byhookorbycrook wrote: » Recently spent time in a private hospital, two beds in my room, a few 4 beds on the floor too. The place was spotless . MRI ordered at 6pm on Sunday , done at 9am on Monday . The nurse to patient ratio seemed to be good and the food was pretty good too. Contrast that to a relation in a public hospital . Minimum 6 patients per room . Litter on the floor - stayed there until one of the visitors picked it up after 2 days . Again, not sure of the nurse to patient ratio but definitely much worse than the private hospital. The public hospital was much bigger , so economy of scale should have been in its favour , as well . Which begs the question, that if a private hospital run as a profit-making business can make money , how on earth can a public hospital be such a mess , considering that many of the patients there were covered by VHI or similar which was billed for those patients ?
Rodin wrote: » No discussion about health should start without addressing the health of the nation. People need to do their bit. And they're not. Obesity and lack or exercise are the biggest challenges facing the health service. If you're not doing your bit to not be a burden on the system, you've no right to criticise waiting times/lists.
the-island-man wrote: » I was born in the late 80's and growing up I remember having all the regional health boards in existence. Anyone else see the irony in the fact that Slaintecare seems to be veering back to that model with the "health areas"?! Anyone here of an older vintage know what the issue with the health boards was? Why did they create the HSE?
byhookorbycrook wrote: » Which begs the question, that if a private hospital run as a profit-making business can make money , how on earth can a public hospital be such a mess , considering that many of the patients there were covered by VHI or similar which was billed for those patients ?
Graces7 wrote: » Ah the " blame the patient" tactic. :rolleyes::eek: Anything but face the reality.
salonfire wrote: » What are you talking about? The services offered by the private hospitals like the Beacon or the Mater are excellent.
Hellrazer wrote: » The health service needs to be run as a business and that goes down to individual contracts of the consultants as in my opinion they are the ones causing the majority of the hold ups in the system. In what other business can you 1.Decide to show up for work whenever you feel like it. Clinic starts at 9.00 - consultant arrives at 9.00,f**ks off for a coffee,comes back at 10.00 and then starts to see patients. Same at 11.00 and then off for lunch for 2 hours.Disappearing halfway through a clinic for no reason. They are not being held accountable. In the last 3 months I have personally experienced this on 3 separate occasions. 2. Decide to work for your competitor ie a private hospital. Cancel your public clinic with no notice yet the patient can get an appointment the same day or the next by paying you 200 + euros. Again leaving the patients waiting. Again Ive experienced this in the last couple of months. This is an absolute disgrace. 3.Decide when you feel like working. Not bothering to show up when a clinic is supposed to be open without any reason whatsoever. So how would I suggest fixing it? Make sure they actually show up on time - introduce a clock in system so they are accountable. Do away with dual contracts. They either work for the public or private but not both. If they decide to stick with the public system then they work a 35 hour week. Starting at the start of their clinic time,taking a realistic lunch break and finishing when all the patients have been seen. In other words make them work like any other employee.
Wanderer78 wrote: » You can be damn sure, it won't be solved on boards, nobody knows what to do here
RobAMerc wrote: » I worked for the HSE for 3 years - what a total basket case, everyone bar non front line staff need to go and the whole organisation be rebooted I watched as senior managers literally spent the whole day txting friends and drinking tea. Other senior managers hired multiple "aides" in order to use up budget and then left the aides watching youtube all day coz there was nothing for them to do. I met an old acquaintance who was a senior manager in the Health Board, she told me she had never been removed when the HSE came in just replaced ! She was left in her post ( pretty much doing nothing ) What people may not understand is the HSE is simply a layer of management smeared over a bunch of fairly autonomous organisations based mainly around specialties. Each of those has in turn its own management structure, and internal organisational structures ( HR, IT etc ) and every one of those (without fail) have one purpose - keep themselves in a job by keeping the HSE out. The patient first ? My hole. The HSE has 0 control over them and only really has the ability to gain some control when they have some leverage over them - such as a crisis. Slainte Care is a pipe dream.( designed to line the pockets of the consultancies who helped define it ) The HSE will achieve nothing until the whole organisation is disbanded and a government with balls tackles the whole poisonous lot.
mikep wrote: » No plan will work until the two big beasts are controlled, HSE and Unions. Recently there was talk about how reforms were blocked, it seems that there was a pilot project introduced to bring in the position of "theatre assistants" which would work in tandem with nurses etc keeping things running in the operating theaters. Common in most modern health systems.. Blocked by the unions so dropped despite the fact that it would have made conditions better... Also there is a rumour that for each new nursing post thwere has to be a "manager" appointed, backed by the union.. Big problems there..
AndrewJRenko wrote: » How exactly were the theatre assistants being blocked?https://www.businesspost.ie/health/cork-university-hospital-hires-theatre-assistants-to-ease-staffing-shortages-68161f64 Is there any chance that we could base our discussions on something more than 'rumour'?
ted1 wrote: » So taking a break from the main GE thread I thought we’d start a separate health thread and see how we fix the system I’m Currently paying about 2,500 a year so 5,000 before tax for private health insurance for myself , wife and three kids. Don’t have day to day , so spend and additional 600 euro cash on doctors a year. So the question is, if there was a good health system would you be willing to pay an extra 2 thousand ( per family, say700 for an individual) in taxes for a proper system as opposed to our current system ? And if so would that fix the system ?
joseywhales wrote: » I am confused by this free visit situation, is that actually true? There a missionary hospital I'm hanging out in in India for the past while they charge people in poverty, and I mean eating scraps having a share of a goat poverty, and they charge them some nominal fee like 50c or e1, which is a big deal for them but the hospital does it so that they value the time and the medication. I would have thought this was a simple concept.
ChikiChiki wrote: » This is a myth. I hate this defeatist attitude that is constantly trotted out.
Pseudonym121 wrote: » Wanderer, It isn't correct to say that adequate mental health and psychological supports effectively don't exist. They are present and are better than many make out. You just don't hear about the 80 or 90% of people who are satisfied with care. You only hear about those who are dissatisfied and there may be many reasons for that dissatisfaction including not getting what they want --- which may not be what they need at all. I know many people who have had complaints made against them for not giving a patient a medicine they don't need because the patient went to Dr Google and now thinks they need it. With that said, there are of course some serious failures, particularly in Child and Adolescent Mental Health. I'm a Consultant in the HSE so I have a decent level of insight into this issue and while there are myriad issues there are also some things to bear in mind: a. We are seeing people today we simply wouldn't have given a new patient appointment to 15 years ago so access has expanded massively as resources have gone in to mental health services. b. People's expectation of the services they'll get has also increased massively. I have patients who are genuinely upset when I won't run a special clinic for them on a day and time that suits them as opposed to the two days a week that we run review clinics. c. The HSE reinforces failure instead of success. If you manage your team well and efficiently you don't get more resources to do more good, instead the team which has the same resources as you but isn't performing gets more resources. This is a major issue. d. Bureaucracy has gone mad. There are endless committees and groups which meet about the smallest of issues which have no clinical relevance whatsoever. I am aware of a pointless group which meets fortnightly which spent three hours one day debating whether they were a "group" or "committee" instead of actually deciding on things which helped patients. e. Clinicians aren't listened to. instead managers who look at budgets instead of what works for patients rule the roost. If clinicians were listened to I'm confident that common sense solutions to many issues would emerge which would be cost-neutral or even save money. I was recently in a situation where we were losing a building in which we conducted outreach and community care and we, as a team, decided to source another building for ourselves after the HSE had failed to find a suitable building over at least a year. Within a couple of months we had found a building suited to our needs at less than 20% of the rental cost. It still took many months of bureaucratic hoop-jumping before we were able to use it to benefit patients.... and, of course, that money wasn't then used to improve care in our area but went into a central pot to be squandered by management. How would you fix it? a. Stop reinforcing failure. b. Stop hiring multiple new admin staff for every new doctor or nurse being hired. c. Devolve budgeting power down the chain of command and have it so that any money saved by a team could be used by that team to invest in local care - this way you'd incentivise people to save money and improve services instead of penalising people who save funds. Staff at the local level know whether hiring an additional radiographer or an additional nurse would be best to stop the bottlenecks in their area. d. Stop the over-bureacratisation of the health service. A certain level is necessary, beyond that level it is simply wasteful and serves only to bolster the power of administrators who think the more admin staff they have under them the more important they are. e. Properly fund primary care so that more chronic illnesses can be managed without acute exacerbations which require hospitalisation - this would hugely reduce bed pressure, save money ( because good chronic care is MUCH cheaper than acute crises care ) and benefit the health of the citizens of Ireland. f. Pay restoration for doctors - there has been a massive brain drain which will continue until this is done. We are in an international market for skilled clinicians. We need to pay accordingly or we will continue to have the current situation where 500 of 2,000 consultant posts in Ireland lie empty or are filled with people who aren't properly trained. Every unfilled post adds to the waiting list while every post filed by an improperly trained person adds to avoidable mistakes in patient care and results in patients who are improperly treated and/or may die. Just monetarily the payouts for these mistakes cost more than paying the doctors properly and getting properly trained doctors who wouldn't make these mistakes. It is incredibly penny wise but pound foolish. g. Proper funding for step down care. The term bed blockers is terrible as these are real people with real issues who are in distress but the solution to their situation is proper funding for step down care. Step down care is expensive but FAR less expensive than being an in-patient. Again penny wise but pound foolish. h. Accelerate the implementation of specialist nursing posts and nurse prescribing - this would help tremendously in allowing nurses to manage many chronic conditions/minor exacerbations themselves without needing to involve doctors. One hour of a nurse's time is cheaper than one hour of a doctor's time so this would also save the health service money whilst improving care. It is a win win situation. i. Massive review of management layers and a redundancy programme ( on generous terms ) for those who aren't actually improving patient care. j. Move investigative equipment ( ECHO, CT, MRI, Ultrasound etc ) onto a 9 to 5 x 7 days per week system and reserve Saturday and Sunday for clearing the backlog of routine investigations which currently have horrendous waiting times. The bottom line is the clinical staff are ( with some exceptions as in any organisation ) excellent and empathic but many are also burned out due to the demands of the job. Couple these clinical staff with far fewer managers and a service which focuses on patient care instead of all the current folderol, add in all of the cost neutral and cost-saving changes I've outlined above which would actually improve patient care and you COULD fix the health service without spending a single extra penny. This idea that the health service is too complex to be solved is utter balderdash. Other countries in Europe have better health services with similar levels of investment. We could have a much better system IF there was a consensus that patient-focused solutions would be brought in and in which the paralysis brought about by endless layers of management was tackled. Do I expect that to happen? Hell no, it is Ireland after all.
AndrewJRenko wrote: » Do you know many people who go to a doctor's surgery for the craic?
