The HSE health service like doomed Russian agriculture

patslatt

Recent news report say the Department of Health has called in consultants McKinsey in order to help the HSE create proper management chains of command,structures and systems of accountability. The Department had apparently considered the drastic alternative of abolition of the HSE and a return to a system of health boards,though only four boards this time around,but decided that would be too prolonged.

The abolition of the HSE would be the right course of action,since far too many patients now know first hand how dysfunctional it is. The HSE is incapable of sufficient reform,given that it is a kind of workers co-op ruthlessly exploited by the public sector unions, the professional medical associations and the unionised management (an oxymoron) for their economic benefit,which include jobs for life.

It should be replaced by a system that is made to compete for the custom of patients,whether state financed or private health insurance patients.The money should follow the patients,not be dropped into the laps of the HSE and hospitals. There are several models,such as those in France,The Netherlands,Germany and Austria, that are vastly more responsive to patients than the HSE monolith with its multiple layers of useless bureaucracy.McKinsey's organisational mapping will merely paper over the cracks and delay the root and branch reform of the health service that requires the HSE's abolition.

The government's argument for more time to heal the HSE reminds me of Russian politicians' promises to reform Russian agriculture. Since collectivisation in the 1930s into huge collective farms until the 1980s, Russian agriculture received huge investments in tractors and production of fertiliser and pesticides. But throughout that 50 years, Russians depended on a mere 2% of land held in small private plots for most of their food production. Down on the collective farms, the workers were more interested in vodka parties than work, the farm machinery lay broken down in the fields, and crops rotted unpicked for lack of transportation to markets. As an English economist said,monopoly is always and everywhere an evil.

Tea drinker

Well,
while all this procrastrination is going on, people are dying.
It truly is a scandal. This huge fattened health service which costs a fair old whack is simply incapable of self reform.
I think the only tool available to the politicians at the moment is the lack of any more money to pour into the health service, and even this will probably result in more poor equipment rather than reform / rationalisation.

I recall a few days ago a woman on the radio saying how she called Amnesty Internation or Human rights watch to help with her case for health care. What sort of mental anguish and physical suffering are these people being put through because of this shambles? For us to have come throught the celtic tiger and still have this awfulness, shocking.

Mr.Micro

The HSE is in its infancy and will take along time IMO to get sorted. It is bogged down in bureaucracy, and too many middle managers and a lack of expertise. The local councillors are still interfering in its operation and trying to have a say when its nothing to do with them, nor do they have any medical knowledge or expertise. It appears any decision taken by the HSE is opposed at a local level. It needs to get rid of all the dross and slim down to the bare essentials and then recruit qualified professionals.

Lemming

Mr.Micro wrote: »

The HSE is in its infancy and will take along time IMO to get sorted. It is bogged down in bureaucracy, and too many middle managers and a lack of expertise. The local councillors are still interfering in its operation and trying to have a say when its nothing to do with them, nor do they have any medical knowledge or expertise. It appears any decision taken by the HSE is opposed at a local level. It needs to get rid of all the dross and slim down to the bare essentials and then recruit qualified professionals.

And right now it appears incapable and/or self-servingly unwilling to do that since a lot of the 'dross' consists of middle management.

Mr.Micro

Lemming wrote: »

And right now it appears incapable and/or self-servingly unwilling to do that since a lot of the 'dross' consists of middle management.

Absolutely, its a catch 22 situation, they are not going to fire themselves.

El Stuntman

Mr.Micro wrote: »

The HSE is in its infancy and will take along time IMO to get sorted. It is bogged down in bureaucracy, and too many middle managers and a lack of expertise. The local councillors are still interfering in its operation and trying to have a say when its nothing to do with them, nor do they have any medical knowledge or expertise. It appears any decision taken by the HSE is opposed at a local level. It needs to get rid of all the dross and slim down to the bare essentials and then recruit qualified professionals.

you are adding to your ministerial portfolio Mr Micro, I now appoint you to Health. Is there no end to your talents?

you've correctly identified that it is not a money problem! it is a people and process problem....

Tea drinker

El Stuntman wrote: »

you are adding to your ministerial portfolio Mr Micro, I now appoint you to Health. Is there no end to your talents?

you've correctly identified that it is not a money problem! it is a people and process problem....

Well, a bit of fear would do wonders to bring a sense of urgency here.