What would you do to sort out the HSE?

Jan Laco · 20-12-2015 10:58PM

[quote="mhge;98145959"

Manage staffing levels better to reduce costly overtime and agency staff dependency.
.[/quote]

There needs to be more staff during weekends as the weekends have similar workloads to working week, but with one third of the staff. Surgeons are bringing their private patients to public hospitals on weekends (taxpayers are paying nurses to do work of private profits).
But that would create more overtime pay...so maybe a 7 day working week needs to be introduced.

thee glitz · 20-12-2015 11:17PM

Jimoslimos wrote: »

I should have said population density.

Regardless my point stands.

My point is that most people don't live in Dublin. And many that do live outside the city.

It wouldn't cost more to build. It most definitely would cost more to run, and you're living in cloud cuckoo land if you think the infrastructure and services are adequate in the midlands to support it.

It wouldn't cost that much more to run and the benefits to society would make it worthwhile. There is a shortage of housing in Dublin, not so much in the midlands, even though accommodation is far less expensive. Why not take some of the pressure off the capital? It's a hospital, not the olympics.

I'm all for developing areas outside of Dublin

Except when it might mean inconvience for Dubs?

Anita Blow · 20-12-2015 11:18PM

Besides the obvious cutting of excess admin staff

1) Close many of the smaller regional hospitals and invest in larger centres. We have a higher complement of nurses than the OECD average but a lower nurse:bed ratio because so many of them are tied up in smaller centres full of elderly people awaiting discharge and not in larger centres where they're needed.

2) Increased investment in step-down facilities so the increasing elderly population can be discharged there when better but not ready for a return to home, rather than taking up acute beds while awaiting a spot in a nursing home or receiving some rehab.

3) Withdraw the free GP care for under-sixes. Access to healthcare should be based on need rather than ability to pay. Makes no sense that little Fiachra whose parents are well-off can take up limited GP resources for a cold meanwhile a 35 year old with CF on their 10th chest infection of the year must go without because they can't afford another GP visit.

Anita Blow · 20-12-2015 11:21PM

thee glitz wrote: »

My point is that most people don't live in Dublin. And many that do live outside the city.

It wouldn't cost that much more to run and the benefits to society would make it worthwhile. There is a shortage of housing in Dublin, not so much in the midlands, even though accommodation is far less expensive. Why not take some of the pressure off the capital? It's a hospital, not the olympics.

Except when it might mean inconvience for Dubs?

The hospital has to be co-located with maternity hospitals and with the large teaching hospitals. There's no point sticking it out in the midlands when the three national maternity hospitals are all in Dublin. A very sick neonate doesn't have the couple hours it would take to transfer from the Rotunda to somewhere in the middle of the country. Also needs to be attached to university hospitals to avail of the specialised services they offer and education of medical students of the three main medical schools.

thee glitz · 20-12-2015 11:53PM

Anita Blow wrote: »

The hospital has to be co-located with maternity hospitals and with the large teaching hospitals. There's no point sticking it out in the midlands when the three national maternity hospitals are all in Dublin. A very sick neonate doesn't have the couple hours it would take to transfer from the Rotunda to somewhere in the middle of the country. Also needs to be attached to university hospitals to avail of the specialised services they offer and education of medical students of the three main medical schools.

Some good points there. It could be colocated with a maternity hospital outside of Dublin city, maybe Blanchardstown. The simplest solution is keep everything in the city. With a bit of vision and planning, it needn't always be so. There are hospitals, universities, babies born and sick children outside of DCC.

Hammer89 · 21-12-2015 12:01AM

I don't concern myself with these matters, but if several elected officials have tried and failed, then the answer probably doesn't lie with someone on Boards.ie.

21-12-2015 12:14AM

You all seem to be talking in term of business like run hospitals, the problem with hospitals is A&E and all these designate hospitals where people has to travel miles is just simply not working not because its a bad system but because all the minor cases are sent there as well.

As always you're going to have someone sitting behind a desk and passing the calls onto someone else, there is a simple solution to the problem and that is listen to those on the floor who know how to do their job, in other words get rid of those fecking assholes to love problems because it give reason for their fat pay cheques.

Corpus Twisty · 21-12-2015 12:24AM

Are there no Taxi-drivers on AH? They generally have all the answers.

Cork Lass · 21-12-2015 12:44AM

Anyone who presents to A&E with a problem that could have been treated by a GPshould be charged at least double the standard fee. That would keep a lot of time wasters at home.

Jimoslimos · 21-12-2015 12:48AM

thee glitz wrote: »

It wouldn't cost that much more to run and the benefits to society would make it worthwhile. There is a shortage of housing in Dublin, not so much in the midlands, even though accommodation is far less expensive. Why not take some of the pressure off the capital? It's a hospital, not the olympics.

Except when it might mean inconvience for Dubs?

The most heavily populated areas in the country are on the east coast. Most of the major arterial routes originate from Dublin. Sticking a hospital in somewhere like Athlone doesn't necessarily mean less travel time.

Take a journey from the second largest city by car (using Google Maps)
Cork - Dublin: 2hr 40m
Cork - Athlone: 2hr 41m

Not even going to consider doing this journey by public transport.

I'm not arguing for a hospital to be built in the city centre. As another poster suggested, somewhere outside the M50/Blanch area would be best.

It has nothing to do with inconveniencing Dubs, it's about ensuring that the hospital serves the greatest possible population density and reducing the overall travel time.

oppenheimer1 · 21-12-2015 12:53AM

blackcard wrote: »

We have had a succession of Ministers for Health from Mary Harney to Brian Cowen to Michael Martin to Leo Varadkar. We have thrown billions at the Health Service. Any time I am in a hospital, I have found staff to be hard working and professional. But we still have patients on trolleys and long waiting lists. I would say that there is no ideological differences between the various parties as to the type of service we should provide. What would you do to sort out the Health Service?

The problem with the HSE isn't a money issue per-se. Its extremely well funded. The truth is that many of the staff are relatively overpaid relative to their peers in other countries. This hoovers up resources and leaves the system short staffed. the ongoing crises in the health services play into the hands of the unions who want more gravy for their members - just look at the recent proposed strike over what was meant to be about patient safety and the reasons why it was called off:

RTE wrote:

A deal between the Health Service Executives and the Irish Nurses and Midwives Organisation, which has averted planned strike action, involves cash bursaries to attract nurses, promotions, extra annual leave and a review to establish appropriate staffing in emergency departments.

Its all about the gravy....

trixychic · 21-12-2015 12:54AM

Jimoslimos wrote: »

Yes, remind me where the vast majority of children live in this country?

Could you also factor in the cost, not just of the hospital, but in providing adequate infrastructure (roads, railways, accommodation etc) so people can reach some sh1thole in the middle of nowhere to get medical attention or indeed work there?

While I don't agree with putting the new children's hospital in the Midlands ( for the exact reason of lack of infrastructure- i.e. roads railways etc) I don't agree with where they are putting it either. Smack in the middle of Dublin city???

IMO all roads in the country eventually lead into the M50, and the luas runs out of the city bearer to tallaght. I would have thought putting it somewhere off the M50 where it can be reached easy enough. And it will have lots of room for playgrounds and walks and gardens etc.

trixychic · 21-12-2015 12:58AM

Earthhorse wrote: »

I don't understand the HSE or the problems facing our health system and I don't think most people do either or the problem wouldn't be so bad.

I have to agree. I am not 100% sure what exactly the problems are. All I know is that there are stupidly long wait lists and the hospital beds are always full.

Another problem... why can't Irish nurses work here??? They all normally have to go abroad coming straight out of college.

BattleCorp · 21-12-2015 10:29AM

Jimoslimos wrote: »

I'm not arguing for a hospital to be built in the city centre. As another poster suggested, somewhere outside the M50/Blanch area would be best.

I think time will show us that the site for the new children's hospital will be a disaster.

It will be poxy to get to. There will be no parking if you do get there. There won't be room for expansion in the future.

It will be a disaster.

A greenfield site on the edge of Dublin city in an easily accessible area is what was needed.

Terrible decision to locate it at St. James'.

Paulzx · 21-12-2015 10:56AM

oppenheimer1 wrote: »

. The truth is that many of the staff are relatively overpaid relative to their peers in other countries. .

Then why can't we attract enough Doctors and nurses into the system? The salaries on offer seem incapable of bringing Irish doctors and nurses into the system that are working elsewhere.

I would have thought that if our medical staff were overpaid as you say we would have people from all over the world beating the doors down to get a job in the gravy train that is the HSE.

Corpus Twisty · 21-12-2015 11:09AM

I've visions of Leo reading this thread with batted breath...dipping in and out, going "ah ffs lads, will ye be specific.."

21-12-2015 11:55AM

All nursling home be required to train staff to give IV antibiotics, home care teams that can give IV antibiotics ( Vhi already have it ) Do everything possible to keep elderly people out of hospital that means more home care, step down fatalities that are not run by he state. Hospitals only for the acutely ill.

Roger_007 · 21-12-2015 12:23PM

The problems of the HSE are not unique to this country. Any country where the average age of population is increasing is going to run into healthcare problems no matter what they do. Most healthcare resources are absorbed by the elderly simply because most health problems increase with age.
There seems to be almost an expectation that everyone can live forever and that death is not an acceptable outcome no matter what.
Because the proportion of the population which is paying the bills is decreasing all the time and because healthcare costs are increasing all the time, there is an inevitability that the point will come where the whole system becomes unmanageable and unaffordable.
Things are not going to get better, they are going to get worse.

blackcard · 21-12-2015 12:32PM

mariaalice wrote: »

All nursling home be required to train staff to give IV antibiotics, home care teams that can give IV antibiotics ( Vhi already have it ) Do everything possible to keep elderly people out of hospital that means more home care, step down fatalities that are not run by he state. Hospitals only for the acutely ill.

I think this is part of the answer. People are living longer but a lot of elderly people are in poor health and need a lot of care and attention and this is using a lot of resources and taking up hospital beds. If more elderly people could be cared for in nursing homes, it would release some of the pressure

Paulzx · 21-12-2015 12:46PM

Roger_007 wrote: »

There seems to be almost an expectation that everyone can live forever and that death is not an acceptable outcome no matter what.

I think you are way off the mark here.

People accept death. What they don't accept is undignified death in circumstances where care and respect is lacking. Most people are well prepared for the death of an 85 year old parent but they are not prepared for it happening on a trolley in a corridor with their parent in pain and frightened.

Just because a patient is terminally ill doesn't make the expense of their treatment a wasted resource. Prolonging life and quality of life due to medical science is something humans have aspired to for hundreds of years.

The problems of the HSE are most certainly not down to societies unreasonable expectation that illness abd death can be treated in a humane fashion

c_man · 21-12-2015 12:48PM

I know it's populist but do ye think there's anything to be said for requiring politicians/public representatives to actually have to go through the public system for any illness or procedures? No private.

21-12-2015 12:57PM

c_man wrote: »

I know it's populist but do ye think there's anything to be said for requiring politicians/public representatives to actually have to go through the public system for any illness or procedures? No private.

It would not work free choice and all that, but it is at the heart of my ethics, I am all for private hospitals and fee paying school if that is what people want, however only if those availing of private health care and fee paying schools pay their fair share of tax and are supportive of the social contract with society, do not advocate less state spending for 'them over there' while they avoid the consonances of less state spending.

snickerpuss · 21-12-2015 12:59PM

Cork Lass wrote: »

Anyone who presents to A&E with a problem that could have been treated by a GPshould be charged at least double the standard fee. That would keep a lot of time wasters at home.

Even though it's extremely difficult to access a GP after 5pm and all weekend? That's what leads people to go to A&E.

I think there needs to be smaller medical centres or GPs who can take X-rays, set bones, do stitches etc. Essentially what the VHI centres do but not privately. Recently my doctor couldn't make an appointment for my dad to get an ECG, he was told the only way to get one was to go to A&E. That seems crazy. (For a checkup not a heart attack obviously)

Graces7 · 21-12-2015 03:04PM

Keith186 wrote: »

They could have a mandatory visit to the GP once a year (or two years at lower ages) where they nag you about eating healthier and doing more exercise kind of lecture tailored to the individual. If you don't go to that, you don't qualify for free treatment in hospital. Could improve general health by being more preventative.

I am insulted! You assume we all neglect our health! By all means monitor those who need it!

Graces7 · 21-12-2015 03:07PM

Cork Lass wrote: »

Anyone who presents to A&E with a problem that could have been treated by a GPshould be charged at least double the standard fee. That would keep a lot of time wasters at home.

Fine if the GPs pulled their weight and were available, especially in rural areas.

Graces7 · 21-12-2015 03:15PM

snickerpuss wrote: »

Even though it's extremely difficult to access a GP after 5pm and all weekend? That's what leads people to go to A&E.

I think there needs to be smaller medical centres or GPs who can take X-rays, set bones, do stitches etc. Essentially what the VHI centres do but not privately. Recently my doctor couldn't make an appointment for my dad to get an ECG, he was told the only way to get one was to go to A&E. That seems crazy. (For a checkup not a heart attack obviously)

Agree totally and utterly. The GPs are not pulling their weight here. They pass far too much on to A and E too easily. Also they need a drunk tank facility to top A and E getting logjammed.

Graces7 · 21-12-2015 03:17PM

mariaalice wrote: »

All nursling home be required to train staff to give IV antibiotics, home care teams that can give IV antibiotics ( Vhi already have it ) Do everything possible to keep elderly people out of hospital that means more home care, step down fatalities that are not run by he state. Hospitals only for the acutely ill.

Do we have Nurse Practitioners here? They are very very successful in the UK and elsewhere. And can do all the above

Graces7 · 21-12-2015 03:21PM

blackcard wrote: »

I think this is part of the answer. People are living longer but a lot of elderly people are in poor health and need a lot of care and attention and this is using a lot of resources and taking up hospital beds. If more elderly people could be cared for in nursing homes, it would release some of the pressure

Why not at home as we used to do? google "granny dumping.." I was in an acute surgical ward a while ago for emergency surgery and two of the six beds were over old folk with no surgical needs. Yet needing so much attention. Home care with the Public health nurses.

BMJD · 21-12-2015 03:35PM

we also need to face up to the fact that for the most part, our dietary and drinking habits are a major part of the problem

but that won't be done anytime soon because of vested interests and too many complete and utter morons

ytpe2r5bxkn0c1 · 21-12-2015 03:45PM

Graces7 wrote: »

Do we have Nurse Practitioners here? They are very very successful in the UK and elsewhere. And can do all the above

Yes indeed we do. A great service in the GP practices in many places.

What would you do to sort out the HSE?

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