naas General Hospital Eastern 8 3 11

25/03/2024 St James' Hospital Eastern 19 0 19

25/03/2024 St Vincent's University Hospital Eastern 21 0 21

25/03/2024 Tallaght University Hospital Eastern 29 0 29

25/03/2024 Bantry General Hospital Country 0 8 8

25/03/2024 Cork University Hospital Country 31 5 36

25/03/2024 Letterkenny University Hospital Country 5 16 21

25/03/2024 Mayo University Hospital Country 4 9 13

25/03/2024 Mercy University Hospital, Cork Country 12 0 12

25/03/2024 Mid Western Regional Hospital, Ennis Country 0 5 5

25/03/2024 Midland Regional Hospital, Portlaoise Country 8 0 8

25/03/2024 Nenagh General Hospital Country 0 4 4

25/03/2024 Our Lady of Lourdes Hospital, Drogheda Country 12 0 12

25/03/2024 Portiuncula University Hospital Country 10 6 16

25/03/2024 Sligo University Hospital Country 19 7 26

25/03/2024 South Tipperary General Hospital Country 9 0 9

25/03/2024 St James' Hospital Country 5 5 10

25/03/2024 University College Hospital Galway Country 41 7 48

25/03/2024 University Hospital Kerry Country 4 0 4

25/03/2024 University Hospital, Limerick Country 31 58 89

25/03/2024 Wexford General Hospital Country 10 0 10

That is every single hospital in the country bar Waterford, Navan, Tullamore, Mullingar, Cavan with numbers on trolleys either in A&E or in wards.

So less of the shyte pedaling by your fellow posters that this is a Limerick only problem.

Just look at Galway FFS.

I suppose you will blame the numbers in Galway on the number of one off houses in Connemara or some such shyte.

skimpydoo

https://www.boards.ie/discussion/comment/121938177#Comment_121938177

One of housing is being used to deflect from how badly the government are handling health. How bad does it have to get before the government cheerleaders admit the governments handling of health is atrocious.

Podge_irl

https://www.boards.ie/discussion/comment/121938170#Comment_121938170

I don't really think it is an issue with doctors and nurses. It is an issue with step-down care.

jmayo

https://www.boards.ie/discussion/comment/121938136#Comment_121938136

And how many of those nurses are now actually managers ?

https://www.boards.ie/discussion/comment/121938143#Comment_121938143

PS what about the 100k plus refugee and asylum seeker/IPA immigrants that arrived in last couple of years that are not contributing to the tax take, but yet are availing of medical cards, free healthcare, etc?

How many of that 100k plus work in healthcare?

Funny how when it comes to public spending some people conveniently forget the immigrants that add no financial value, but just take out of the pot.

https://www.boards.ie/discussion/comment/121938170#Comment_121938170

Ah so it is all the fault of the doctors and nurses.

If you get sick or in an accident I hope you tell the front line staff treating you that.

PS I have a couple of relatives that would like a little word with you.

blanch152

https://www.boards.ie/discussion/comment/121938227#Comment_121938227

Nobody is exempt from criticism, nurses and doctors have to take their share of the blame for the mess that is the current health system. There are still many archaic work practices out there.

blanch152

https://www.boards.ie/discussion/comment/121938224#Comment_121938224

That is another aspect of the problem all right, but even if we had 100,000 step-down beds, there would be nobody discharged on a Sunday.

jmayo

https://www.boards.ie/discussion/comment/121938239#Comment_121938239

Ahh I see.

First it was us country yokels wanting a hospital at the end of the boreen.

Then it was one off housing.

Now it is doctors and nurses working in the hospitals.

Well at least you are finally noticing it has something to do with workers in hospitals.

Maybe eventually you will join the dots all the way to Dr Steevens Hospital Dublin and 50-58 Lower Baggot St.

Hell you might even eventually figure out Kildare St and Merrion St Upper have something to do with the farce.

Podge_irl

https://www.boards.ie/discussion/comment/121938227#Comment_121938227

PS what about the 100k plus refugee and asylum seeker/IPA immigrants that arrived in last couple of years that are not contributing to the tax take, but yet are availing of medical cards, free healthcare, etc?

How many of that 100k plus work in healthcare?

Funny how when it comes to public spending some people conveniently forget the immigrants that add no financial value, but just take out of the pot.

Few enough. So we are not pivoting to the current government should have done even less for Ukraine then they did?

Ukrainians are allowed work and many of them will have started to do so. There is a war on our continent and everyone is contributing something to it.

eggy81

https://www.boards.ie/discussion/comment/121937437#Comment_121937437

The A&E experience is worse now than it was 20 years ago. Or 30 years ago.

blanch152

https://www.boards.ie/discussion/comment/121938472#Comment_121938472

Nonsense.

The fact that life expectancy has increased means that the A&E experience must be better, otherwise, we would all be dying younger.

https://www.oecd.org/ireland/health-at-a-glance-Ireland-EN.pdf

A couple of stats stand out in regard to A&E:

"30-day mortality after stroke was 6.3% (OECD average 7.8%), and 5.4% after AMI (OECD average 6.8%)"

The problems with A&E relate more to the type of issues that people go to A&E for. We need better education in that regard, though I doubt that the phenonemon of young lads throwing punches on a weekend night and clogging up A&E can be put down solely to education.

Other states are interesting:

"Ireland spends $6047 per capita on health, more than the OECD average of $4986 (USD PPP)"

There is not a problem with funding provided by the government then.

"There are 4.0 practising doctors per 1,000 population (OECD average 3.7); and 12.7 practising nurses (OECD average 9.2)"

That money pays for plenty of doctors and nurses.

So the government is handing over a lot of money, more than the OECD average to the HSE, and the HSE is hiring a lot of doctors and nurses, more than the OECD average, draw your own conclusions, but the problems in the health service aren't about the amount of money from government, and neither are they about the number of doctors and nurses employed by the HSE.

blanch152

https://www.boards.ie/discussion/comment/121938276#Comment_121938276

It is about several of those things combined. Complex problems do not have simple solutions. It is only idiots like Pearse Doherty who believe that.

SC2023

As someone working in healthcare at the moment the most common delays in discharging medically ‘well’ patients are

1. lack of /rehab care beds
2. patient preference to return home when a nursing home might be the quicker option. If they don’t want NH care then there are a lot of adaptations that need to be made, involving a lot of staff (medical social workers, physios, OTs). If you’re lucky they all meet once per week to get on the same page. If a patient accepts nursing home care then waiting for fairdeal paperwork is the hold up.
3. waiting for outstanding investigations or imaging. Where I worked it was not uncommon for inpatients to wait up to a week for a non urgent imaging request. We would ask these patients if they would prefer to stay in hospital or would they rather wait 12-18 months if they left.

if a patient was well and able to leave the hospital to safe accommodation on a Sunday then the doctors would discharge them on a Sunday. Without a doubt.

I entirely agree regarding there needing to be better public education about what is appropriate to present to A&E with and what is not. However we would first need to increase the numbers of GPs practicing in the country. It is almost impossible to register at a GP practice as a new patient now and the previously thought ‘brilliant quality of life’ that drew doctors to GP is a mirage. Huge insurance premiums, frequent litigation letters, patient lists far beyond what is possible. They don’t feel they’re doing a good job because there is just not enough of them. Without good primary care tertiary care is overrun and useless. They rely on each other.

beeker1

I heard its due to medical issues ! If true , I wish him all the best !

creedp

https://www.boards.ie/discussion/comment/121940689#Comment_121940689

I propose this for the most idiotic post of the day accolade

blanch152

https://www.boards.ie/discussion/comment/121940742#Comment_121940742

The post I was replying to was far more idiotic, dogwhistling racism should not be tolerated.

My response in sarcasm obviously passed over your head.

Cluedo Monopoly

https://www.boards.ie/discussion/comment/121938136#Comment_121938136

This has been shown to be absolute BS before yet you keep spinning the misinformation. Why?

Cluedo Monopoly

Nurse to patient ratio ‘completely poor practice’ - INMO | Newstalk

The nurse to patient ratio in Irish hospitals is putting increasing pressure on staff, according to the Irish Nurse and Midwife Organisation (INMO). 

INMO is calling for the HSE to attend this week’s Emergency Department Taskforce meeting “with renewed and workable solutions” to reduce overcrowding and staffing issues.  

While there should be one nurse of every six to eight patients, the current ratio in Ireland is typically 14 to one.  

INMO General Secretary Phil Ní Sheaghdha said this puts incredible pressure on staff.  

“If you have 14 patients instead of eight, obviously everybody is going to get less time and there is going to be delays,” she said.  

“That is not the fault of the person who is rostered and trying to do their best, but they simply cannot do two people’s jobs.”  

INMO also said 5,210 patients have been without a bed in Irish hospitals since September, including 100 children.  

-------------

Nobody can blame the nurses. No wonder they leave.

Cluedo Monopoly

Survey done in summer last year

Almost three-quarters of nurses and midwives considering emigration after qualifying (irishexaminer.com)

Almost three-quarters of intern nurses and midwives have said they are considering leaving Ireland after receiving their qualification, according to a new survey from the Irish Nurses and Midwives Organisation (INMO). 

However, a third of them have said if staffing and working conditions were improved then they would delay their departure. More than half (54%) also stated that pay was a significant factor in whether they would consider remaining in Ireland or moving to the private healthcare sector. 

The survey, published on Thursday morning as the INMO conference got underway in Killarney, also noted that the lack of adequate breaks, unmanageable pressure, exhaustion, and a lack of safe staff-to-patient ratios across the health service were significant factors that led to interns to consider leaving Ireland. 

blanch152

There are self-fulfilling surveys, there are union statements, and there are cold hard facts published by the OECD.

Anyone can choose their own source of information.

magicbastarder

https://www.boards.ie/discussion/comment/121941247#Comment_121941247

that seems to be nurse to patient ratios, not nurse to population ratios.

according to this link, we're the second highest in the EU, and fifth in europe overall. only finland, switzerland, norway and iceland are higher.

https://www.oecd-ilibrary.org/sites/507433b0-en/1/3/2/5/8/index.html?itemId=/content/publication/507433b0-en&_csp_=69a1197833db420974a2940c01518500&itemIGO=oecd&itemContentType=book

Cluedo Monopoly

https://www.boards.ie/discussion/comment/121941283#Comment_121941283

The OECD numbers have been rubbished many times. They are not comparing like with like.

OECD nurse patient ratios do not give the full picture - Health Manager

The OECD figures for nurse patient ratios in Ireland did not portray the full picture of nursing work in Ireland, Prof. Jonathan Drennan, Professor of Nursing and Health Services Research, School of Nursing and Midwifery, University College, Cork, told the conference.

Speaking on “Safer nurse staffing: the right person in the right place at the right time, he said that if you just looked at OECD figures, Ireland, with 12.4 nurses per 1,000 population, had more nurses than most OECD states. However, this was not the full picture, as the Irish figures included nurses working in management and education and that made it difficult to get accurate figures of those working directly in clinical practice. In other countries, part of the registration process involved stating place of work – this did not happen in Ireland.

It had also to be remembered that the environment in which Irish nurses worked was very complex, because Ireland had one of the lowest number of beds per thousand population and one of the highest bed occupancy rates in the OECD. The number of beds in hospitals, patient acuity and dependency, support from other health professionals and patient turnover determined the kind of work which nurses carried out. A small number of beds, increasing patient acuity and dependency and high turnover meant nurses would be much busier.

According to the OECD (2015) Ireland had 2.6 beds per thousand of the population, compared to 13.17 in Japan, 6.13 in France, 4.82 in Luxemburg and 4.35 in Finland.

The bed occupancy rate in Ireland was also very high. According to the OECD, we had a 94% bed occupancy rate, while the rate in Europe ranged from 68% in Slovenia to 84% in the United Kingdom, and 46% in the Netherlands.

“So nurses in Ireland are working clinical settings with high rates of patient turnover, which leads to increased nursing work. 

Spanish Eyes

https://www.boards.ie/discussion/comment/121938255#Comment_121938255

Sorry (and I'm no Government cheerleader either), but a friend was admitted to James' via A+E recently. He had massive infection possible sepsis. Treated very promptly as possible sepsis is, was in for four days on IV treatment and was discharged on St Patrick's Day, which was a Sunday. So it does happen, maybe not all the time though!