How to improve the HSE

Graces7 · 21-07-2019 03:17PM

Wanderer78 wrote: »

so people, how may not/probably dont have 100 euro, should pay, and should go to their gp first, who may or may not be on duty, or there maybe a wait for a couple hours to seen them, in an emergency situation, and this would work just fine?

Yep. If an emergency happens at night or in a rural area, and you call the GP chances are he will tell them to go to a and e.

If folk on a very low income were facing E100 they would not be able to get medical help in emergency. Trust me on this that there is no way someone eg a pensioner or unemployed or low income could find E100.

Amazing how the "solution" by non medical folk to the issues re a and e is to advocate barring folk or making a visit financially impossib,e rather than upgrade the service

Graces7 · 21-07-2019 03:19PM

irishgeo wrote: »

Your trying to get people out of a and E who don't need to be there. A gp visit first might clear some of these.

If it's an emergency that's fine but often it's not.

The problem is people think I'll skip the GP wait of s few hours and go straight to A + E and increase the waiting time there.

what kind of urgent need are you thinking of? A broken bone? Vomiting blood? Chest pains?

Graces7 · 21-07-2019 03:23PM

irishgeo wrote: »

The problem in a nutshell.

Let's just skip the GP sure he will only send us to A and E.

Should be a 100 euro for the medical card people too unless they have a gp letter.

I have done that. with a shattered wrist.. after a fall and in the wee small hours. Oh and once when I was bringing up blood I called the duty dr to be ordered to call an ambulance.

There are urgent situations that call for immediate action.

21-07-2019 03:24PM

Squall Leonhart wrote: »

How to improve the HSE

I brought my toddler to the local out of hours GP service last week, and to my surprise they told me it is now, since last April, open all hours outside regular GP surgery hours (and the service was renamed from EastDoc to EDoc). It used to close down at 10pm. This will be a fantastic improvement on 8-hour waits in Temple Street or Crumlin. I wonder is it motivated entirely by reducing A&E waiting lists? How is the HSE going to get this extra spend back financially?

Graces7 · 21-07-2019 03:53PM

Deleted User wrote: »

I brought my toddler to the local out of hours GP service last week, and to my surprise they told me it is now, since last April, open all hours outside regular GP surgery hours (and the service was renamed from EastDoc to EDoc). It used to close down at 10pm. This will be a fantastic improvement on 8-hour waits in Temple Street or Crumlin. I wonder is it motivated entirely by reducing A&E waiting lists? How is the HSE going to get this extra spend back financially?

sounds as if they have radically reorganised the practice? always a dr on duty at night etc

21-07-2019 04:47PM

Graces7 wrote: »

If folk on a very low income were facing E100 they would not be able to get medical help in emergency. Trust me on this that there is no way someone eg a pensioner or unemployed or low income could find E100.

So how do they find 100 to pay their electric bill? Rent? Car insurance? Fuel? Food? Booze? Internet? Mobile credit?

angel eyes 2012 · 21-07-2019 05:07PM

Wanderer78 wrote: »

what if you actually cant afford it? i know working people that sometimes cant even afford to go to the doctor

If you attend A&E and pay €100, you can claim it back from the HSE once you are admitted as an in-patient.

Wanderer78 · 21-07-2019 05:37PM

angel eyes 2012 wrote:

If you attend A&E and pay â‚¬100, you can claim it back from the HSE once you are admitted as an in-patient.

Again, what if you don't have a â‚¬100?

21-07-2019 08:22PM

Wanderer78 wrote: »

Again, what if you don't have a €100?

Then how are you feeding yourself, clothing yourself, getting about, using a mobile phone, using the internet, etc?

end of the road · 21-07-2019 08:56PM

salonfire wrote: »

Outsource the routine and the mundane to private clinics. If they fail to deliver or are continously unable to operate due to striking staff, strip the service from them and give it to the competition.

It will break the stranglehold unions have in the HSE.

I have experience of private health care and couldn't fault it.

there is a massive difference between private health care existing along side a public system, and private health care replacing a public system as you propose in part. private health care being the only option definitely doesn't work. there also aren't going to be many companies equipped to tender in the first place.
also, given the unions have no stranglehold anywhere in this country and they exist in the private sector as well, your proposal makes absolutely no difference in that regard.

salonfire wrote: »

So how do they find 100 to pay their electric bill? Rent? Car insurance? Fuel? Food? Booze? Internet? Mobile credit?

very simple. they are paying those from their income. which is likely wiped out once they have all of those paid for. and some of those won't even be spending money on luxuries such as drink.

_blaaz · 21-07-2019 08:59PM

salonfire wrote: »

Then how are you feeding yourself, clothing yourself, getting about, using a mobile phone, using the internet, etc?

Free wifi/3 network data packages/second hand shops,lidl for food

Youd be suprised how many people couldnt come up.100 euro day before payday or have even 20 left over at end of week

The Rape of Lucretia · 21-07-2019 09:09PM

Close 10-12 hospitals. Increase consultant salaries to 250k and reduce their working hours. Close service in some others and concentrate specialties.

It really is that simple. Everyone in the business knows the above is the answer. But the general public, with a simplistic understanding of the problem, react incorrectly with horror to those actions. Local business and political opportunists exploit this wider ignorance for their own ends, making it political suicide for anyone in office to implement them. So the people of Ireland get the health service they deserve.

angel eyes 2012 · 21-07-2019 10:18PM

end of the road wrote: »

there is a massive difference between private health care existing along side a public system, and private health care replacing a public system as you propose in part. private health care being the only option definitely doesn't work. there also aren't going to be many companies equipped to tender in the first place.
also, given the unions have no stranglehold anywhere in this country and they exist in the private sector as well, your proposal makes absolutely no difference in that regard.

very simple. they are paying those from their income. which is likely wiped out once they have all of those paid for. and some of those won't even be spending money on luxuries such as drink.

Try paying 134 euro per month for your medication for the rest of your life and the 60 euro doesn't look so harsh.

Calhoun · 21-07-2019 11:49PM

How to improve the HSE is a very big question as its a big bloated beast. If i personally was to do it i would start to look at a number of areas.

First being a value for money review, are we getting the best bang for our buck? Do we have duplicate roles in place that we could downsize on? Could we invest in IT infrastructure that would stream line admin roles?

Second being investing in our front line staff, making sure we have the right amount of numbers hired, put in place practices like we see in the UK where depending on the cost of living in your area you get a salary modifier to make sure your not on the breadline.

Third is to review how we handle intake on our front line, when i was at A+E with my daughter a while back in addition to the usual drink related there was also a few on the medical card. I got the impression as they are on it they just turned up without going to out of hours doctor. I would also maybe invest in the likes of a drunk tank so we aren't clogging up A+E with people who need to sleep it off.

Four we need to remove the whole trial by media process we have been going on for the past couple of years. It helps no one that people are actively engaging with the media to push for decisions on drugs ect

I know these alone will not help it but we have to start somewhere and not all problems with our health system are actually because of the HSE on its own.

KaneToad · 21-07-2019 11:58PM

ToddyDoody wrote: »

Michael O'Leary

The CEO of a budget airline?

At least you didn't mention the other "classic" - get rid of all the admin staff and hire more nurses/doctors.

Graces7 · 22-07-2019 01:47AM

salonfire wrote: »

So how do they find 100 to pay their electric bill? Rent? Car insurance? Fuel? Food? Booze? Internet? Mobile credit?

Do you know how much pensioners actually get?

The idea of a power bill being E100! We live carefully.
No car. Food is the cheapest and simplest and don't drink. Any household and clothing needs are met from charity shops.

Internet a small local server and as I am housebound, it is my library my social contact, my shopping,

No idea what mobile credit is? I make almost no calls. email is better

E100 for A and E or E60 for a GP visit is not viable. Hence the medical card....nb only other way would be to raise the pension /disability allowances..

Sure it might cut some a and E queues. But then you are judging the medical condition of folk you have never met ? Had there been that fee I would have wrapped my shattered wrist and gritted my teeth, and I mean that.

Thankfully there is no such fee .Health care is a basic right and a necessity not a luxury. But then I was raised and lived in the UK and the NHS is for everyone. " from the cradle to the grave". It has as many problems ad as much overcrowding as we do here but no demands for high fees from those who have little .

Graces7 · 22-07-2019 01:58AM

angel eyes 2012 wrote: »

Try paying 134 euro per month for your medication for the rest of your life and the 60 euro doesn't look so harsh.

Not sure what your point is here? If you are earning?

Graces7 · 22-07-2019 02:01AM

Calhoun wrote: »

How to improve the HSE is a very big question as its a big bloated beast. If i personally was to do it i would start to look at a number of areas.

First being a value for money review, are we getting the best bang for our buck? Do we have duplicate roles in place that we could downsize on? Could we invest in IT infrastructure that would stream line admin roles?

Second being investing in our front line staff, making sure we have the right amount of numbers hired, put in place practices like we see in the UK where depending on the cost of living in your area you get a salary modifier to make sure your not on the breadline.

Third is to review how we handle intake on our front line, when i was at A+E with my daughter a while back in addition to the usual drink related there was also a few on the medical card. I got the impression as they are on it they just turned up without going to out of hours doctor. I would also maybe invest in the likes of a drunk tank so we aren't clogging up A+E with people who need to sleep it off.

Four we need to remove the whole trial by media process we have been going on for the past couple of years. It helps no one that people are actively engaging with the media to push for decisions on drugs ect

I know these alone will not help it but we have to start somewhere and not all problems with our health system are actually because of the HSE on its own.

Not sure what you mean? Nowhere I have lived has there been viable access to an out of hours dr? When you call them, the majority they tell you to go to a and e anyways. Makes perfect sense to go to a and e.

Calhoun · 22-07-2019 02:05AM

Graces7 wrote: »

Not sure what you mean? Nowhere I have lived has there been viable access to an out of hours dr? When you call them, the majority they tell you to go to a and e anyways. Makes perfect sense to go to a and e.

There is the out of service doctors, if those who are paying for the service have to filter through them then i don't see why those on the medical card should have to unless there is urgent care required. Just today i had to drive my wife 40 minutes away to the out of service Dr.

The people i was sitting near just commented that they couldn't go the Dr during the day so they turned up in A+E.

Its simple as, things are never going to change if we don't go through the proper in take processes.

gctest50 · 22-07-2019 02:56AM

Graces7 wrote: »

Do you know how much pensioners actually get?

The idea of a power bill being E100! We live carefully.
No car. Food is the cheapest and simplest and don't drink. Any household and clothing needs are met from charity shops.

Internet a small local server and as I am housebound, it is my library my social contact, my shopping,

No idea what mobile credit is? I make almost no calls. email is better

E100 for A and E or E60 for a GP visit is not viable. ...............................

might want to check

13160 pension

420 electricity allowance

468 living alone

660 coastal island allowance

30 phone allowance

630 fuel allowance

160 tv licence

300 waste

€ 15828

Rubberchikken · 22-07-2019 03:59AM

the hse is clogged with middle managers all watching their little space like a savage and unwilling to relinquish one inch.

get rid of them.
look at the mental health system and see how inefficient it is with people being given appointments to see obe inexperienced and uninterested 'team member' after another.
appointments that can last a total of 5 minutes just to check 'all is well' and the next time theyre seen its a different person and so explanations have to be gone through again.
its a useless top heavy plodding system that woukd need to suffocate itself to be gotten rid of.
it will never change

angel eyes 2012 · 22-07-2019 06:43AM

Graces7 wrote: »

Not sure what your point is here? If you are earning?

Yes when you are working. I think a nominal charge keeps the time wasters away. I have spent hours in A&E, once I had to sit on the ground while getting sick - there were no seats left. There was a gang of young lads waiting, it transpired they had been rear ended in an accident. They were boasting about how much they were going to win on compo and there appeared to be little wrong with them, although of course I could be completely wrong. Another time I spent a night in a sluice room on a ward.

Similarly, I wonder how effective the management of staff is. I had to attend a major hospital yesterday for a prescription (long story). I was waiting over 4 hours in a waiting room in a ward for the one piece of paper. I was in the room on my own and a staff member, nurse attendant, sat in a chair and proceeded to have a nap for about 40 minutes. Now maybe he was on a break, I still thought it was an inappropriate area to have a nap. I manage staff in my role and if one of them went awol for 40 minutes I'd be looking for them. I was going to take a photo as I was increasingly getting frustrated but I couldn't bring myself to do it, again I had to consider he may have been on his lunch.

I could write a book on the inefficiencies of the health system but then again the tragedy is that many of us could.

Graces7 · 22-07-2019 08:17AM

gctest50 wrote: »

might want to check

##

13160 pension

420 electricity allowance

468 living alone

660 coastal island allowance

30 phone allowance

630 fuel allowance

160 tv licence

300 waste

€ 15828

per annum? Far easier for us to put it per month? And yes I am well acquainted with the figures .. rent allowance also and a travel pass. many of these are not cash in hand.

waste? a new one to me. NB the electricity allowance covers the standing charge and some units; it was drastically cut a while back

Oh and not everyone will qualify for every allowance of course . Only single folk living on qualifying islands eg.

Drifter50 · 22-07-2019 08:21AM

salonfire wrote: »

Then how are you feeding yourself, clothing yourself, getting about, using a mobile phone, using the internet, etc?

FGS, stop and think for a minute, there clearly are thousands of people not as privileged as you. But to answer your questions, 1. living with parents / friends / family, 2. ready to go €20 per month, no internet, using wifi in shops etc, can`t get around unless walking, getting a lift.

There is another life out there

Graces7 · 22-07-2019 08:21AM

Rubberchikken wrote: »

the hse is clogged with middle managers all watching their little space like a savage and unwilling to relinquish one inch.

and not one of them with any clinical training and with the sole aim of discrediting any patient who dares to complain validly rather than take any blame that may result in legal action. slippery and no medical ethics.

Martina1991 · 22-07-2019 08:39AM

irishgeo wrote:

It's easy. GP surgery need to upgraded to deal with more tests etc that are currently done in the hospital. GP clinics should be a mini hospital in regards to tests anyway.

What tests? GPs can't perform laboratory testing or radiographic imaging like xrays or CT scans. These services can only be performed at the hospital.

mikep · 22-07-2019 08:55AM

HSE urgently needs 24/7 use of diagnostic equipment, technicians on shift etc..

e.g a second cath lab is not needed in Waterford, just add staff and run the equipment longer

In the real world where major investments are made for equipment the idea is to maximise the running time so as to get value for money..

Martina1991 · 22-07-2019 12:04PM

mikep wrote: »

HSE urgently needs 24/7 use of diagnostic equipment, technicians on shift etc..

e.g a second cath lab is not needed in Waterford, just add staff and run the equipment longer

What equipment, technicians do you mean? Employing more staff costs more money. There are staff shortages in many health care fields where there simply isn't enough graduates to fill positions.

mikep · 22-07-2019 12:32PM

Martina1991 wrote: »

What equipment, technicians do you mean? Employing more staff costs more money. There are staff shortages in many health care fields where there simply isn't enough graduates to fill positions.

Anywhere there is a deficiency identified there could be a targeted training programme put in place perhaps to allow those in other areas of the organisation to retrain..

From what I recall of when I took a look at the cath lab in waterford it seems to operate 9-5 which probably means that testing occurs from 10 - 3 only.
Most other countries have a facility like this running into the evening at a minimum.

If I ran the HSE I'd have a retrain or redundancy program to boost skills where needed and eliminate the layers of admin..

As in if you don't accept to retrain..you are gone..

JJayoo · 22-07-2019 12:37PM

One annoying thing I noticed when working for HSE is that everyone wants a paper trail to show that they got permission from above to do every action, so they can't be blamed.

This led to every email being printed off, in colour. So if two people exchanged 20 emails the entire chain of emails would be printed off each time a few email would come, and the previous emails would be shredded.

They had 3 printers and each printer would go through at least 2 cartridges of black ink per week, and the amount of Fcuking paper.

When you consider that this probably happens in every office the expense, needless expense, adds up.

How to improve the HSE

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