What is wrong with the health service, HSE

Good loser · 18-01-2019 10:08pm

Matt Barrett wrote: »

What's your point? Nurses and doctors get paid for working? How dare they.

If they say they need more money thankfully they still have the freedom to seek it and strike if needed, thanks to socialist values held dear by society, the bowsies.

Socialist values cost society dearly alright.

Too often get their ends through blackmail,threat and intimidation.

Watch the next few months' headlines. Although for once (so far) RTE don't seem to be cheering them on.

VonZan · 18-01-2019 11:18pm

Matt Barrett wrote: »

What's your point? Nurses and doctors get paid for working? How dare they.

If they say they need more money thankfully they still have the freedom to seek it and strike if needed, thanks to socialist values held dear by society, the bowsies.

Striking only exists as an option for a tiny fraction of society. The majority of strikes are called by public sector workers in vital services who use it as a method to hold the taxpayer to ransom due to the pressure on the government by loss of service. Thankfully isn't the word I'd use.

AndrewJRenko · 18-01-2019 11:26pm

Podge_irl wrote: »

Right, but just to focus on this one point, if the result is both profit being made for the company and better service for the "client" then is that not basically a win-win? Is there any proof that relying on private providers over public providers results in worse service?

You seem to think serving the public and making a profit are mutually exclusive and I don't agree with that line of thinking.

Many health services are fundamentally unprofitable. Mental health services, addiction services, treating chronic illnesses etc. You can make great money with a nice simple, predictable orthopaedic or cardiac procedure, so private medical providers cherrypick the services they provide.

Tell me how · 18-01-2019 11:34pm

Good loser wrote: »

No great difference in my opinion.
Many in the pharma business switch between the 2 modes of working - payroll or contracting. Same difference.

The concept of Profit versus pay and contract versus payroll are not related.

kippy · 19-01-2019 6:58pm

Good loser wrote: »

What's obvious to me is that they do profit from it.

They would have no income if there were no sick or ill people.

What's more the nurses want more profit (out of their labour) than they're already getting.

How are you defining "profit"?

road_high · 19-01-2019 8:45pm

There’s a whole load of clinics, hospitals, management all doing the same thing- goes back to when we had Health Boards and services were almost duplicated on a county basis (I think even the county councils ran them)- so there’s still not enough efficiency of scale and centralization of things like HR and the like. Must add msssivle to the costs

AndrewJRenko · 20-01-2019 1:21am

road_high wrote: »

There’s a whole load of clinics, hospitals, management all doing the same thing- goes back to when we had Health Boards and services were almost duplicated on a county basis (I think even the county councils ran them)- so there’s still not enough efficiency of scale and centralization of things like HR and the like. Must add msssivle to the costs

And yet, when the HSE do try to rationalise services, we have every sh1t stirring TD and local councillors manning the barricades to protest against 'losing our' whatever.

Good loser · 20-01-2019 2:03am

kippy wrote: »

How are you defining "profit"?

Remuneration.

kippy · 20-01-2019 2:12am

Good loser wrote: »

Remuneration.

Ah, well if you are using the wrong definition, no one can help you.

They are indeed getting remunerated for doing a job.

James Brown · 21-01-2019 12:19am

Good loser wrote: »

No great difference in my opinion.
Many in the pharma business switch between the 2 modes of working - payroll or contracting. Same difference.

You're confusing choices private individuals make with choices the people's government might make with the people's money.

Good loser wrote: »

Socialist values cost society dearly alright.

Too often get their ends through blackmail,threat and intimidation.

Watch the next few months' headlines. Although for once (so far) RTE don't seem to be cheering them on.

Society is built upon socialist values. We all pay tax to government to manage our state.
Despite the best efforts in some areas the government should be working for you and I despite any scaremongering and spin from selfish concerns, inappropriate behaviour or looking after our own.

Podge_irl · 21-01-2019 9:41am

AndrewJRenko wrote: »

Many health services are fundamentally unprofitable. Mental health services, addiction services, treating chronic illnesses etc. You can make great money with a nice simple, predictable orthopaedic or cardiac procedure, so private medical providers cherrypick the services they provide.

Sure, that's a fair point. My preference is a good, all-encompassing public health care system. I just think that talking about for-profits "making money off the misery of the sick" is overly emotive language. There are many, many good services provided in all manner of fields where people end up making money off it.

Although no system is perfect, it does work quite well here in Switzerland. There is no public heath system per se, but it is mandatory for every working person to have health insurance. The unemployed and other groups are covered by the state. You can indeed pay more to get "better" treatment, though a lot of it is focused more around perks then core treatment - e.g. better insurance can get you a private rather than public room. I don't personally have an issue with that kind of stratification.

Sam Russell wrote: »

Is that the kind of private health care you want?

What could be done is the pay the state funded acute hospitals on a per procedure basis so it funds what they do.

The current system for hospitals funds them whatever they do (or do not do). This system encourages waiting list because a patient on a waiting list costs nothing, while treating them does. Perhaps if they were paid less the longer the waiting list, it might incentive them to reduce those waiting lists.

I don't particularly want private health care.

The NHS does something akin to this with under-performing hospital trusts. I'm not entirely sure its seen as overly effective.

Matt Barrett wrote: »

The big problem is why would a specialist want shorter waiting lists when he or she can offer up their private practice for those who are willing to pay for quicker service?

I thought they were cutting down on this?

Geuze · 21-01-2019 11:31am

Podge,

a few questions about the Swiss system:

Can people switch insurers?
How many insurers are there?
Are the insurers for-profit?

Who provides the hospitals? State, for-profit or not-for-profit churches, etc.?

Are GPs self-employed like here?
Does insurance cover the GP fees?

James Brown · 21-01-2019 2:39pm

Podge_irl wrote: »

Sure, that's a fair point. My preference is a good, all-encompassing public health care system. I just think that talking about for-profits "making money off the misery of the sick" is overly emotive language. There are many, many good services provided in all manner of fields where people end up making money off it.......

It's factual language. The key word here is profit. The patient should come before profit. Cost effectiveness and value for the tax payer should never be confused with profit for private concerns or the state for that matter.
If you are talking private enterprise you are talking a two tier system.

Podge_irl wrote: »

...

I thought they were cutting down on this?

Hopefully. It's a big problem. If they are great. Well done unions and nurses.

FreudianSlippers · 21-01-2019 2:51pm

It's fantasy politics to continue to post about how you believe the world should work as opposed to how the world actually works. How long do we need to be subjected to these posts which are based in no way in reality?

blanch152 · 21-01-2019 4:01pm

Matt Barrett wrote: »

. We don't need 'for profit' to be efficient.

So we get the Children's hospital cost overruns in an inefficient public sector as a result.

FreudianSlippers · 21-01-2019 4:07pm

blanch152 wrote: »

So we get the Children's hospital cost overruns in an inefficient public sector as a result.

If the Children's Hospital was a private company it'd be done and on budget.

Podge_irl · 21-01-2019 4:54pm

Matt Barrett wrote: »

It's factual language. The key word here is profit. The patient should come before profit. Cost effectiveness and value for the tax payer should never be confused with profit for private concerns or the state for that matter.
If you are talking private enterprise you are talking a two tier system.

It is about as factual as saying that Tesco make money off the misery of the hungry.

James Brown · 21-01-2019 5:00pm

Podge_irl wrote: »

It is about as factual as saying that Tesco make money off the misery of the hungry.

Can you elaborate? I don't see how private health would not be making money off of sick people. Your Tesco analogy would work if people only had Tesco to go to and Tesco were charging as much as they could get away with. Public is supposed to serve the public not shareholders. Tesco is not beholden to the tax payer.
We already have public and private options in health so can you clarify?

Podge_irl · 21-01-2019 5:04pm

Geuze wrote: »

Podge,

a few questions about the Swiss system:

Can people switch insurers?
How many insurers are there?
Are the insurers for-profit?

Who provides the hospitals? State, for-profit or not-for-profit churches, etc.?

Are GPs self-employed like here?
Does insurance cover the GP fees?

Yes, easily
Not sure, but well over 10.
Yes, they are just private insurance providers. There "basic" offering is mandated to cover a certain amount and they make no money on that, but they can offer other plans over and above the minimum. They also can not refuse to insure anyone at the basic level.

There are university hospitals and private hospitals and you can basically just pick where you go.

Dunno about GPs employment to be honest. A lot of them seem to be in medical centres. Insurance will cover it but nothing is completely free. You always have to pay a certain amount, at least up until you hit a cap.

Podge_irl · 21-01-2019 5:14pm

Matt Barrett wrote: »

Can you elaborate? I don't see how private health would not be making money off of sick people. Your Tesco analogy would work if people only had Tesco to go to and Tesco were charging as much as they could get away with. Public is supposed to serve the public not shareholders. Tesco is not beholden to the tax payer.
We already have public and private options in health so can you clarify?

I agree, they would be making money off sick people. The same way shops make money off hungry people or do the likes of food banks no longer exist? Tesco are charging as much as they can get away with. It would be weird if they weren't.

This started from the suggestion that public services could learn from being run more like a private business. You claimed that the problem with private businesses is that all they care about is profits and would thus just be making money off people's suffering. The aspect you are not getting, is that most private businesses have to make profit while also competing for customers - this can often result in a driving upwards of standards with focuses on efficiencies. The idea that there is nothing to be gained by looking at some private health practices and emulating successful aspects of it, and indeed completely dismissing them, is incredibly blinkered.

listermint · 21-01-2019 5:23pm

FreudianSlippers wrote: »

If the Children's Hospital was a private company it'd be done and on budget.

If the childrens hospital was a private company it wouldnt have been built in James Street from a cost analysis perspective and access to your customers.

FreudianSlippers · 21-01-2019 5:25pm

listermint wrote: »

If the childrens hospital was a private company it wouldnt have been built in James Street from a cost analysis perspective and access to your customers.

The Mater was a much better site.

James Brown · 21-01-2019 5:30pm

Podge_irl wrote: »

I agree, they would be making money off sick people. The same way shops make money off hungry people or do the likes of food banks no longer exist? Tesco are charging as much as they can get away with. It would be weird if they weren't.

Yes we have options, however if we didn't, what they could get away with would likely differ greatly to current marketplace competitiveness.

Podge_irl wrote: »

This started from the suggestion that public services could learn from being run more like a private business. You claimed that the problem with private businesses is that all they care about is profits and would thus just be making money off people's suffering. The aspect you are not getting, is that most private businesses have to make profit while also competing for customers - this can often result in a driving upwards of standards with focuses on efficiencies. The idea that there is nothing to be gained by looking at some private health practices and emulating successful aspects of it, and indeed completely dismissing them, is incredibly blinkered.

You spell it out yourself bolded above. It's two different aspects on the same topic. Both can equally be true.
The idea of private business competing and therefore creating the best options for the customer often doesn't work. From car insurance to a loaf of bread we've private enterprises collaborating to fix pricing. While private business has it's lessons to teach we can take them on board without having to follow the private route. It's a matter of treating the tax payer as they are shareholders, but without the drive for profit, replacing it with value for tax monies. We can't take the risk with health that the market will provide a fix. Look at housing.

listermint · 21-01-2019 5:31pm

FreudianSlippers wrote: »

The Mater was a much better site.

Subjectively to james's yes. but to other sites no it was not.

James Brown · 21-01-2019 5:34pm

listermint wrote: »

If the childrens hospital was a private company it wouldnt have been built in James Street from a cost analysis perspective and access to your customers.

The part the state played was bad management of private contracting.
Or I wonder which pool of civil servants are they drawing the brickies from?

FreudianSlippers · 21-01-2019 5:34pm

listermint wrote: »

Subjectively to james's yes. but to other sites no it was not.

Connolly and greenfield sites lack the fundamental requirements for such a hospital: adult surgical suites, paediatric health services and training/education link with a university med school. I also suggest that country people who were praising the M50 have not been on the M50 - it's a traffic nightmare.

listermint · 21-01-2019 5:38pm

FreudianSlippers wrote: »

Connolly and greenfield sites lack the fundamental requirements for such a hospital: adult surgical suites, paediatric health services and training/education link with a university med school. I also suggest that country people who were praising the M50 have not been on the M50 - it's a traffic nightmare.

Tallaght hospital had all of them, and huge amount of land beside it which we not have planning permission for 450+ apartments.

And ive lived the majority of my life on the M50. Putting a hospital in the city centre was a fools errand for all. The majority of your 'customers' are not and will not be from within the M50. These are inescapable facts.

FreudianSlippers · 21-01-2019 5:42pm

Kind of forgot about Tallaght. Do we know why it was rejected (or was it never considered) - Connolly was rightly rejected, it's an awful choice and a terrible hospital.

listermint · 21-01-2019 5:44pm

FreudianSlippers wrote: »

Kind of forgot about Tallaght. Do we know why it was rejected (or was it never considered) - Connolly was rightly rejected, it's an awful choice and a terrible hospital.

no idea, we may never know. Mad decision all the same. would have cost less than half the figure we have now. and has all the transport links one could want.

AndrewJRenko · 21-01-2019 5:44pm

FreudianSlippers wrote: »

listermint wrote: »

If the childrens hospital was a private company it wouldnt have been built in James Street from a cost analysis perspective and access to your customers.

The Mater was a much better site.

The esteemed national and international experts on the Dolphin committee disagree with you. Do you know something that they don't?

listermint · 21-01-2019 5:46pm

AndrewJRenko wrote: »

The esteemed national and international experts on the Dolphin committee disagree with you. Do you know something that they don't?

Yeah probably. Its hard to get consultants to work outside the M50 ring. Too far from their city centre haunts.

AndrewJRenko · 21-01-2019 5:52pm

listermint wrote: »

AndrewJRenko wrote: »

The esteemed national and international experts on the Dolphin committee disagree with you. Do you know something that they don't?

Yeah probably. Its hard to get consultants to work outside the M50 ring. Too far from their city centre haunts.

So four of the committee members ARE consultants who've spent their entire careers hanging round with other consultants, but you know more about what consultants think than they do? Really?

FreudianSlippers · 21-01-2019 6:06pm

AndrewJRenko wrote: »

The esteemed national and international experts on the Dolphin committee disagree with you. Do you know something that they don't?

IIRC the committee considered the reworked Mater site and not the original proposal so, yes, I know about the original proposal which (if my memory serves - I can't look it up now) they did not consider.

Podge_irl · 21-01-2019 6:14pm

AndrewJRenko wrote: »

The esteemed national and international experts on the Dolphin committee disagree with you. Do you know something that they don't?

The esteemed national and international experts on the Dolphin committee originally picked the Mater site did they not? Or was the report done after the original application was denied?

Podge_irl · 21-01-2019 6:31pm

Matt Barrett wrote: »

Yes we have options, however if we didn't, what they could get away with would likely differ greatly to current marketplace competitiveness.

Yes, much like state owned services. It was private enterprise that brought air travel to the masses, not state airlines.

Matt Barrett wrote: »

The idea of private business competing and therefore creating the best options for the customer often doesn't work.

Sure. But public monopolies often don't work either.

A huge benefit of the Swiss system is that it is essentially another taxation, but one that is ringfenced for healthcare. It takes the politics out of the funding issue. People still pay a portion of the costs so aren't keen on hospitals performing unnecessary tests/procedures just to rack up the bill.

James Brown · 21-01-2019 7:12pm

Podge_irl wrote: »

Yes, much like state owned services. It was private enterprise that brought air travel to the masses, not state airlines.

Aye...

Ryanair ranked 'worst airline' for sixth year in a rowhttps://www.theguardian.com/business/2019/jan/05/strike-hit-ryanair-ranked-worst-airline-for-sixth-year-in-a-row

I'm not sure what your point is now. Are we still operating on the misconception I think everything about private business is bad or only as it refers to looking after the public interest with tax payer monies?

Podge_irl wrote: »

Sure. But public monopolies often don't work either.

A huge benefit of the Swiss system is that it is essentially another taxation, but one that is ringfenced for healthcare. It takes the politics out of the funding issue. People still pay a portion of the costs so aren't keen on hospitals performing unnecessary tests/procedures just to rack up the bill.

Just because our system is poorly run and rotating FF/FG governments choose to throw money at it and do little else, doesn't mean we need look to private concerns IMO. Looking at Ireland, how ever bad things are ran we need to be able to look to the state and elected officials lest they be able to hide behind contracts and roll out 'our hands are tied'. Just because our chosen brand of representatives are found wanting doesn't mean we can't find competent people with an interest in fixing things at some point, maybe even from the ranks of FF/FG.

AndrewJRenko · 21-01-2019 10:28pm

Podge_irl wrote: »

The esteemed national and international experts on the Dolphin committee originally picked the Mater site did they not? Or was the report done after the original application was denied?

No, the Dolphin committtee picked St James.

FreudianSlippers wrote: »

IIRC the committee considered the reworked Mater site and not the original proposal so, yes, I know about the original proposal which (if my memory serves - I can't look it up now) they did not consider.

Oh, so if they had considered the original proposal, which had LESS capacity than the reworked proposal, and had already been rejected by the planning authorities, you think that might have been a more viable decision? They should have chosen a proposal that had already been refused planning?

As it happens, if you read Dolphin, you'll see they were well aware of the original proposal too.

charlotte.york · 22-01-2019 12:34am

Podge_irl wrote: »

Yes, much like state owned services. It was private enterprise that brought air travel to the masses, not state airlines.

Sure. But public monopolies often don't work either.

A huge benefit of the Swiss system is that it is essentially another taxation, but one that is ringfenced for healthcare. It takes the politics out of the funding issue. People still pay a portion of the costs so aren't keen on hospitals performing unnecessary tests/procedures just to rack up the bill.

Swiss model is really up there. It is vary hard to make that argument in the political climate here.

ednwireland · 22-01-2019 3:45pm

did that ambulance strike go under the radar a bit, never realised it was on until i went past the ambulance station on my road.

not much point striking IMO if no one notices

listermint · 22-01-2019 4:59pm

AndrewJRenko wrote: »

So four of the committee members ARE consultants who've spent their entire careers hanging round with other consultants, but you know more about what consultants think than they do? Really?

So 4 of the decision makers were consultants, What was the make up of the rest of the committee.

Intrigued.

AndrewJRenko · 22-01-2019 8:49pm

listermint wrote: »

So 4 of the decision makers were consultants, What was the make up of the rest of the committee.

Intrigued.

Two expert planners, one architect, one hospital CEO
https://health.gov.ie/blog/press-release/announcement-of-the-composition-of-the-review-group-into-the-national-paediatric-hospital/

theguzman · 22-01-2019 10:51pm

The time has come to Privatise the operation of the Healthcare system in Ireland, get rid of the unions and the thousands of unnecessary administrative, management and clerical positions. The HSE like the rest of the Public sector is a dumping ground for the failed careers of Fianna Fail crony hacks. HSE property to remain state-owned, Private Healthcare to be PRSI deductable, let the Private companies in and watch a real proper system be delivered. There is too many vested interested sucking from the teat of the sacred cow that is the HSE.

oscarBravo · 23-01-2019 9:22am

theguzman wrote: »

...get rid of the unions...

I don't understand why people espouse views like this and expect to be taken seriously. I mean, I have my issues with trade unions, but I would never argue that they should be gotten rid of - unless I was actively trying to come across as some sort of parody account.

It's one of those proposals that, frankly, indicates a lazy unwillingness to think through the consequences of what you're proposing. And if you couldn't be bothered putting even a hint of effort into thinking about your proposed solution, why should anyone else?

FreudianSlippers · 23-01-2019 11:25am

Unionism itself isn't the problem necessarily, but it impedes or perhaps prevents any meaningful reform of the system. If you had the silver bullet to fix the HSE tomorrow morning, you wouldn't be able to implement it because of the unions. I don't think there is anyone who could seriously claim otherwise.

I have no problem with union representation of front-line workers - of course nurses need a union.

James Brown · 23-01-2019 2:50pm

theguzman wrote: »

The time has come to Privatise the operation of the Healthcare system in Ireland, get rid of the unions and the thousands of unnecessary administrative, management and clerical positions. The HSE like the rest of the Public sector is a dumping ground for the failed careers of Fianna Fail crony hacks. HSE property to remain state-owned, Private Healthcare to be PRSI deductable, let the Private companies in and watch a real proper system be delivered. There is too many vested interested sucking from the teat of the sacred cow that is the HSE.

How many civil servants or the HSE policy and decision makers are unionised I wonder?

Unions are often the only protection workers have. They are not there to stymie progress but to ensure any changes do not unduly effect their membership. They are not the tax payers representatives and have no remit to protect the interests of anyone but their members.
Unions are a necessity. Even if you are not a member it's likely you benefit in some way from the institution.

The idea that public owned entities can't be run as efficiently as any private one is a nonsense. The problem could very well be that any official, political or politically appointed might not be so eager to address problems if favouring privatisation. Contracts mean deals and our politicians like dining out on them.

The unions are not responsible for the farcical children's hospital cost over run.

Tell me how · 23-01-2019 3:38pm

Matt Barrett wrote: »

How many civil servants or the HSE policy and decision makers are unionised I wonder?

Unions are often the only protection workers have. They are not there to stymie progress but to ensure any changes do not unduly effect their membership. They are not the tax payers representatives and have no remit to protect the interests of anyone but their members.
Unions are a necessity. Even if you are not a member it's likely you benefit in some way from the institution.

The idea that public owned entities can't be run as efficiently as any private one is a nonsense. The problem could very well be that any official, political or politically appointed might not be so eager to address problems if favouring privatisation. Contracts mean deals and our politicians like dining out on them.

The unions are not responsible for the farcical children's hospital cost over run.

The point in bold is not necessarily the case in my opinion. The WRC is accessible for any Irish worker and does not require Union membership.

The "unduly affect their membership" is where I have a problem with a lot of how unions seem to operate in Ireland in the 21st century.

One mans interpretation of being unduly affected is another mans interpretation of adjusting to meet market realities. Unions (seem) to be focused on maintaining inefficient practices within certain industries and while they can justifiably say they are doing so because that is their purpose, the end result seems to be public sector organisations which are top heavy in management and administration and are therefore hampered from delivering efficient services due to in part to the mass of bureaucracy which exists.

James Brown · 23-01-2019 4:16pm

Tell me how wrote: »

The point in bold is not necessarily the case in my opinion. The WRC is accessible for any Irish worker and does not require Union membership.

The "unduly affect their membership" is where I have a problem with a lot of how unions seem to operate in Ireland in the 21st century.

One mans interpretation of being unduly affected is another mans interpretation of adjusting to meet market realities. Unions (seem) to be focused on maintaining inefficient practices within certain industries and while they can justifiably say they are doing so because that is their purpose, the end result seems to be public sector organisations which are top heavy in management and administration and are therefore hampered from delivering efficient services due to in part to the mass of bureaucracy which exists.

You've a problem with:

Unions are often the only protection workers have. They are not there to stymie progress but to ensure any changes do not unduly effect their membership

When is it not the case? Can you show where unions are stopping progress and not looking after the interests of their members?

Your following elaboration states some possible/likely side effects of looking after members interests. This happens for sure, Irish Press workers etc.
The point is they are not in existence to merely retard progress but it can be an effect of looking after their membership in some circumstances.
Unions have a vote, the majority view is their stance and therefore the 'one mans' debate doesn't come into it. It's on the government to argue the case for the tax payer and hopefully come to a mutually beneficial agreement.
Simply writing off unions or calling to 'get rid' of them suggests it's all a one way street and everything publicly ran would go off without a hitch and we could fix the HSE without bothersome unions. When you look at Irish Water, housing, education, e-voting and a myriad other jacked up state enterprises, it's apparent to me that as with the HSE (and children's hospital cost over run for that matter) although convenient, blaming unions for looking after their members can not be looked to as the bigger problem. For instance what measures have been suggested to 'fix' the HSE that unions are stopping? I don't even see anything of much on the table other than bringing in consultants and bitching about over worked nurses taking due holidays at unverified inappropriate times.

And again, how many civil servants or the HSE policy and decision makers are unionised?

Tell me how · 24-01-2019 11:59am

Matt Barrett wrote: »

You've a problem with:

When is it not the case? Can you show where unions are stopping progress and not looking after the interests of their members?

Your following elaboration states some possible/likely side effects of looking after members interests. This happens for sure, Irish Press workers etc.
The point is they are not in existence to merely retard progress but it can be an effect of looking after their membership in some circumstances.
Unions have a vote, the majority view is their stance and therefore the 'one mans' debate doesn't come into it. It's on the government to argue the case for the tax payer and hopefully come to a mutually beneficial agreement.
Simply writing off unions or calling to 'get rid' of them suggests it's all a one way street and everything publicly ran would go off without a hitch and we could fix the HSE without bothersome unions. When you look at Irish Water, housing, education, e-voting and a myriad other jacked up state enterprises, it's apparent to me that as with the HSE (and children's hospital cost over run for that matter) although convenient, blaming unions for looking after their members can not be looked to as the bigger problem. For instance what measures have been suggested to 'fix' the HSE that unions are stopping? I don't even see anything of much on the table other than bringing in consultants and bitching about over worked nurses taking due holidays at unverified inappropriate times.

And again, how many civil servants or the HSE policy and decision makers are unionised?

Black bolded point - I didn't suggest getting rid of unions. I believe they do serve a function but that their motivation is not best motivated in improving the service offering which their members are providing in conjunction with serving those members needs. And this goes for groups which are unions in practice if not in name as much as it does the traditional interpretation of the role.

Red bolded point - Why have we consistently heard about top heavy structures (and I include the number of nursing managers in that) but not seen any change in this area. Who is preventing the numbers in such roles being reduced when contracts expire or people retire and leave? Maybe we are not 'hearing about such measures' because it is known that they are a dead duck because of the groups (unions) which have negotiated, such as the time of the creation of the HSE that no role would be abolished.

Blue bolded point - The Healthcare budget has increased by more than double in 17 years within which was the greatest global financial crash in nearly 100 years. I'd say that's a pretty significant lump on the table.

James Brown · 24-01-2019 2:53pm

Tell me how wrote: »

Black bolded point - I didn't suggest getting rid of unions. I believe they do serve a function but that their motivation is not best motivated in improving the service offering which their members are providing in conjunction with serving those members needs. And this goes for groups which are unions in practice if not in name as much as it does the traditional interpretation of the role.

Red bolded point - Why have we consistently heard about top heavy structures (and I include the number of nursing managers in that) but not seen any change in this area. Who is preventing the numbers in such roles being reduced when contracts expire or people retire and leave? Maybe we are not 'hearing about such measures' because it is known that they are a dead duck because of the groups (unions) which have negotiated, such as the time of the creation of the HSE that no role would be abolished.

Blue bolded point - The Healthcare budget has increased by more than double in 17 years within which was the greatest global financial crash in nearly 100 years. I'd say that's a pretty significant lump on the table.

Never said you did. My post was in response to another saying we should get rid of unions. Then you commented on that post and asked questions. I answered referencing my reasoning for saying what I said.
You can't step into the chain of conversation and expect the previous posts on discussion be ignored especially when making queries on a response to a previous post. That said you are rewording what I've already conceded to.

I don't believe unions are the major problem. Treating workers with respect is important. Are you suggesting there are no moves to fix the HSE because with unions and union like entities, what's the point, (dead duck)? I think that's a cop out and not one I've even heard Harris or Varadkar use.
If a clear idea of how to proceed is put to the public and explained, if it's deemed fair and useful not some mish-mash of looking after our own or another quango, I can't see anyone holding it up. Even the unions. Health is everybody's business and we've all got an interest.

It's an exercise in can kicking not a solution.

Tell me how · 24-01-2019 5:10pm

Matt Barrett wrote: »

Never said you did. My post was in response to another saying we should get rid of unions. Then you commented on that post and asked questions. I answered referencing my reasoning for saying what I said.
You can't step into the chain of conversation and expect the previous posts on discussion be ignored especially when making queries on a response to a previous post. That said you are rewording what I've already conceded to.

I don't believe unions are the major problem. Treating workers with respect is important. Are you suggesting there are no moves to fix the HSE because with unions and union like entities, what's the point, (dead duck)? I think that's a cop out and not one I've even heard Harris or Varadkar use.
If a clear idea of how to proceed is put to the public and explained, if it's deemed fair and useful not some mish-mash of looking after our own or another quango, I can't see anyone holding it up. Even the unions. Health is everybody's business and we've all got an interest.

It's an exercise in can kicking not a solution.

First bolded point - Calm down, no need to instruct me on how to use boards at this point. I was ensuring there was no ambiguity about my position.

Second bolded point - Why do you think the imbalance in staff numbers in terms of administration/medical staff still exists? Do you think Harris or Varadkar would publicly suggest unions are a problem even if they thought they were?

We have a series of very qualified or politically experienced people hold the position of Minister for health (from at least 3 of the major political parties) over the last 20 years. Why have the problems persisted (grown) in your view?

Do you think they are all trying to maintain the same quangos?

What is wrong with the health service, HSE

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