blanch152 wrote: » It makes a difference from the people attempting to blame the weather and the failures of the Irish soccer team on Leo and Eoghan (or are they the only things they haven't been blamed for?). Seriously, nobody is saying the HSE would be grand it it wasn't for the poor quality sick. That is either a misrepresentation of a failure to understand. If the reasonable proposals made on here for a small charge to be paid by everyone (yes, medical card holders, pensioners and even members of the travelling community), we would have a small element of demand management so that only people who are really sick would bother turning up. The restaurant comparison doesn't make sense by the way.
Sam Russell wrote: » Older people do not generally have a single complaint but have many minor complaints that add up to a serious syndrome that needs treating if one of those complaints goes from minor to serious. There is a reason elderly are recommended to get the flu jab.
FreudianSlippers wrote: » A&E is not for "treating a condition" it's for accidents and emergencies; clue's in the name.
Podge_irl wrote: » Sam Russell wrote: » Well, that sounds OK, but someone who delays treating a condition because of a charge, and they wait till it gets serious, or critical, will cost the HSE many time over the charges. This is particularly true of the older people - many of whom do not want to be a burden or nuisance. Older people do not generally have a single complaint but have many minor complaints that add up to a serious syndrome that needs treating if one of those complaints goes from minor to serious. There is a reason elderly are recommended to get the flu jab. A charge might deter some who should not be there but also deter many who should be there. Which they should be going to their GP for.
Sam Russell wrote: » Well, that sounds OK, but someone who delays treating a condition because of a charge, and they wait till it gets serious, or critical, will cost the HSE many time over the charges. This is particularly true of the older people - many of whom do not want to be a burden or nuisance. Older people do not generally have a single complaint but have many minor complaints that add up to a serious syndrome that needs treating if one of those complaints goes from minor to serious. There is a reason elderly are recommended to get the flu jab. A charge might deter some who should not be there but also deter many who should be there.
Tell me how wrote: » But, what do you suggest? Is it the service users (the public) who are the root of the problem? What do we do? 24Hr GP type cover before people go to A&E? Or a marketing drive to show the way incorrect attendance impacts the system? People will only stay away if they feel they have a suitable alternative.
Sam Russell wrote: » If they need admission to hospital for cardio-vascular treatment or broken bones, the GP cannot help them, and would direct them to A&E anyway. Many are taken to A&E by ambulance and require serious level of nursing. The average life expectancy for elderly women who suffer broken hips from a fall is something like six months. These elderly people are very fragile, or at least those that end up in A&E.
AndrewJRenko wrote: » I wonder if we should open up all complex issues to management by the crowdsourced wisdom of boards.ie posters? If we're going to do 'design the health service' by boards.ie posters, let's go all the way - let's do 'brain surgery' by boards.ie posters. We'll stick a surgeon in theatre and have all the experts here tell them where and when and how deep to cut and poke around. I'm sure it's work out fine, because so many people have such deep expertise on the health service.
Tell me how wrote: » How is it you have nearly 5,500 posts on boards and still don't understand the meaning of the word "discussion".
AndrewJRenko wrote: » Discussion is great, but let's not kid ourselves that it has any more value than us sitting round discussing brain surgery techniques.
Matt Barrett wrote: » How likely is it that after what amounts to decades of decline, the HSE has over paid managers, (surplus?) poorly scheduled front line staff? I'm not saying this is the case, just wondering, if true, how is it that nobody, HSE, Government, Administration, Unions etc. etc. made moves to fix these issues, or are they issues at all? It's been going on long enough now that the problems should be obvious to those with insider knowledge? If it's unions and staff, why do we throw money at the problem? If it's bad admin/management, why do we continue as is/throw money at the problem? There's no point in the same people making the same complaints and continuing as is.
Geuze wrote: » When the eight regional health boards were merged into the HSE, a deal was done by Ahern with the unions. No job losses. There are 2,000 staff in HR, and the head of HR says he needs 800. There are 62 payroll offices in the HSE.
Sam Russell wrote: » In any empire, there are empire builders who manage to increase their little bailiwick and increase their (perceived) importance by adding unnecessary procedures for others to comply with. The longer an empire exists, the more of this goes on. Of course, the more important these builders are, the more they demand in salary, office space, juniors, etc. Happens in every enterprise - public or private. It is countered by subsidiarity, as practised by the EU. Decisions are made at the lowest level that can competently make the decision. This has the effect of reducing the need for managers higher up the tree.
Matt Barrett wrote: » That might explain a surplus of staff, but not the running. Also we can revisit these deals. We had to eventually let the lamplighters go. But it's not a new phenomena surely? Do we just go on so? I don't know much about the inner workings but one would expect there are people who do and have ideas for fixes at the stage.
Sam Russell wrote: » Only turkeys vote for Christmas. Most organisations go through rationalisation from time to time, usually when the money looks like running out. Jaguar Land Rover are currently looking to shed 5,000 jobs in the UK due to falling sales. The job losses are in management, marketing etc. - but not manufacturing. State funded organisations do not usually run out of money because they just ask for more and usually get it.
Matt Barrett wrote: » Over payed, over staffed shouldn't mean poorly run. If anything it should mean surplus in staff. If we're expecting staff to quit or take a pay cut..... Pity we've no administrative/mangerial body beholden to the tax payer to address this.
Tell me how wrote: » One in 23 workers in the country work for the HSE. Taking their friends and family in to account, that's quite the reach to influence governmental opinion. Not to mention if they cut staff and the way that would be used with negative headlines to blame solely the government for impact on people's health. Absolute behemoth to try to control now.
Sam Russell wrote: » Very few do brain surgery, but most interact at some level with the HSE. At one time, GPs would refer patients to an outpatient clinic in the local hospital for an appointment, but now they tend to refer patients to A&E. Why? A&E is certainly the sharp end of the criticisms of the H&E, and certainly a major centre of the problems patients see, but not necessarily the area that should get the most attention. We have a lot of highly paid managers in the HSE - what is it exactly that they do? Could we do with fewer and less well paid managers? Perhaps that is worthy of attention. Mental health, children's scoliosis treatment, waiting lists, provision of care packages, patients over-staying in acute hospital beds - these all deserve attention, along with many more. Why do we not insist Irish trained doctors must stay within the Irish health care system for a minimum time? Why do we train so many foreign doctors at the expense of Irish trainees? To fix the HSE, all the small, minor to major issues need tackling, instead all that happens in the subvention gets bigger year on year with no incremental improvements. No-one is in charge.
blanch152 wrote: » To be fair to the HSE, I would guess that there are more highly paid managers in the university sector than in the HSE.
Tell me how wrote: » Nobody suggested any differently. Discussing the health service on Boards is about as valuable as discussing the traffic and commuting implications associated with the M50. But that didn't stop you playing an active part in that discussion. If you didn't want to join in here, you could have just stayed away.
FreudianSlippers wrote: » Do you think a neurosurgeon knows how to fix the HSE because they know about brain surgery?
Sam Russell wrote: » Very few do brain surgery, but most interact at some level with the HSE.
Sam Russell wrote: » At one time, GPs would refer patients to an outpatient clinic in the local hospital for an appointment, but now they tend to refer patients to A&E. Why?
Sam Russell wrote: » A&E is certainly the sharp end of the criticisms of the H&E, and certainly a major centre of the problems patients see, but not necessarily the area that should get the most attention.
Sam Russell wrote: » We have a lot of highly paid managers in the HSE - what is it exactly that they do? Could we do with fewer and less well paid managers? Perhaps that is worthy of attention.
Sam Russell wrote: » Mental health, children's scoliosis treatment, waiting lists, provision of care packages, patients over-staying in acute hospital beds - these all deserve attention, along with many more.
Sam Russell wrote: » Why do we not insist Irish trained doctors must stay within the Irish health care system for a minimum time? Why do we train so many foreign doctors at the expense of Irish trainees?
Sam Russell wrote: » To fix the HSE, all the small, minor to major issues need tackling, instead all that happens in the subvention gets bigger year on year with no incremental improvements. No-one is in charge.
Tell me how wrote: » ^^^ What are you doing here? You obviously don't want to discuss ways to improve the HSE.
AndrewJRenko wrote: » The Head of HR is a she. So where exactly did 'he' say anything about the need for HR staff?
AndrewJRenko wrote: » Here's one way to improve it - let's leave the improving to people who know what they are talking about.
![Photo of [Deleted User]](https://w1.vanillicon.com/v2/19a7a778b727ad07a3bbcea8101c61b3.svg)
![Photo of [Deleted User]](https://www.boards.ie/applications/dashboard/design/images/banned.png)
