challenging time for Hospitals

judeboy101 · 03-01-2017 11:43PM

Atoms for Peace wrote: »

There should be limit placed on free visits for medical card holders, under six's etc. unless they have a valid medical condition.

Three strokes and you're out!

Tom Mann Centuria · 04-01-2017 12:12AM

Kristopherus wrote: »

Plenty of private nursing home beds available -check.

Yep, who can select who they do or don't want, so aggressive, confused, high falls risk, full care, complicated care patients are not high on most wanted new residents.

Also the same owners dread people dying in their nursing homes as it looks bad for HIQA so send terminally Ill patients into HSE hospitals to die, and this isn't always a quick process as you find people don't die on demand.

Also the fair deal paperwork has to go through and be approved before the home accepts patients.

Same as any private company, they decide what is a "good" risk for them to take on or otherwise, HSE doesn't have that choice, and neither did the community beds these difficult to place patients used to go before all the beds closed.

But, yeah, plenty of private nursing home beds available.

steddyeddy · 04-01-2017 12:50AM

Beasty wrote: »

I'm one of those immigrants. Am I putting pressure on resources? Well actually my employer pays over 10 grand a year for my (and my family's) private health insurance. I also reckon I've paid significantly more tax in Ireland than the average "native" pays in a lifetime. That's on top of the boost to the economy my own employment brings. Most immigrants come here to earn a living and are net contributors to the economy

I'm working in the UK and hear the same thing in relation to immigrants and the NHS here.

darkpagandeath · 04-01-2017 12:57AM

Remember getting rid of the likes of the Eastern Health board and others were supposed to produce Savings and streamline the health service setting up the HSE ?

Boggy Turf · 04-01-2017 01:00AM

darkpagandeath wrote: »

Remember getting rid of the likes of the Eastern Health board and others were supposed to produce Savings and streamline the health service setting up the HSE ?

Harney bottled it by not reducing the number of admin staff using compulsory redundancies (i.e. the original plan). Then they made a bureaucracy to support the overstaffing. They tried it again with Irish Water, it doesn't work.

Beasty · 04-01-2017 01:13AM

steddyeddy wrote: »

I'm working in the UK and hear the same thing in relation to immigrants and the NHS here.

London in particular is massively dependent on immigrants, and the NHS employs a very large number across the country. This whole idea of Brexit cutting immigration is absurd - there will be insufficient workers to pay all the pensions (the UK has a pensions timebomb - much worse than Ireland although better than places like France), never mind fund the NHS, unless the UK economy is allowed to continue growing on the back of immigration

oneilla · 04-01-2017 03:08AM

Dr Crayfish wrote: »

You can't blame immigrants and junkies/med card holders at the same time. Immigrants tend to work and pay tax, people from certain areas of Dublin haven't paid tax for generations, their net contribution to our society is quite negative.

How do they escape paying VAT?

qo2cj1dsne8y4k · 04-01-2017 04:12AM

When people can walk into an accident and emergency with an issue that's neither accident nor emergency, it of course compromises the resources for actual accidents and emergencies. When people can avail of this service free of charge there isn't really any deterrents or incentives to use GP or the out of hours care dr.

darkpagandeath · 04-01-2017 04:30AM

LexieOnRale wrote: »

When people can walk into an accident and emergency with an issue that's neither accident nor emergency, it of course compromises the resources for actual accidents and emergencies. When people can avail of this service free of charge there isn't really any deterrents or incentives to use GP or the out of hours care dr.

http://www.citizensinformation.ie/en/health/health_services/gp_and_hospital_services/hospital_charges.html

Sigh... Do they get free sky tv too ?

mansize · 04-01-2017 04:33AM

jay1988 wrote: »

Did anyone say particularly inward migration?

No they didn't, one poster added that to all the other reasons posted above him.

Nice try on pushing your agenda though.

Are you going to retract this falsehood now?

Graces7 · 04-01-2017 05:02AM

LexieOnRale wrote: »

When people can walk into an accident and emergency with an issue that's neither accident nor emergency, it of course compromises the resources for actual accidents and emergencies. When people can avail of this service free of charge there isn't really any deterrents or incentives to use GP or the out of hours care dr.

True but not quite the whole story.

I was in A and E over the holidays. The problem believe me was very real and a medical emergency.

Our local after hours service was in the news as being so overloaded they were taking 3-5 hours even to answer the phone. The ambulance paramedics who were stars. said that the GP would just have sent me to A and E anyways . I had tried to access them
And getting a GP appointment? They seem to send so many to A and E who surely could be treated at home.

This is the norm with this out of hours service.

Bu the way, the A and E service is free to medical card holders AND to anyone referred by a GP, which is open to question.

The place was in chaos. Seemed no one in charge. I do not think they are understaffed,, Just disorganised.
Reception staff were rude to the point of abuse

Waited for many hours to be seen and then only as I was in a state of collapse and made waves.

The last time I had been in A an d E was nearly 3 years ago with a smashed wrist and there was no waiting etc. The atmosphere was totally different

One of the main problems now is that folk with flu are going to A and E rather than seeing their GP or coping at home. Place was full of coughing and sneezing and I came home infected.

I wonder why? I would not go near A and E unless there was no other way. I waited 24 hrs with the broken wrist .

The only part of HSE that seems to be working is the ambulances. I know they get criticised but they were stars.

mansize · 04-01-2017 05:05AM

The last time I was in A&E I wasn't able judge the room

Graces7 · 04-01-2017 05:12AM

mansize wrote: »

The last time I was in A&E I wasn't able judge the room

So sorry but that actually is a very valid statement. Thank you. When I was young GPs did far more and we rarely saw them. If the dr came to the house the next would be the vicar and then the undertaker... and that was NHS and totally free .. well apart from the undertaker :rolleyes::rolleyes:

qo2cj1dsne8y4k · 04-01-2017 10:53AM

Graces7 wrote: »

True but not quite the whole story.

I was in A and E over the holidays. The problem believe me was very real and a medical emergency.

Our local after hours service was in the news as being so overloaded they were taking 3-5 hours even to answer the phone. The ambulance paramedics who were stars. said that the GP would just have sent me to A and E anyways . I had tried to access them
And getting a GP appointment? They seem to send so many to A and E who surely could be treated at home.

This is the norm with this out of hours service.

Bu the way, the A and E service is free to medical card holders AND to anyone referred by a GP, which is open to question.

The place was in chaos. Seemed no one in charge. I do not think they are understaffed,, Just disorganised.
Reception staff were rude to the point of abuse

Waited for many hours to be seen and then only as I was in a state of collapse and made waves.

The last time I had been in A an d E was nearly 3 years ago with a smashed wrist and there was no waiting etc. The atmosphere was totally different

One of the main problems now is that folk with flu are going to A and E rather than seeing their GP or coping at home. Place was full of coughing and sneezing and I came home infected.

I wonder why? I would not go near A and E unless there was no other way. I waited 24 hrs with the broken wrist .

The only part of HSE that seems to be working is the ambulances. I know they get criticised but they were stars.

If I need to attend a+e, i always try go to GP (50 euro) or out of hrs dr (60 euro) as if I have a letter from them, I don't need to pay 100 euro. If i go straight to a+e without a letter, it's 100 euro unless I'm admitted, then you're just charged per night.

It's no secret the service is completely abused by people attending with conditions more suited to their own GP or out of hrs doctor. If people had to weigh up the costs between Drs and casualty then I'm pretty sure we'd see a reduction. If a person (medical card or not) attends a+e but doesn't meet the criteria, they should be subject to the full price.

NIMAN · 04-01-2017 10:58AM

We aren't the only country with a Health service/A&E crisis, UK is very similar.

Kimbot · 04-01-2017 11:02AM

I was in A&E with my mother a couple of days before christmas, from 11pm until 12pm 3 young girls (Between 10 & 16) came in with their parents, as they were talking at the reception all 3 stated they were in A&E because the girls have "A bit of a cough". Now 1 out of the 3 was a very chesty cough, the other 2 it sounded mild enough. To make matters worse 2 of the girls were both sitting there with boob tubes and mini skirts with no jackets etc. Now I was in Midoc with my mam first who were open etc so they could have gone there but they would have been charged the "Out of Hours" rate.

To me there are various paeople in A&E all over the country that would be far better served going to their GP's but as someone else pointed out these people are on medical cards so a trip to A&E costs them nothing. The sooner the Governement cop on to this and put a stop to it the better.

beggars_bush · 04-01-2017 11:09AM

There are around 1000 private nursing home beds that could be used to move along patients ready to leave hospital but not able to go home yet

cajonlardo · 04-01-2017 11:21AM

I have spent several stays on A & E trollies. The longest was 4 nights.

I saw an elderly lady pass away in full view of all and sundry, her family without any privacy. I distinctly remember a woman being told after 2 days there was a bed for her at last. Then they came back and apologised that the bed was given to someone else. There was a man in terrific pain with multiple injuries from a road accident. There was another old dear who was afraid of a dodgy looking group around the public jacks and she'd sit on her trolley in torment waiting until a nurse was free to walk her down. I remember it was impossible to sleep, not a chance. I remember a young lady Doctor giving man a full examination and loudly asking highly personal questions as children passed by and I remember that man sobbing quietly after the Doctor left.

I never saw the place full of drunks, never noticed lots of old folks who shouldn't be there, it wasn't full of "foreigners". It was jammed full of dying, frightened and sick people.Any extended stay on a trolley makes you feel utterly worthless and it weakens your fight to recover.

Don't know why I'm posting this. Everyone already knows, only ones saying different are either clueless or cheerleaders for the Government parties.

Mehapoy · 04-01-2017 11:51AM

Boggy Turf wrote: »

Having worked with the HSE, you would not believe the level of waste and bureaucracy within the "organisation". The levels of zero value add middle management boggles the mind. The unions block any reform but the only solution is widespread redundancies for excessive back office staff and rebuild the system from scratch. There are also many vested interests with political connections e.g I saw tens of millions wasted on renting portacabins at exorbitant prices where they could have built extensions or new buildings for fractions of the cost. It wont happen.

This, like most things in Ireland, is the answer rather than bed blockers, flu epidemics and any other excuses...

Mehapoy · 04-01-2017 11:57AM

LexieOnRale wrote: »

Graces7 wrote: »

True but not quite the whole story.

I was in A and E over the holidays. The problem believe me was very real and a medical emergency.

Our local after hours service was in the news as being so overloaded they were taking 3-5 hours even to answer the phone. The ambulance paramedics who were stars. said that the GP would just have sent me to A and E anyways . I had tried to access them
And getting a GP appointment? They seem to send so many to A and E who surely could be treated at home.

This is the norm with this out of hours service.

Bu the way, the A and E service is free to medical card holders AND to anyone referred by a GP, which is open to question.

The place was in chaos. Seemed no one in charge. I do not think they are understaffed,, Just disorganised.
Reception staff were rude to the point of abuse

Waited for many hours to be seen and then only as I was in a state of collapse and made waves.

The last time I had been in A an d E was nearly 3 years ago with a smashed wrist and there was no waiting etc. The atmosphere was totally different

One of the main problems now is that folk with flu are going to A and E rather than seeing their GP or coping at home. Place was full of coughing and sneezing and I came home infected.

I wonder why? I would not go near A and E unless there was no other way. I waited 24 hrs with the broken wrist .

The only part of HSE that seems to be working is the ambulances. I know they get criticised but they were stars.

If I need to attend a+e, i always try go to GP (50 euro) or out of hrs dr (60 euro) as if I have a letter from them, I don't need to pay 100 euro. If i go straight to a+e without a letter, it's 100 euro unless I'm admitted, then you're just charged per night.

It's no secret the service is completely abused by people attending with conditions more suited to their own GP or out of hrs doctor. If people had to weigh up the costs between Drs and casualty then I'm pretty sure we'd see a reduction. If a person (medical card or not) attends a+e but doesn't meet the criteria, they should be subject to the full price.

The solution to this is surely staring everyone in the face then, get a GP service into each hospital to look after these cases, coughs, flus etc. do a triage and if you're condition isn't bone breakage, heart problems etc. see the GP get your persription and go home... or is it truly that the problem is more acute than this and not as easily answered?

Hans Bricks · 04-01-2017 12:03PM

Boggy Turf wrote: »

Having worked with the HSE, you would not believe the level of waste and bureaucracy within the "organisation". The levels of zero value add middle management boggles the mind. The unions block any reform but the only solution is widespread redundancies for excessive back office staff and rebuild the system from scratch. There are also many vested interests with political connections e.g I saw tens of millions wasted on renting portacabins at exorbitant prices where they could have built extensions or new buildings for fractions of the cost. It wont happen.

+1. I worked in one of Dublin's major hospitals up until recently. You would not effing believe the wages that all the PAs were on. Glorified e-mail correspondents. Not to mention an overly bloated HR department where everyone is on grade V 42k salaries at minimum.

I had to leave for the private sector just out of shame. Even the department I worked in had over paid wages given some of the job titles.

foggy_lad · 04-01-2017 12:20PM

Tom Mann Centuria wrote: »

If you become a manager in the NHS, that is no longer clinical, with zero patient care, you are a manager. If you do the same in Ireland you are still a nurse, and counted as such. This not only scews nursing numbers, but also average wage stats for nurses.

On the wider subject, flu this year is rampant in Irish hospitals putting enormous strain on the already struggling health service.

Maybe the minister should be looking at this then instead of telling lies and fairy stories about how this year is worse than any other year for flu and other illnesses.

Really what is needed by the government(all governments) is to spend a proper amount on mental health and addiction services but there is no votes in spending money on lunatics and junkies.

A proper Drunk tank system should be set up in those hospitals experiencing issues with drunks and junkies where people are confined in a seperate area on a matterss with a security guard and can be physically restrained if required using the mental health legislation.

On a different note, years ago our GP would put in a few stitches if you needed them or relocate a finger or thumb if required but there is no way any GP will ever do that sort of work today particularly with Medical card patients! AMybe their insurance forbids it but these days they prescribe less potent medicines and refer most minor issues which they once dealt with to A&E

Graces7 · 04-01-2017 12:33PM

LexieOnRale wrote: »

If I need to attend a+e, i always try go to GP (50 euro) or out of hrs dr (60 euro) as if I have a letter from them, I don't need to pay 100 euro. If i go straight to a+e without a letter, it's 100 euro unless I'm admitted, then you're just charged per night.

It's no secret the service is completely abused by people attending with conditions more suited to their own GP or out of hrs doctor. If people had to weigh up the costs between Drs and casualty then I'm pretty sure we'd see a reduction. If a person (medical card or not) attends a+e but doesn't meet the criteria, they should be subject to the full price.

Who is going to assess and judge , please? I chatted with several there who had been sent by their GP, one old man who had been told A and E would be quiet as it was the holidays!

I am not going to accuse anyone..... BUT this year not being able to even get a phone call through to Southdoc for 3-5 hours? Let alone see a doctor.

If you are in pain?

And suppose you send someone away and it emerges they are really ill and die?

It is a minefield and not cut and dried.

Graces7 · 04-01-2017 12:44PM

Mehapoy wrote: »

The solution to this is surely staring everyone in the face then, get a GP service into each hospital to look after these cases, coughs, flus etc. do a triage and if you're condition isn't bone breakage, heart problems etc. see the GP get your persription and go home... or is it truly that the problem is more acute than this and not as easily answered?

WOndering what the GPs would think of that ? No reason why on of the drs on duty could not do that though,

What works in some places is the smaller Local Injuries Unit that is within existing faciliites,open most of the day and deals with cuts and broken bones etc with very little waiting time.

Graces7 · 04-01-2017 12:45PM

foggy_lad wrote: »

Maybe the minister should be looking at this then instead of telling lies and fairy stories about how this year is worse than any other year for flu and other illnesses.

Really what is needed by the government(all governments) is to spend a proper amount on mental health and addiction services but there is no votes in spending money on lunatics and junkies.

A proper Drunk tank system should be set up in those hospitals experiencing issues with drunks and junkies where people are confined in a seperate area on a matterss with a security guard and can be physically restrained if required using the mental health legislation.

On a different note, years ago our GP would put in a few stitches if you needed them or relocate a finger or thumb if required but there is no way any GP will ever do that sort of work today particularly with Medical card patients! AMybe their insurance forbids it but these days they prescribe less potent medicines and refer most minor issues which they once dealt with to A&E

This..

freedominacup · 04-01-2017 01:01PM

foggy_lad wrote: »

On a different note, years ago our GP would put in a few stitches if you needed them or relocate a finger or thumb if required but there is no way any GP will ever do that sort of work today particularly with Medical card patients! AMybe their insurance forbids it but these days they prescribe less potent medicines and refer most minor issues which they once dealt with to A&E

When did gps stop doing this? As late as a couple of years ago our physio would never bring someone requiring stitches to a and e. Straight to caredoc, job done.

Wanderer78 · 04-01-2017 01:05PM

More austerity! Too many people on this planet!

snowbabe · 04-01-2017 01:19PM

beggars_bush wrote: »

There are around 1000 private nursing home beds that could be used to move along patients ready to leave hospital but not able to go home yet

That wasn't my experience when my mum was in hospital. She ended up staying in hospital 3 months,we were offered after she was apparently ready to be discharged a bed in a nursing home miles from where my dad lives with no chance of himbgetting there,we refused that and suddenly a home a bit closer became available. There are not thousands available to hospitals.The whole system is broken,it cost the HSE 1,400 a week for my mums 3 week stay in a nursing home. The reason she took up a bed for so long was because we were waiting to be granted care hours..She was unable to come home without care hours in place. Iwrote to the health minister and explained that 4.200 would pay for alot of care hours.I have to say he did help out and got things rushed through,a letter was sent from his office and it got sorted pretty quick. Unfortunately ,this is an everyday occurance up on the wards,people waiting weeks for nursing home beds to become available,when people are downstairs on trolleys. The whole system is broken,but I have faith that Harris will do something with the poison chalice he's been given

Boggy Turf · 04-01-2017 01:23PM

snowbabe wrote: »

The whole system is broken,but I have faith that Harris will do something with the poison chalice he's been given

I doubt it very much. It needs a stronger character than Harris and full backing from the Dáil and a willingness to take on the unions. Leo is capable but made zero progress. Enda will not rock the boat, has always feared the unions and has never shown any strategic vision.

rainbow kirby · 04-01-2017 01:25PM

My mum was 48 hours on a trolley in Tallaght after she had a stroke 11 months ago. A fcuking stroke and it took that long to get a bed. Absolutely ridiculous stuff.

People give out yards about the NHS and how overstretched it is but they do a much better job than the Irish health service.

challenging time for Hospitals

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