The health service - most damning report yet

Unfortunately you could be correct in that we are incapable of fixing it.

The HSE has been bedivilled by poor work practices protected by intransigent unions and stupid pay deals such as the one that created nursing management grades and promoted nurses who were actually good at nursing into a management job they weren't good at, therefore making both the nursing and management grades worse.

There are also societal issues. 75% of the people who turned up at A&E didn't need to be admitted and could have been treated in the community. Why are people turning up like that? It is madness. That isn't on the HSE, that isn't on the nurses, that isn't on local management or A&E Departments, it is on the people who turned up and the GPs who sent them.

We spend huge amounts of taxpayer money per capita on the health service. It isn't a case of money, it isn't a case of politicians being able to fix it either, no legislation or Ministerial direction will change the poor quality of nurse management and poor practices on the ground by frontline staff, neither will it stop idiots turning up at A&E on a Friday night, just needing to sleep off drink and drugs.

With a problem that big, no Ministerial direction or legislation can solve it.

A lot of it comes from organisational behaviour, a culture of poor performance that permeates the health service right down to the frontline.

How hard do they need to damn before something gets done about it?

Two excellent examples of the problems I am talking about. If someone is able to collect their kids from school, they don't need to be in A&E.

I don't ever recall him saying anything of Substance, ever 😏

That's primarily because of the Lack of Gp"s rather than the system being broken but I do agree the system is broken.

It amazes me that after decades and multiple billions given to the Health Service, the same annual excuses given.

It's not lack of funding thats the problem it's how that funding is being managed or more likely miss managed.

The Pandemic shown a bright light on the Senior Management Team at the HSE and some of the stuff they spun was simply beggar's belief.

Does that expenditure include private health insurance?

What do they mean that they didn't need to be there? Did they not need to be there because what ever ailment they had could have been handled outside A&E but they people were in A&E because those services were not available at the time like after 6 in the evening or the weekends?

Would anyone who is not really seriously sick or injured go to A&E and sit there for god knows how long to seen? Speaking for myself I would need to be seriously ill/injured to even contemplate going to A&E, I could think of nothing worse than being stuck on a chair waiting hours to be seen when not being seriously ill/injured. In my case I will go to somewhere like Roc Doc and in saying that the last time I went to Roc Doc they told me that I needed to go to A&E right away as I needed to be on a drip so even if you do try to avoid A&E the facilities are not there to do that.

So for those 75% of people who are turning up to A&E, I assume they are not going there for the fun of sitting in a chair for hours on end but believe that there is something wrong and need to see someone as soon as possible.

Read the report, it sets it all out.

If you don't believe it, read many of the posts on this thread who give other examples.

It's a good deal for TCD.

To be honest, when it gets down to those types of problems at those types of levels, that isn't on the central HSE, that is the responsibiltiy of local supervisory management and middle management in the hospital who arrange such things. That is where a large part of the problem is. Hospitals are managed for the convenience of staff, and are not patient-centred.

Anecdotal I know, but I'm a doctor who has previously worked in the ED. I can attest to the fact that at least half of cases I saw did not need to attend the department and would've been better managed in the community. In some cases it was due to difficulty accessing the GP but in other cases it wasn't clear why they didn't attend the GP first.

I've had parents bring their children in with a cough at 2AM for the sole reason that they knew the ED would be quieter then. I've had other parents lie about their children's symptoms to get investigations done and upon completion tell me "That's good I just wanted an MOT for her" and clear off and tell me to phone them with the results. In most non-urgent cases it's that they felt the ED would give them a quicker answer to minor complaints like non-serious back pain than going through their GP for referral.

Reducing ED wait times would be best achieved by increasing GP numbers, allowing greater access to diagnostics in primary care and maybe something like the 111 number in the UK that the public could use to get phone advice about where is best to attend for their medical complaint.

I honestly wonder about that aspect of the report. I'm aware there is a cohort who do clog up A&E departments needlessly and it was telling how quite A&E departments were during most of the Pandemic.

I can't see people willingly go to A&E unless they absolutely had too. Does The report in relation to this matter ask why the 74% went to A & E, did they wonder was it due to lack of GP accesss, the fact that there's little option between the hours of 5pm and 9am 5 days a week and entire weekends and of course bank Holidays were GP's are not available. Out of hours GP care might be efficient in some parts of the country but certainly not all and from what I've heard it's very hit and miss.

The 74% not needing to be in A&E is figure seems a little far fetched in my humble opinion.

I'm with you on this, I find it hard to believe 74% of people attending A&E didn't need to be there, infact it's far fetched and I believe another attempt to spin the narrative by the HSE.

It's a simple fact that there IS no GP cover for an astonishing amount of hours in a given week. Infact GP's are only available, by my reckoning for a 3rd of the hours in any given week.

Out of hours GP services seem very hit and miss and Ironically if you live rural, it's probably quicker to go to an A&E.

I'm not being critical of Gp"s, my own excellent but when you've essentially no GP cover for 2/3 of any given week, what are people to do if there's an urgency or concern 🤔