Whats gone wrong with our health system?

Spiritoftheseventies

Heard this woman on Ray D'Arcy this morning who is quite distraught that she cant find a hospital bed for her young daughter in the ICU of the Crumlins Childrens hospital who is waiting open heart surgery . This case I think needs highlighting.
Like the Cystic Fibrosis scandal awhile back its not enough in this day age that hospital beds are not being freed up when its a matter of life and death.
Doing this as public service to a Woman who is very anxious to highlight her daughters plight.

http://www.rollercoaster.ie/boards/mc.asp?ID=292407&G=37&forumdb=1

irish_bob

bayviewclose wrote: »

Heard this woman on Ray D'Arcy this morning who is quite distraught that she cant find a hospital bed for her young daughter in the ICU of the Crumlins Childrens hospital who is waiting open heart surgery . This case I think needs highlighting.
Like the Cystic Fibrosis scandal awhile back its not enough in this day age that hospital beds are not being freed up when its a matter of life and death.
Doing this as public service to a Woman who is very anxious to highlight her daughters plight.

http://www.rollercoaster.ie/boards/mc.asp?ID=292407&G=37&forumdb=1

always amazes me how it never seems to occur to the parents of sick kids that the reason thier is a lack of essential services is because the vast bulk of health expenditure goes towards making our nurses , consultants and doctors the highest paid in europe , couple this with the fact that through union domination of the HSE , its nion impossible to sack surplus to requirement adminstrators , the problem has always been malfunding , not underfunding

Taxipete29

irish_bob wrote: »

always amazes me how it never seems to occur to the parents of sick kids that the reason thier is a lack of essential services is because the vast bulk of health expenditure goes towards making our nurses , consultants and doctors the highest paid in europe , couple this with the fact that through union domination of the HSE , its nion impossible to sack surplus to requirement adminstrators , the problem has always been malfunding , not underfunding

I seem to be agreeing a little too easy with the right-wing today, but I do have to agree with this. We have one of the best funded health services around. Its never been about money, its always been about putting the resources in the right place.

There was an economist on Vincent Browne last night( his name escapes me). He was talking about how consultants were paid so much as there was a fear they would go overseas if not properly renumerated. His point was is there some mass head-hunting operation to lure our doctors to other countries. Is the medical world banging down Irelands door to steal our medical talent. I think not.

The health service must be worst value for money public service we have. Its a disgrace.

aoboa

irish_bob wrote: »

always amazes me how it never seems to occur to the parents of sick kids that the reason thier is a lack of essential services is because the vast bulk of health expenditure goes towards making our nurses , consultants and doctors the highest paid in europe , couple this with the fact that through union domination of the HSE , its nion impossible to sack surplus to requirement adminstrators , the problem has always been malfunding , not underfunding

Are you sure about that? I'd like to see figures.
I thought that the biggest problem was the duplication of roles and excess administration and management after the consolidation of the Health Boards and not the front line wage bill.

spank_inferno

2 points:

I agree with the previous posters, if the pay and perks was cut back just a smidge we would have beds coming out of our ears.

And, this is a bug bear of mine.
Why is that parent even relying on the government to do this operation!!

I've wondered ths before, why to the parents of Ireland abdicate nearly all responsibility for the health and upbringing of their children to the government.

If my child needed life saving surgery they would never know what a waiting list looked like.

Whatever the cost, whatever the sacrafice will be overcome to save a loved one irrespective of cost...

Biggins

1. Harney - that is WHEN she actually at her job and desk - and not disappearing again!
2. Too many Harney under-dog departmental chiefs and admin' committee bureaucracy.
3. Some unions/consultants have the HSE up against the wall with pay demands and threats. Some still think they are gods and should be paid as such!
4. Funding being directed and controlled properly.
5. TOO MANY POLITICIANS TOO BUSY PLAYING POLITICAL FOOTBALL WITH THE HOSPITALS TO ACTUALLY GIVE FCUK ABOUT WHAT'S ACTUALLY GOING ON AT HOSPITAL FLOOR LEVELS!

Crumlin is a classic case in point for (5) as you can read in this thread here.

I've been (and still am) on TV, Radio, in the papers about the farce that directly effects all of us - not just my own child who is suffering.

Spiritoftheseventies

Yes the money was there. It was there during the Boom and it was blown on putting up houses left right and centre regardless of whether there was a demand for it.
It is beyond me how we can not find x amount of post op beds that are needed for these procedures on high risk patients.
D'Arcy was saying that Harney had said he was being a bit too emotional about matters like these when she was on before.
Says it all. Those in charge of making life and death decisions cant get their heads around things as important as these.
This is enshrined in our constitution. Walk into any garda station. Every citizen is entitled to a proper standard of living.
And the health of a child is top of that. Start writing to your tds!

FlutterinBantam

irish_bob wrote: »

always amazes me how it never seems to occur to the parents of sick kids that the reason thier is a lack of essential services is because the vast bulk of health expenditure goes towards making our nurses , consultants and doctors the highest paid in europe , couple this with the fact that through union domination of the HSE , its nion impossible to sack surplus to requirement adminstrators , the problem has always been malfunding , not underfunding

Absolutely correct, it's very easy to hang everything on those easily identifiable like Drumm and Harney, when in reality it's the focking enormous cost, the almost complete intransigence of the stake holders in the HSE who drive up the costs to unsustainable proportions.

Everybody is protecting their own patch and nobody will move an inch to change and allow expenditure to cascade down to patient welfare.

"Angola" and "Black Hole" are two terms used to describe the health service in Ireland by those trying to get bang for buck.

Those terms were used for a reason.

Spiritoftheseventies

End of the day the buck stops with Harney and Drumm. Drumm gets a bonus of 70k and yet we cant find a bed for a critically sick girl. Its not right.

FlutterinBantam

Don't agree with you totally there.

The subject under discussion here is "What's gone wrong with the health service"

As far as I am concerned the vested interests and various groups in the HSE have combined to make the thing unworkable.

If a strongly unionised workforce,buttressed by an almost unsackable term of employment, coupled with political and outside vested interest interference,decide to drag their feet ,it makes for very difficult management.

John Q taxpayer is not getting bang for his buck, far far from it.

There's your problem.

spank_inferno

Flutt is completely right.

Blame is there from top to bottom.

its not and never has been about lack of funding.

Spiritoftheseventies

FlutterinBantam wrote: »

Don't agree with you totally there.

The subject under discussion here is "What's gone wrong with the health service"

As far as I am concerned the vested interests and various groups in the HSE have combined to make the thing unworkable.

If a strongly unionised workforce,buttressed by an almost unsackable term of employment, coupled with political and outside vested interest interference,decide to drag their feet ,it makes for very difficult management.

John Q taxpayer is not getting bang for his buck, far far from it.

There's your problem.

Yes agree with that. And George Lee says that we need to take on the vested interests if we are to get this country up and running.
But again how hard is it to find a bed. How many ICU beds are there in the Childrens hospital.
How hard can it be to free up a bed for a high priority case. Make enough noise and the bed becomes available. Say nothing and nothing gets down.

MeatProduct

If we focused on prevention rather than cure it would go a hell of a long way to reduce the madness in the hospitals. Naturally it makes big pharma less money so its not going to happen.

Nick

irish_bob

Taxipete29 wrote: »

I seem to be agreeing a little too easy with the right-wing today, but I do have to agree with this. We have one of the best funded health services around. Its never been about money, its always been about putting the resources in the right place.

There was an economist on Vincent Browne last night( his name escapes me). He was talking about how consultants were paid so much as there was a fear they would go overseas if not properly renumerated. His point was is there some mass head-hunting operation to lure our doctors to other countries. Is the medical world banging down Irelands door to steal our medical talent. I think not.

The health service must be worst value for money public service we have. Its a disgrace.

that economist who appeared on VB last night , elderly gentlemen , his name escapes me but he always comes across as a very thoughtfull and impartial observer , apparently he has done much charity work in africa in the recent past

lmimmfn

Unions

irish_bob

FlutterinBantam wrote: »

Absolutely correct, it's very easy to hang everything on those easily identifiable like Drumm and Harney, when in reality it's the focking enormous cost, the almost complete intransigence of the stake holders in the HSE who drive up the costs to unsustainable proportions.

Everybody is protecting their own patch and nobody will move an inch to change and allow expenditure to cascade down to patient welfare.

"Angola" and "Black Hole" are two terms used to describe the health service in Ireland by those trying to get bang for buck.

Those terms were used for a reason.

the HSE 1st and foremost serves those who work within its ranks , the tax payer and more importantly the patient is a lesser priority , and to think most people brand private healthcare as being all about the profit motive

doc_17

too much waste and poor work practices. The incident in limerick last year when the hospital manager and the patients parents had to wheel the girl into surgery as the porter on another floor would not come down to do it as it wasn't his area, even though he was doing nothing at the time! How do i know he was doing nothing? well he rang his union to ask should he go down and do it. so if he had time to that he could have came down and did his job.

beggars_bush

1 - Unions. Some terrible work practices in every section of the HSE, Department of Health andevery hospital in the country. Problem is most people cannot be fired in the current system. This includes admin, maintenance staff etc

2 - Medical snobbery. The medical profession in Ireland seem to think that they have a right to squeeze money from the Irish state and people. They set their own prices as there is no advertising of prices allowed... Best paid in Europe and they operate a closed cartell - who else can join this elite group? Not you, or I? a limited number of places each year for new doctors. Closed system.

3 - Consultants. Yes, they might be specialised in their area of work. But what has happened to the idea of a person doign an honest days work and not fleecing the customer and patient? If they are so good at what they do and don't like working for less then fcuk off to the USA or the UK and see how they get on

Spiritoftheseventies

Just to be fair here this woman I mentioned in op mentioned that surgeons are having to perform surgeries around times when beds are free and sometimes that means into the early morning.
Again I think we can achieve a lot by making a lot of noise. That cystic fibrosis patient who regularly writes for Irish times has done a great service for the CF patients.
But overall I just dont think the HSE is set up to deal on a human interest with cases like this.
An over emphasis on administration has led to them being bogged down in Red Tape.

silverharp

There is a consultant in Dublin that hires out theatre facilities at the weekend, he brings in his own staff etc and he carries out more operations at the weekend then he can get done during a normal work week. He was saying that he has lost count of the number of cancellations which occur for petty reasons like porters on tea breaks or calling impromptu union meetings.

There is no shortage of money and probably facilities in the health service, its the lack of a market. Think flying in the 1970's on gov. run airlines versus what happens now when there is real competition.

Spiritoftheseventies

Yes there seems to be a work to rule situation going on here. And that its happening in a high pressure situation is unbelievable.
Yes we are in a bit of a bind here. And bringing in competition will probably lead to one day walkouts which is being planned by our public servants next months.
Will the governments make the tough decisions though and call their bluff. Or maybe they will just continue to focus on those who can not defend themselves.

Omnipresence

Sadly Simple:

Q: Whats gone wrong with our health system?

A: Our Health System

Aidric

irish_bob wrote: »

that economist who appeared on VB last night , elderly gentlemen , his name escapes me but he always comes across as a very thoughtfull and impartial observer , apparently he has done much charity work in africa in the recent past

His name is Joe Durkan, one of this country's most outstanding economic brains. He is a lecturer @ UCD.

spank_inferno

silverharp wrote: »

There is a consultant in Dublin that hires out theatre facilities at the weekend, he brings in his own staff etc and he carries out more operations at the weekend then he can get done during a normal work week. He was saying that he has lost count of the number of cancellations which occur for petty reasons like porters on tea breaks or calling impromptu union meetings.

There is no shortage of money and probably facilities in the health service, its the lack of a market. Think flying in the 1970's on gov. run airlines versus what happens now when there is real competition.

In fact I'm availaing of such a service very soon
I need a small operation and to get it done quicker, my consultant is going to a public bed for me in a public hospital, I pay for the surgeon and the anasthetic guy etc, the hospital bed is only €70

no muss.... no fuss....

and apparently privitisation is a bad thing

Clawdeeus

Someone quickly get the word to the Americans, before its too late!

silverharp

Clawdeeus wrote: »

Someone quickly get the word to the Americans, before its too late!

Here is a short article on a freemarket solution for the US health service


http://mises.org/story/3643

A Four-Step Healthcare Solution
Mises Daily by Hans-Hermann Hoppe | Posted on Friday, August 14, 2009

It's true that the US health-care system is a mess, but this demonstrates not market but government failure. To cure the problem requires not different or more government regulations and bureaucracies, as self-serving politicians want us to believe, but the elimination of all existing government controls.

It's time to get serious about health-care reform. Tax credits, vouchers, and privatization will go a long way toward decentralizing the system and removing unnecessary burdens from business. But four additional steps must also be taken:

Eliminate all licensing requirements for medical schools, hospitals, pharmacies, and medical doctors and other health-care personnel. Their supply would almost instantly increase, prices would fall, and a greater variety of health-care services would appear on the market.

Competing voluntary accreditation agencies would take the place of compulsory government licensing — if health-care providers believe that such accreditation would enhance their own reputation, and that their consumers care about reputation, and are willing to pay for it.

Because consumers would no longer be duped into believing that there is such a thing as a "national standard" of health care, they would increase their search costs and make more discriminating health-care choices.

Eliminate all government restrictions on the production and sale of pharmaceutical products and medical devices. This means no more Food and Drug Administration, which presently hinders innovation and increases costs.

Costs and prices would fall, and a wider variety of better products would reach the market sooner. The market would force consumers to act in accordance with their own — rather than the government's — risk assessment. And competing drug and device manufacturers and sellers, to safeguard against product liability suits as much as to attract customers, would provide increasingly better product descriptions and guarantees.

Deregulate the health-insurance industry. Private enterprise can offer insurance against events over whose outcome the insured possesses no control. One cannot insure oneself against suicide or bankruptcy, for example, because it is in one's own hands to bring these events about.

Because a person's health, or lack of it, lies increasingly within his own control, many, if not most health risks, are actually uninsurable. "Insurance" against risks whose likelihood an individual can systematically influence falls within that person's own responsibility.

All insurance, moreover, involves the pooling of individual risks. It implies that insurers pay more to some and less to others. But no one knows in advance, and with certainty, who the "winners" and "losers" will be. "Winners" and "losers" are distributed randomly, and the resulting income redistribution is unsystematic. If "winners" or "losers" could be systematically predicted, "losers" would not want to pool their risk with "winners," but with other "losers," because this would lower their insurance costs. I would not want to pool my personal accident risks with those of professional football players, for instance, but exclusively with those of people in circumstances similar to my own, at lower costs.

Because of legal restrictions on the health insurers' right of refusal — to exclude any individual risk as uninsurable — the present health-insurance system is only partly concerned with insurance. The industry cannot discriminate freely among different groups' risks.

As a result, health insurers cover a multitude of uninsurable risks, alongside, and pooled with, genuine insurance risks. They do not discriminate among various groups of people which pose significantly different insurance risks. The industry thus runs a system of income redistribution — benefiting irresponsible actors and high-risk groups at the expense of responsible individuals and low-risk groups. Accordingly, the industry's prices are high and ballooning.

To deregulate the industry means to restore it to unrestricted freedom of contract: to allow a health insurer to offer any contract whatsoever, to include or exclude any risk, and to discriminate among any groups of individuals. Uninsurable risks would lose coverage, the variety of insurance policies for the remaining coverage would increase, and price differentials would reflect genuine insurance risks. On average, prices would drastically fall. And the reform would restore individual responsibility in health care.

Eliminate all subsidies to the sick or unhealthy. Subsidies create more of whatever is being subsidized. Subsidies for the ill and diseased promote carelessness, indigence, and dependency. If we eliminate such subsidies, we would strengthen the will to live healthy lives and to work for a living. In the first instance, that means abolishing Medicare and Medicaid.

Only these four steps, although drastic, will restore a fully free market in medical provision. Until they are adopted, the industry will have serious problems, and so will we, its consumers.

bleedinrapidbud

I can't understand why we haven't had a general election yet-after all thats happened, the people in power are the ones who ruined the country.I think FF are forgeting that they work for us and not the other way around!
If the whole country just got together we could call for an election but all we do is give out about the situation and get nowhere!!!!!
By the way Enda Kenny has a great plan for our health system where rich and poor are all equal when it comes to health care.The Dutch use the system he wants to introduce.

(I am not part of any political party-i just like Enda's plan for health care.)

piby

We need to take a leaf out of Cuba's book and convert to communism! It may be a hard old slog but at least we'd have good health care

On a serious note the one point I'd make is the copious amounts of managers and 'surplus' admin staff. I don't work in healthcare myself but I have many friends who do and hold this opinion as well.

At the end of the day we're Irish, we can't do thing efficiently and effectively.

CelticTiger*

Private run healthcare will always fail, why is our system regarded as universal?

It clearly isnt

Soldie

What's wrong with our health system is that the government is running it.

SleepDoc

beggars_bush wrote: »

1 - Unions. Some terrible work practices in every section of the HSE, Department of Health andevery hospital in the country. Problem is most people cannot be fired in the current system. This includes admin, maintenance staff etc


2 - Medical snobbery. The medical profession in Ireland seem to think that they have a right to squeeze money from the Irish state and people. They set their own prices as there is no advertising of prices allowed... Best paid in Europe and they operate a closed cartell - who else can join this elite group? Not you, or I? a limited number of places each year for new doctors. Closed system.


3 - Consultants. Yes, they might be specialised in their area of work. But what has happened to the idea of a person doign an honest days work and not fleecing the customer and patient? If they are so good at what they do and don't like working for less then fcuk off to the USA or the UK and see how they get on

1. Most workers in the health service are incredibly dedicated and don't deserve to be fired. A hospital cannot function without admin, maintenance, receptionists, catering staff.


2. Its not a closed system. If you work hard enough you can become a doctor. There are high standards because lives literally depend on you. There is very little snobbery. Medicine, more than other careers is a meritocracy.


3. Most consultants work hard and perform their public duties to the same standard as they do to their private. To become a consultant is not easy, particularly in Ireland. In general they are better qualified and better practitioners than in other countries.