FG to just do nothing for the next 5 years.

Mortelaro wrote: »

It depends
If we had the feared surge it would have been very good value and a Godsend
It would not have been prudent to be without them
Secondly see the cost of those beds to the insurance companies
The HSE is getting them for A LOT less

Its effectively partly an insurance policy for the State that we now have them as an overcapacity

I get the block booking for a few months. I think any government would have seen that as a wise move. 6 weeks ago we had absolutely no idea how many people would require hospital treatment.

THe government is paying more for those bed than the hospital would charge the insurance companies. In normal practice not all beds would be used in the private hospitals, It appear that the hospitals have totalled up the number of beds they have and charged full rate for every bed. While I have no objection to the hospital charging their normal rate, they are a business after all, it seems they have been a bit on the cute side and charged for a capacity they would not normally experience.

Deleted User wrote: »

Critism.of this makes no sense,its what we should be aiming to do long term with healthcare here

Develop.capacity to handle any shocks,and not usual thing of rushing from one crisis to.another fire-fighting while waiting lists spiral out of control

Alot to be said,if we get on top.of this virus,to burn through waiting lists for simplier procedures and ease massively pressure on healthcare

The nurses asked for a small pay raise last year and the place went nuts....search this forum for people going nuts over it, they didnt deserve it, they earn too much etc etc

Now you want to hire the whole privates hospitals? who exactly is paying for it?

You? on the other thread you complained about the current tax you are paying. Or is this another "oh well xyz can pay for that"

Shefwedfan wrote: »

The nurses asked for a small pay raise last year and the place went nuts....search this forum for people going nuts over it, they didnt deserve it, they earn too much etc etc

Now you want to hire the whole privates hospitals? who exactly is paying for it?

You? on the other thread you complained about the current tax you are paying. Or is this another "oh well xyz can pay for that"

The contracts are signed,why not use the extra capcity,while we have it??

Like unless you prefer paying for empthy beds,deosnt seem.much sense in that to me anyway mate (but if you deem.that ok,your entitled to your view too)

Deleted User wrote: »

The contracts are signed,why not use the extra capcity,while we have it??

Like unless you prefer paying for empthy beds,deosnt seem.much sense in that to me anyway mate (but if you deem.that ok,your entitled to your view too)

This is already happening as I posted and other people. The hospitals are already been used.

You mentioned long term, not what they are doing now. I am just asking who long term will be able to pay for this additional healthcare?

efanton wrote: »

I get the block booking for a few months. I think any government would have seen that as a wise move. 6 weeks ago we had absolutely no idea how many people would require hospital treatment.

THe government is paying more for those bed than the hospital would charge the insurance companies. In normal practice not all beds would be used in the private hospitals, It appear that the hospitals have totalled up the number of beds they have and charged full rate for every bed. While I have no objection to the hospital charging their normal rate, they are a business after all, it seems they have been a bit on the cute side and charged for a capacity they would not normally experience.

The bed charge I mentioned to VHI etc is bed only
Everything else is on top eg procedures doctors medicines etc

You'd be surprised how full private hospitals get
My mother couldn't get a bed at one stage

Medicine is an expensive business
Public or private

Shefwedfan wrote: »

This is already happening as I posted and other people. The hospitals are already been used.

Quite why your argueing (poorly) about then is beyond me

You mentioned long term, not what they are doing now. I am just asking who long term will be able to pay for this additional healthcare?

The state??
Like long term,we are going to hit present capacity and exceed it,as our population rises,this is fairly basic demographic and medium term planning stuff

Mortelaro wrote: »

The bed charge I mentioned to VHI etc is bed only
Everything else is on top eg procedures doctors medicines etc

You'd be surprised how full private hospitals get
My mother couldn't get a bed at one stage

Medicine is an expensive business
Public or private

I fully understand how expensive helathcarecan be.

What I do not understand is why the government or the hospitals refuse to release the details of the contract. AS I stated earlier from what I gather that €345 million is the MINIMUM they will be charged. I assume there will be additional charges for treatment and medicines on top of that as you have already suggested.

FG seem to constantly do this. Everything is a big secret, the public cant be fully informed 'because they would not understand'. This inevitably backfires on them.
Why not be totally open? Very few would argue that it was stupid to ensure we had additional capacity at the ready. All they do is raise suspicions and open themselves up for serous criticism at a later date.

What I do not understand is why they did not have a contract on a pay as you use basis.

Deleted User wrote: »

The state??
Like long term,we are going to hit present capacity and exceed it,as our population rises,this is fairly basic demographic and medium term planning stuff

The state pays via tax. As I posted people cried last year for a small pay wage to nurses. Even yourself on the other thread posted about the MNC paying more so you could pay less

So who is going to pay? how is asking a question arguing now?

Shefwedfan wrote: »

The state pays via tax. As I posted people cried last year for a small pay wage to nurses. Even yourself on the other thread posted about the MNC paying more so you could pay less

Rain is wet,i can post obvious facts too??

So who is going to pay? how is asking a question arguing now?

The state is going to pay??

Its not...Just aswell i never said asking a question was argueing,then isnt it :pac:

smurgen

Mortelaro wrote: »

It depends
If we had the feared surge it would have been very good value and a Godsend
It would not have been prudent to be without them
Secondly see the cost of those beds to the insurance companies
The HSE is getting them for A LOT less

Its effectively partly an insurance policy for the State that we now have them as an overcapacity

1 the cost quoted to the HSE does not factor staffing costs.
2 what would had happened if the private hospitals stayed private? How much would they have spent to get their hospitals PPE or would they have refused private patients suffering from Covid?
3 would private patients have been refused procedures if private hospitals stayed private
4 if item 3 happened would policy holders have been refunded policy payments?
5 why were elderly patients suffering from Covid kept in nursing homes and not isolated in private hospitals?

These are things I'm wondering.

efanton wrote: »

What I do not understand is why they did not have a contract on a pay as you use basis.

Pay as you go for any product or service is usually more expensive because the provider lacks certainty
I am glad the State didn't negotiate that kind of deal tbh

As regards details of the contract, it may be commercially sensitive
Undoing that part of the contract might have took months
I know what I'd do in that case when the need to prepare for the unknown is pressing

smurgen

Mortelaro wrote: »

Pay as you go for any product or service is usually more expensive because the provider lacks certainty
I am glad the State didn't negotiate that kind of deal tbh

As regards details of the contract, it may be commercially sensitive
Undoing that part of the contract might have took months
I know what I'd do in that case when the need to prepare for the unknown is pressing

Why are you glad if you don't have figures to compare?

smurgen wrote: »

1 the cost quoted to the HSE does not factor staffing costs.

where did you get the breakdown of what's included and excluded?

2 what would had happened if the private hospitals stayed private? How much would they have spent to get their hospitals PPE or would they have refused private patients suffering from Covid?

Private hospitals do have disease outbreaks including sepsis and mrsa
Looking at what was happening in New York, yes I'd say private hospitals would have had trouble accessing ppe

3 would private patients have been refused procedures if private hospitals stayed private
4 if item 3 happened would policy holders have been refunded policy payments?

I'd say no and to 4,in my experience No

5 why were elderly patients suffering from Covid kept in nursing homes and not isolated in private hospitals?

well the question is why were they not hospitalized when they were that gravely ill, that's a question for the homes and the Hse
I can only speak from my own experience but generally speaking very old people aren't always hospitalized from nursing homes,they are often quite hospice like in that respect in normal circumstances
That's my experience anyhow
Others may differ

[Deleted User] wrote: »

Ok

Rain is wet,i can post obvious facts too??

The state is going to pay??

Its not...Just aswell i never said asking a question was argueing,then isnt it :pac:

Another excellent response.....with your deep insight into health, tax, multi nationals and farming I wouldn’t have expected anything less

smurgen wrote: »

Why are you glad if you don't have figures to compare?

Because every experience of pay as you go versus contracted that I've ever came across in anything is more expensive
Stands to reason for me then

Shefwedfan wrote: »

Another excellent response.....with your deep insight into health, tax, multi nationals and farming I wouldn’t have expected anything less

Like i have responded to pints you have raised?

Im.kind of at a loss as to what you feel.the above adds to the discussion,

Perhaps you could outline your taught process,which lead to above appearing constructive to you??

Off topic but I never realised you couldn’t put people on ignore list via phone, learn something new

Back on topic, are nursing home not an extension of a hospital, so they have nurses/doctors etc in majority? Maybe I’m wrong. But if an old person is sick and getting looked after correctly would moving them not hurt them more?

The problem in the nursing home is the rate of spread if I’m correct? Based on information from Italy if older people get the chances of recovery are very low

Shefwedfan wrote: »

Off topic but I never realised you couldn’t put people on ignore list via phone, learn something new

Back on topic, are nursing home not an extension of a hospital, so they have nurses/doctors etc in majority? Maybe I’m wrong. But if an old person is sick and getting looked after correctly would moving them not hurt them more?

The problem in the nursing home is the rate of spread if I’m correct? Based on information from Italy if older people get the chances of recovery are very low

Just click on the full site button on the bottom
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Mortelaro wrote: »

well the question is why were they not hospitalized when they were that gravely ill, that's a question for the homes and the Hse
I can only speak from my own experience but generally speaking very old people aren't always hospitalized from nursing homes,they are often quite hospice like in that respect in normal circumstances
That's my experience anyhow
Others may differ

I get the reasoning for block booking private hospitals. Many dont unfortunately.
6 weeks ago the government, and indeed anyone else, had no idea of how many people would need to be admitted to hospital. Making sure there was additional hospital capacity was a sensible precaution. Like any wise precaution they are precautions because often they are not needed.

You could argue back and forth as to whether it would have been better to pay as you use, or pay en-mass as the government have chosen to do. To be honest at this point in time without full details of the costs and the contract clauses that's a pointless argument.

I also understand the reluctance of doctors to tie up ICU beds with patients that are unlikely to benefit from that sort of care. ICU can be hard on the body, especially someone who is old and very frail, and there is the risk that that sort of treatment would have no effect or actually be more harmful even if there was spare capacity in the ICU wards.

What I simply do not understand is with all these additional beds residents of the nursing homes are not segregated so that those with the virus or virus like symptom are in a totally different location to those who have tested negative and do not show symptoms. The crazy situation we have at the moment is we have medical and nursing home staff working with both groups going back and forth between them. The risk of transfer must be significant especially with staff that do not have sufficient PPE, or who are not trained to deal with contagious disease.

Surely the smart thing to do is to test all residents in the nursing homes and those that are showing positive move them to the private or public hospitals so that those remaining are at a significantly lower risk of getting the virus.
THe empty beds are there, the properly trained staff are there and the state has already paid for the use of those beds. Not knocking the staff in the nursing homes but many are not trained nurses and have little or no experience with dealing with serious diseases. The treatment they receive might not be any different but the fact that you have segregated them means that those resident who have not yet got the virus are a lot safer.

At the moment over half the reported deaths are elderly people, surely we owe them a duty of care and should be doing everything possible to prevent more infections.

I'm not qualified to discuss what might or might not be a reasonable best practice clinical addressing of very sick old people in nursing homes
The decision would be clinical
My hunch is they don't like moving frail old people and prefer treatment in situ isolated

Mortelaro wrote: »

I'm not qualified to discuss what might or might not be a reasonable best practice clinical addressing of very sick old people in nursing homes
The decision would be clinical
My hunch is they don't like moving frail old people and prefer treatment in situ isolated

Neither am I.

But I was looking at it from the perspective of not just the care of the sick, but the care of those that are not sick. Surely both are equally important.

Surely there must be some sort of sensible solution for properly segregating residents in nursing homes who do become sick with the virus.
Segregating the residents is not really the problem, in order for it to be effective you would need one group of staff treating those with the virus or symptoms of the virus, and another group of staff dealing with the resident that do not have the virus or symptoms. Obviously Nursing homes are short staffed already.