More cuts in health spending

ncdadam

Welease wrote: »

I don't know whether to be amused or to dispair at this stage..

A courier turned up at our house today with a delivery from the HSE of a..
.
.
<Wait for it>...
.
.
Single (as in 1) nappy for our son..


With Admin organisation and Delivery costs it must be one of the most expensive nappies ever used.

WTF?

femur61

woodoo wrote: »

The public sector is not a private company and shouldn't be compared to one. Plenty of countries are running at a loss yet their public servants aren't getting cut. The UK is one example.

Because their PS aren't paid as much as here.

http://www.nhscareers.nhs.uk/explore-by-career/doctors/pay-for-doctors/
http://www.nhscareers.nhs.uk/explore-by-career/nursing/pay-for-nurses/


http://www.education.gov.uk/get-into-teaching/salary/teaching-salary-scales.aspx
http://www.prospects.ac.uk/firefighter_salary.htm

Welease

ncdadam wrote: »

WTF?

Children with long term diabilities are entitled to free nappies under the HSE. Despite living within spitting distance of a health centre and Pharmacy who distribute my long term medication (seperate issue).. they refuse to do anything except utilise couriers to ship nappies to the house direct.. Anyway..

The HSE have recently changed nappy brands (one hopes to save costs), and sent out a sample Size 5 nappy to us (and I assume others) to check for fitting (it's a standard child's nappy so not sure this is even necessary) via courier.. We responded that size 5 was too small and requested a supply of size 6 (he had been wearing size 6 previously).. A courier delivered a supply of size 5 nappies (2 boxes).. which were obviously too small.. So we contacted the HSE again, who decided they needed to ship a sample Size 6 nappy via courier in order to check that it fit.. It Does (amazing that)!!! So next week, we will get a 4th courier delivery which should contain size 6 nappies.. then we will continue with ongoing courier deliveries of nappies.

It's a sad reflection of our mentality that its easier to cut home help for sick people rather than take a few minutes effort to eradicate unnecessary waste..

ncdadam

femur61 wrote: »

Because their PS aren't paid as much as here.

http://www.nhscareers.nhs.uk/explore-by-career/doctors/pay-for-doctors/
http://www.nhscareers.nhs.uk/explore-by-career/nursing/pay-for-nurses/


http://www.education.gov.uk/get-into-teaching/salary/teaching-salary-scales.aspx
http://www.prospects.ac.uk/firefighter_salary.htm

Jesus, look at what consultants earn over there!

Then look at how we do it in our banana republic,
http://www.google.ie/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&ved=0CDYQFjAD&url=http%3A%2F%2Fwww.irishtimes.com%2Fnewspaper%2Ffrontpage%2F2012%2F0326%2F1224313896189.html&ei=LNREUPHxJI-JhQfg_oDgCQ&usg=AFQjCNHeuejVcJd7wue9PlkKDkDvG3uvjA&sig2=Qc_4XZT9xa_fgPJl7FmuLg

ncdadam

Welease wrote: »

Children with long term diabilities are entitled to free nappies under the HSE. Despite living within spitting distance of a health centre and Pharmacy who distribute my long term medication (seperate issue).. they refuse to do anything except utilise couriers to ship nappies to the house direct.. Anyway..

The HSE have recently changed nappy brands (one hopes to save costs), and sent out a sample Size 5 nappy to us (and I assume others) to check for fitting (it's a standard child's nappy so not sure this is even necessary) via courier.. We responded that size 5 was too small and requested a supply of size 6 (he had been wearing size 6 previously).. A courier delivered a supply of size 5 nappies (2 boxes).. which were obviously too small.. So we contacted the HSE again, who decided they needed to ship a sample Size 6 nappy via courier in order to check that it fit.. It Does (amazing that)!!! So next week, we will get a 4th courier delivery which should contain size 6 nappies.. then we will continue with ongoing courier deliveries of nappies.

It's a sad reflection of our mentality that its easier to cut home help for sick people rather than take a few minutes effort to eradicate unnecessary waste..

That's crazy.

I wonder what all these middle ranking managers we hear about actually do all day.
Maybe a few could be used to administer this section and control the wastage.
I won't hold my breath though...

Idbatterim

€600 million to the bondholders tomorrow!

another contentious issue, but NOTHING to do with the the topic being discussed! the pay many of the mid and upper levels of HSE employees receive is outrageous. hopefully FG win an outright majority at next election, the cost of the CPA at this stage as has been noted by several ministers is just too high.

sarumite

woodoo wrote: »

The public sector is not a private company and shouldn't be compared to one. Plenty of countries are running at a loss yet their public servants aren't getting cut. The UK is one example.

I would check your facts on that. There have been cuts to pay, pensions and numbers in different PS organisations within the UK.

hmmm

Welease wrote: »

It's a sad reflection of our mentality that its easier to cut home help for sick people rather than take a few minutes effort to eradicate unnecessary waste..

The problem as I see it is that they have no incentive to save money. In your case, to meet targets all they need to do is make sure you get your nappies - and if they have to deliver it via concorde it makes no difference.

If their budget can't stretch to meet it, they cut back on services or look for higher taxes. They have no prospect of losing their jobs, receiving paycuts or seeing their company go bust, which you would get in the private sector.

The simple solution (to my mind) is to outsource these functions to the private sector. The existing public service management can bid for the business if they wish.

ardmacha

There have been cuts to pay, pensions and numbers in different PS organisations within the UK.

Lss than in the Republic and the cut phase is ending
End of public pay freeze in NI

Welease

hmmm wrote: »

The problem as I see it is that they have no incentive to save money. In your case, to meet targets all they need to do is make sure you get your nappies - and if they have to deliver it via concorde it makes no difference.

If their budget can't stretch to meet it, they cut back on services or look for higher taxes. They have no prospect of losing their jobs, receiving paycuts or seeing their company go bust, which you would get in the private sector.

The simple solution (to my mind) is to outsource these functions to the private sector. The existing public service management can bid for the business if they wish.

The problem with any potential solution is that it would take the government to face down the unions.. and no party in this country is willing to do so.. so like it or not we have to rely on people in those positions to do the right thing, and apply some common sense..

Without making it sound like a rant ... We have a fairly unique housename, and delivery folks do tend to comment on it...

The package was addressed to..
<sons name>
<housename>
Kildare

Thats it.. By pure luck the delivery guy remembered the housename from Littlewoods deliveries, as the label doesnt mention the townland, town or area we live in.. Who the hell sends a package out like that and expects it to get delivered?

But.. if I try (as I did before) to escalate the issue.. there is no one I can actually get to deal with it.. People (not all I should add) genuinely don't seem to care, and that in itself is sad from a country on it's knees that deems it more acceptable to remove home help from the elderly and SNA's from kids than to address some of these simple but costly issues.

femur61

ncdadam wrote: »

Jesus, look at what consultants earn over there!

Then look at how we do it in our banana republic,
http://www.google.ie/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&ved=0CDYQFjAD&url=http%3A%2F%2Fwww.irishtimes.com%2Fnewspaper%2Ffrontpage%2F2012%2F0326%2F1224313896189.html&ei=LNREUPHxJI-JhQfg_oDgCQ&usg=AFQjCNHeuejVcJd7wue9PlkKDkDvG3uvjA&sig2=Qc_4XZT9xa_fgPJl7FmuLg

I know of consultants openly said when hired here they couldn't beleive the wages they were offered. They previously had worked in Scotland. Most of them are Irish and want to move home but the one thing they found was that the facilities in the hospitals were archaric. I suspect a lot doctors not only because of the money and don't come here because they can't deliver the best service of care.

woodoo

Welease wrote: »

Children with long term diabilities are entitled to free nappies under the HSE. Despite living within spitting distance of a health centre and Pharmacy who distribute my long term medication (seperate issue).. they refuse to do anything except utilise couriers to ship nappies to the house direct.. Anyway..

The HSE have recently changed nappy brands (one hopes to save costs), and sent out a sample Size 5 nappy to us (and I assume others) to check for fitting (it's a standard child's nappy so not sure this is even necessary) via courier.. We responded that size 5 was too small and requested a supply of size 6 (he had been wearing size 6 previously).. A courier delivered a supply of size 5 nappies (2 boxes).. which were obviously too small.. So we contacted the HSE again, who decided they needed to ship a sample Size 6 nappy via courier in order to check that it fit.. It Does (amazing that)!!! So next week, we will get a 4th courier delivery which should contain size 6 nappies.. then we will continue with ongoing courier deliveries of nappies.

It's a sad reflection of our mentality that its easier to cut home help for sick people rather than take a few minutes effort to eradicate unnecessary waste..

These couriers are paid a set fee to carry out deliveries. It doesn't matter how many times they turn up at your house., It is the same as couriers working for the likes of NEXT.

Welease

woodoo wrote: »

These couriers are paid a set fee to carry out deliveries. It doesn't matter how many times they turn up at your house., It is the same as couriers working for the likes of NEXT.

I've no idea on the contractual details so can't confirm or deny.. can you link to the relevant info?

But irrespective, courier companies are not charities they will intend on making a profit, and the cost will be largely based on the expected number of packages to be delivered etc.. It would be reasonable to assume, that sending less packages will result in less deliveries and a reduction in costs (pending renegotiation of contracts). It would also incur less direct cost to the HSE (or contractor) for the time, effort and resource to post out single nappies (or any items) to folks.
Without trying to sound rude (apologies if it does), its a pretty poor reason to continue with such a wasteful process, considering the alternatives we have chosen to reign in budget overspend.

sarumite

ardmacha wrote: »

Lss than in the Republic and the cut phase is ending
End of public pay freeze in NI

The UK is far less centralised than Ireland so getting accurate numbers is actually more difficult. The NHS for example cut many people salaries (although also giving payrises to other staff) through its Agenda for Change. The MOD has made pay cuts and job cuts (both within the military itself and within its non-military parts such as DSTL).

However, the point remains that there have been pay cuts, job cuts and pension changes in the UK.

Godge

Welease wrote: »

The problem with any potential solution is that it would take the government to face down the unions.. and no party in this country is willing to do so.. so like it or not we have to rely on people in those positions to do the right thing, and apply some common sense..

Without making it sound like a rant ... We have a fairly unique housename, and delivery folks do tend to comment on it...

The package was addressed to..
<sons name>
<housename>
Kildare

Thats it.. By pure luck the delivery guy remembered the housename from Littlewoods deliveries, as the label doesnt mention the townland, town or area we live in.. Who the hell sends a package out like that and expects it to get delivered?

But.. if I try (as I did before) to escalate the issue.. there is no one I can actually get to deal with it.. People (not all I should add) genuinely don't seem to care, and that in itself is sad from a country on it's knees that deems it more acceptable to remove home help from the elderly and SNA's from kids than to address some of these simple but costly issues.

Like every other organisation in the world, the HSE was relying on the information provided to it by the customer.

It is actually more likely that your son didn't give his full address on the form leading to the problem.

Welease

Godge wrote: »

Like every other organisation in the world, the HSE was relying on the information provided to it by the customer.

It is actually more likely that your son didn't give his full address on the form leading to the problem.

My son is 3.. He didn't complete any forms It is a standard order that has been delivered for the past 6 months or so, so the information provided is correct.

It is (and was) poor internal process which caused the issue in addressing terms, wrong sized product and pointless costly process.

Head The Wall

woodoo wrote: »

The public sector is not a private company and shouldn't be compared to one. Plenty of countries are running at a loss yet their public servants aren't getting cut. The UK is one example.

Isn't the UK supposed to be letting 250-300k PS workers go?

old boy

i was sitting in a hospital que for some time when i noticed an eldery guy wearing a white coat, moving a trolly with some medical equipment between two rooms every so often, then across from them were some elderly nurses who were doing there best to look busey, then a bit of a commotion in the nurses room, one nurse said quiteloudly you would think that he owned it the way he keeps looking for it, it it turned out to be an instrument that could measure if a patient was emptying their bladder, then a young coloured guy approached the nurses room, walked up and down the corridor, he repeated this for an hour, eventually he was shown into a room, a few minutes later he came out of the room and called my name, the young coloured guy and the old man turned out to be my oncology team, the consultant and his intern, if i read it in a newspaper or on a bullitin board i would not believe it.

bbam

Z

tinner777

hse today, overtime has to be cut by 10%, fair enough, so take 10% from the rate paid, not great but we understand the pressures, we get to keep the ward safe with our minimum staff numbers.
Not with these clowns in charge we've been told the number of shifts we can book, in my place its 25 per month, now given that we used 21 last week. Had to cover two special observations, patients on 1:1, 24 hour, nursing care, and 1 to cover staff who left last year and have not been replaced. No one sick at the moment, thank god.
So in two weeks time if my ward doesn't change i'll be making the two patients on special stay in their room all day so one of us can keep an eye on them, giving our old men breakfast at ten and no more physical investigations off the ward such as X-ray as i will not be able to send a nurse with them.
The thing is they won't even maintain this because something will happen, someone will get hurt or jump over the fence, and the shifts will then be covered again.
Doing it properly the first time, lowering the rate of overtime, would of meant a consistent saving..

Godge

tinner777 wrote: »

hse today, overtime has to be cut by 10%, fair enough, so take 10% from the rate paid, not great but we understand the pressures, we get to keep the ward safe with our minimum staff numbers.
Not with these clowns in charge we've been told the number of shifts we can book, in my place its 25 per month, now given that we used 21 last week. Had to cover two special observations, patients on 1:1, 24 hour, nursing care, and 1 to cover staff who left last year and have not been replaced. No one sick at the moment, thank god.
So in two weeks time if my ward doesn't change i'll be making the two patients on special stay in their room all day so one of us can keep an eye on them, giving our old men breakfast at ten and no more physical investigations off the ward such as X-ray as i will not be able to send a nurse with them.
The thing is they won't even maintain this because something will happen, someone will get hurt or jump over the fence, and the shifts will then be covered again.
Doing it properly the first time, lowering the rate of overtime, would of meant a consistent saving..

Why do you need a nurse to wheel someone down to X-Ray? Surely a highly-qualified nurse is not needed to do such a job which could be done by a less highly-qualified, less well-paid care assistant?

Again why nurses to give breakfasts? Could this not be done by a care assistant as well?

If those changes were made, it would free up more nursing time for real nursing work that requires highly specialised knowledge.

Lawrence1895

Godge wrote: »

Why do you need a nurse to wheel someone down to X-Ray? Surely a highly-qualified nurse is not needed to do such a job which could be done by a less highly-qualified, less well-paid care assistant?

Again why nurses to give breakfasts? Could this not be done by a care assistant as well?

If those changes were made, it would free up more nursing time for real nursing work that requires highly specialised knowledge.

Usually, they give out medications with meals, and care assistants are not supposed (trained/qualified?) to give out tablets. Maybe that's why.

Godge

Lars1916 wrote: »

Usually, they give out medications with meals, and care assistants are not supposed (trained/qualified?) to give out tablets. Maybe that's why.

Fair enough, if that is the case but doesn't explain why they are pushing beds down to X-Ray.

Staffing mixes on wards and getting people to do jobs at levels appropriate to their qualifications rather than at levels less than their qualifications is one way of making savings. Unfortunately, it needs a level of engagement from nursing managers, mostly former nurses promoted in the last 10-15 years and I do not believe that they have the necessary skills/training to do that kind of management.

tinner777

we don't have care assistants and the hospital management decided that they wouldn't supply our unit with a porter so nurses get to do everything. Believe me its not what i envisaged nurses to be doing. The course on offer to train care assistants here does not yet have a mental health part either.

Welease

Godge wrote: »

Fair enough, if that is the case but doesn't explain why they are pushing beds down to X-Ray.

Staffing mixes on wards and getting people to do jobs at levels appropriate to their qualifications rather than at levels less than their qualifications is one way of making savings. Unfortunately, it needs a level of engagement from nursing managers, mostly former nurses promoted in the last 10-15 years and I do not believe that they have the necessary skills/training to do that kind of management.

That was largely the problem in all of my recent dealing with the HSE.. (although on my ward in Beaumont, all food was delivered by canteen staff and all transport to/from services was provided by porters.. nurses were not involved in any of those tasks)..

HSE staff don't feel empowered (or inclined) to challenge the status quo.. They will complain, they will blame other departments, they will shrug their shoulders, they will apologise.. but never once did I see anyone actually try and fix the problem..

beeno67

I had to attend out patients recently over a number of months. Every time was the same. All patients were given similar times. Eg 20 told to come at 2 pm next 20 at 3 pm. You were seen in order of the time you arrived. So if you had an appointment for 3pm but came at 1.45 you would be seen before someone who had an appointment for 2pm and came at 1.50 Obviously this causes chaos. 2 separate waiting rooms were needed and you moved from one to the other as you moved up the Q. One nurse was on crowd control duties to move people between waiting rooms and then into the correct consulting room. Total waste of time. I'm sure the nurse felt she was very busy and worked hard but it was a total waste of a job.

tinner777

Godge wrote: »

Fair enough, if that is the case but doesn't explain why they are pushing beds down to X-Ray.

Staffing mixes on wards and getting people to do jobs at levels appropriate to their qualifications rather than at levels less than their qualifications is one way of making savings. Unfortunately, it needs a level of engagement from nursing managers, mostly former nurses promoted in the last 10-15 years and I do not believe that they have the necessary skills/training to do that kind of management.

i'd be well able to manage a skill mix, you need to have a mix, one shift equals a cnm2 and 4 staff nurses, we manage the best we can.

Its not as simple as just complaining, the portering department, have x amount of porters to cover the hospital, my ward is not seen as a priority so we dont get one. But in fairness although its not right i do not need a porter as much as a and e or a busy medical ward.

Qualitymark

I have been told by young medics that the computer system used in the hospitals is antedeluvian and mostly sheets of paper are still the technology of choice. Can anyone comment?

tinner777

Welease wrote: »

HSE staff don't feel empowered (or inclined) to challenge the status quo.. They will complain, they will blame other departments, they will shrug their shoulders, they will apologise.. but never once did I see anyone actually try and fix the problem..

How exactly would you know? I'm in meetings all the time fighting with upper management on how we could do things differently. As I've said here before the only game in town is cutting staff regardless of the impact. our workload has increased dramatically, we cant get people into nursing homes, no funding, more special obs, if they employed the student nurses they have been paying to train over the last four years, we could cut overtime to nothing

Lawrence1895

Qualitymark wrote: »

I have been told by young medics that the computer system used in the hospitals is antedeluvian and mostly sheets of paper are still the technology of choice. Can anyone comment?

Old fashioned computer systems, not up-to-date, slow, insufficient, inadequate...

Qualitymark

Lars1916 wrote: »

Old fashioned computer systems, not up-to-date, slow, insufficient, inadequate...

How old-fashioned? Windows 3.1? DOS?

Welease

tinner777 wrote: »

How exactly would you know? I'm in meetings all the time fighting with upper management on how we could do things differently. As I've said here before the only game in town is cutting staff regardless of the impact. our workload has increased dramatically, we cant get people into nursing homes, no funding, more special obs, if they employed the student nurses they have been paying to train over the last four years, we could cut overtime to nothing

Because for various medical reason (many listed previously in this thread) and knowing HSE folks.. the same issues continue to exist over years, and very little has changed in regard to those specific issues.

I'm not talking about cutting staff, I'm (and have been) talking about removing process that exists for the sake of process which forces the HSE to undertake tasks that have little or no value. Something that (I'll have to check his name again) McGrath the previous HR manager of the HSE complained about.. process which delays the delivery of services..

As an example, I recently spent 10 days in Beaumont (and 6 days in Naas) under no medication, no treatment (until the last 2 days when I was operated on) and by agreement was allowed to leave at 9am each morning once I returned by 8:30 each evening. I was in because I have a brain tumor.. I was not operated on because the services needed (MRI scan etc. for needle control) were unavailable to me at the time.. So why have me there? If I am able to come and go as I please (and I had already spent time at home between Naas and Beaumont) then I don't need to be in hospital (like many other folks there) until the services are available.. I needed to be there because the process said i had to be there.. so i came and went as I pleased for days (as did many others).. Each day I refused to fill in the food request, and each day the canteen lady filled it out because she had to deliver the food, then she put in directly into the bin an hour later.. Each time I asked why we were wasting money, i got the apologies, shrug of shoulders etc..
It was a waste of money me being there.. and it was a waste of nurses time (who were running flat out trying to keep up with the demands)

And when I am back in a few weeks.. it will be exactly the same..

We wouldnt need so much overtime or staff if we didnt fill beds for the sake of it.. If you can't get person for A to X in a timely manner with services (where applicable) then fix the process so they are in and out in a more timely manner.. Adding more staff isn't a reasonable solution.

Or we can look at the nappy situation for my son.. etc etc etc..

I am not having a go at Nurses they worked their asses off.. but the process behind the system was rediculous.. and nothing has changed.
...............................................................

Or I could flip your question back to you and say.. Ok so you had all those meetings... So whats changed???? (I'm guessing very little otherwise you wouldnt be complaining)..

Lawrence1895

Qualitymark wrote: »

How old-fashioned? Windows 3.1? DOS?

Don't know, I never worked in a hospital, am working in the community. But the term 'ante deluvian' refers to something, which is pretty out of date.

tinner777

yes i get your point little has changed but its not through the lack of trying, i was pointing out your lack of inclination for us to get things to change, i cant comment for medical/surgical wards, in my place we fought for five years to get appropriate training for dealing with violence and aggression, training that would keep the both the patient and staff safe, we finally got this last year after years of complaining in meetings, so now less restraining and less people hurt.
I must say i'm surprised at the food problem, we get called ever night about our menu, if we send a load of food back, i get moaned at, rightly so, by the catering manager.

I hate going back to the ward after meetings, anger, frustration and disappointment, are not the best emotions to be carrying around you for hours at work.

Welease

tinner777 wrote: »

yes i get your point little has changed but its not through the lack of trying, i was pointing out your lack of inclination for us to get things to change, i cant comment for medical/surgical wards, in my place we fought for five years to get appropriate training for dealing with violence and aggression, training that would keep the both the patient and staff safe, we finally got this last year after years of complaining in meetings, so now less restraining and less people hurt.
I must say i'm surprised at the food problem, we get called ever night about our menu, if we send a load of food back, i get moaned at, rightly so, by the catering manager.

I hate going back to the ward after meetings, anger, frustration and disappointment, are not the best emotions to be carrying around you for hours at work.

I can understand your frustration.. But you have to (as I'm sure you do) understand the frustration of a taxpayer who has to deal with the utter waste of time (and money) to interact with the service, then has to deal with other services being cut for lack of funding...

The issues of waste are well understood within the HSE, and I'm sure you could details 100's more than I could.. Yet we don't see anything done..
I have not seen any union propose a walkout unless changes are made, I have not seen HSE protests against the waste or unproductive process, and I have seen very little change..
As per my original point, when are the HSE staff going to stand up and deliver these changes? Even if just to prevent further paycuts to themselves.

It would have been great if they had been done because they were the right thing to do.. but that wasn't done.. We are now even cutting services to desperately needy folks (disabled, mental health, elderly) and still the waste continues.. It's hard to feel sympathy (and I mean this with the upmost respect) when the only complaints we hear from the HSE Staff and Unions are about themselves and their benefits.....

tinner777

I'm paying taxes too mate and i have to use the same service you do. I'm also a member of the hse, as i say just because them clowns in the unions are not in the papers shouting about the changes we are trying to make dont think there not happening. Do you really think i want to run my ward on overtime? Different staff every day, every one pissed off cause they cant any time off. I suppose you know that the hse is being broken up again, so what we do locally isn't big news but don't think that we're not trying to get things to run better.
I suppose i only post here to vent my frustrations, if i didn't care i wouldn't be so frustrated with it all, and there's a load more just like me.

Welease

tinner777 wrote: »

I'm paying taxes too mate and i have to use the same service you do. .

I know and I (as per my upmost respect comment) know you are frustrated..

tinner777 wrote: »

I'm also a member of the hse, as i say just because them clowns in the unions are not in the papers shouting about the changes we are trying to make dont think there not happening. .

They have managed to prevent most things to don't want to happen from happening (via bargaining etc.).. Why haven't they managed to get the positive things you do want to happen (process change for better services, cost savings etc.) happen?

tinner777 wrote: »

Do you really think i want to run my ward on overtime? Different staff every day, every one pissed off cause they cant any time off. I suppose you know that the hse is being broken up again, so what we do locally isn't big news but don't think that we're not trying to get things to run better..

But again, who is stopping this change (where it saves time and money)??
I haven't seen the government or non HSE folks stopping it.. It is the HSE itself which appears to be stopping it...

99% of the time the answer is "the management".. yet if any attempt was made to remove "the management" each and everyone union (containing all members of the HSE) would likely walk out in support of "the management".. So it is everyone in the HSE (to various degrees) which have to shoulder the blame (or be praised if they fix the issues).

tinner777 wrote: »

I suppose i only post here to vent my frustrations, if i didn't care i wouldn't be so frustrated with it all, and there's a load more just like me.

I understand, and appreciate your position.. But the point (which I'm not making clear I suppose.. apologies) is that its the HSE which is deciding not to change (or change slowly).. not anyone else.. It is the HSE which has implemented rediculous costly process, and it is the HSE which is slow/refusing/not committed to solving the problem.. True it's not everyone in the HSE.. but the problem (and solution) lies apparently completely within the remit of the HSE, and therefore the HSE needs to shoulder the blame for the issues (and fix them)..

It doesn't make it easy for those who have to work there, but its a damn sight more uncomfortable for those whose vital services are being cut so we can continue to deliver food directly to the bins..

(and again, while posting directly at you I understand and do have sympathy for your individual plight and efforts..I just refuse to agree that anyone in the HSE is blameless for this mess.. even if merely for being a member of the unions who have and continue to cause such havoc and waste)

mollymosfet

Welease wrote: »

I think it's somewhat shortsighted to throw out complaints about bond holders elsewhere when "we" ourselves choose to offer jobs for life within the HSE, have unnecessary multiples of admin staff, waste money left right and centre, allow the consultants to keep beds full unnecessarily over the weekends, and run one of the most inefficient organisations I have ever had the misery to deal with.... The bulk of the problems within the HSE could and should be sorted out by the HSE, Unions and staff members.

My current experience (brain tumor) has been similar to your wife's.. so I do sympathise, but I believe the blame for issues within the HSE lies fairly and squarely within Ireland and more specifically the HSE members itself.

Look, the HSE is a shambles but you can't say that cutbacks aren't the ultimate cause of a situation like this. You can't take more money out of an already poorly performing service and not end up with dead people. Saying the bondholders had "Nothing" to do with this is ludicrous when we have been directing insane amounts of money to them that could be used to keep hospitals open.

Welease

mollymosfet wrote: »

Look, the HSE is a shambles but you can't say that cutbacks aren't the ultimate cause of a situation like this. You can't take more money out of an already poorly performing service and not end up with dead people. Saying the bondholders had "Nothing" to do with this is ludicrous when we have been directing insane amounts of money to them that could be used to keep hospitals open.

I don't see the point in going through the whole thread again, with the same points being made again..

Cutbacks are not the cause of the issues, they are the chosen solution to the issues.

The HSE has been adequately funded and it's funding had been increased drastically in the boom years.. However, a considerable % of that funding is consumed via poor practice and waste. Many of those financial sinkholes remain open today as detailed in many posts here. If they were remedied then the funding could be diverted to reinstate those closed services. That solution is still available and viable, but in many cases not the chosen solution..

It has little to do with bondholders...

ardmacha

The PS may have an unsually high number of "managers". But most people have no ability to address these issues, but they know they are there and know that much can be saved this way. This is why the minister's ranting about pay is always going to cause problems as nobody will accept that their pay should be further cut before this waste is addressed, especially when the minister does nothing about it.

I fail to see why O'Reilly and his colleagues do not try and bypass this. A super suggestion box if you like, but a process where anyone can identify savings and the minister agrees to make sure that any practical ones are followed through. This was Welease can say stop delivering single nappy samples by courier and the something has to be done about it. Put reasonable ideas on a public website and pressure comes on whether it is management or unions or even suppliers that are dragging their feet. I would have done this on the first day in office when people were positive about change.

Chris_5339762

The PS may have an unsually high number of "managers". But most people have no ability to address these issues, but they know they are there and know that much can be saved this way.

This is critical. Everyone in the PS knows of this, but barely anyone can do anything about it. They almost need to audit what EVERYONE in the PS does, so they can target those lacking areas properly.

ART6

I read today that minister Reilly is again blustering about consultant's pay, and he might have a case although he won't do a damned thing about it finally. However, it occurs to me that consultants actually cure people, and so I am tempted to ask the question "What do you do Dr. Reilly to justify your large salary, pension, and expenses? (other, of course, from wreaking havoc in an already dysfunctional health service)."

Your job is strategic planning rather than issuing soundbites in the hope that someone might believe them. Strategic planning involved keeping the mouth shut unless a foot enters by mistake, and then getting the job done. Have you done that? NO! I see your grizzly face in the papers almost every day, and what do you appear to bring to the resolution of HSE problems? A few more soundbites. "That will do it lads! Let's close a few dozen more hospital beds or even a few hospitals. Some people will die? Well, it's all the fault of them bloody consultants, isn't it?. Have to travel 50 miles in an ambulance to a breast cancer clinic? Ah! but we have saved the cost of a radiotherapist in your local hospital and we have given you a centre of excellence even if you die before you get there!"

The first responsibility of any government is the health and welfare of it's citizens, and in this I claim the the current government has failed.

syklops

ART6 wrote: »

I read today that minister Reilly is again blustering about consultant's pay, and he might have a case although he won't do a damned thing about it finally. However, it occurs to me that consultants actually cure people, and so I am tempted to ask the question "What do you do Dr. Reilly to justify your large salary, pension, and expenses? (other, of course, from wreaking havoc in an already dysfunctional health service)."

Your job is strategic planning rather than issuing soundbites in the hope that someone might believe them. Strategic planning involved keeping the mouth shut unless a foot enters by mistake, and then getting the job done. Have you done that? NO! I see your grizzly face in the papers almost every day, and what do you appear to bring to the resolution of HSE problems? A few more soundbites. "That will do it lads! Let's close a few dozen more hospital beds or even a few hospitals. Some people will die? Well, it's all the fault of them bloody consultants, isn't it?. Have to travel 50 miles in an ambulance to a breast cancer clinic? Ah! but we have saved the cost of a radiotherapist in your local hospital and we have given you a centre of excellence even if you die before you get there!"

The first responsibility of any government is the health and welfare of it's citizens, and in this I claim the the current government has failed.

I was putting together an intelligent reply to this post despite how angry it made me, but in the end I didn't bother. This thread is 16 pages long, most of which is people lambasting the Government for not doing anything practical in terms of the HSE. Dr James O'Reilly then tries to do something practical and he gets lambasted again. He can't win. Lazy f**king attitudes like the above don't help things.

However, it occurs to me that consultants actually cure people, and so I am tempted to ask the question "What do you do Dr. Reilly to justify your large salary, pension, and expenses?

Dr james O'Reilly is a Doctor of Medicine, not skullduggery, and therefore used to cure people in the past. He gave that up to try and fix the system. He could very easily be on the other side of the fence earning a lot more money as a consultant himself but he chooses to do this instead.

Do you know how much hospital consultants earn, and do you know what the Minister earns? I don't think you do, and until you do there is no point in arguing with you.

christmas2012

The hospitals seem to have a problem with being top heavy at consultant and management side,to put it lightly theres too many cheifs and not enough indians,ie nurses..

ardmacha

The hospitals seem to have a problem with being top heavy at consultant and management side,to put it lightly theres too many cheifs and not enough indians,ie nurses..

They may be top heavy on the management side. But there are far too few consultants.

The Irish PS is characterised by the much higher ratio of managers than other places, but a much lower ratio of specialists be they consultants, professors, economists, programmers or social workers.

ART6

syklops wrote: »

I was putting together an intelligent reply to this post despite how angry it made me, but in the end I didn't bother. This thread is 16 pages long, most of which is people lambasting the Government for not doing anything practical in terms of the HSE. Dr James O'Reilly then tries to do something practical and he gets lambasted again. He can't win. Lazy f**king attitudes like the above don't help things.



Dr james O'Reilly is a Doctor of Medicine, not skullduggery, and therefore used to cure people in the past. He gave that up to try and fix the system. He could very easily be on the other side of the fence earning a lot more money as a consultant himself but he chooses to do this instead.

Do you know how much hospital consultants earn, and do you know what the Minister earns? I don't think you do, and until you do there is no point in arguing with you.

I am fully aware of Dr. Reilly's qualifications, and I would never question his abilities in that respect since I am not qualified to question. I also have an idea of what consultants earn since I have the ability to read media reports. Equally, I would not question Dr. Reilly's motives for entering politics. I simply question (as every citizen has the right to do) how successful he has been in that role that is one of management rather than medicine. I lean towards the opinion that there has been a lot of bluster but not much action other than closing facilities, which is pretty standard with the present government.

I am also aware that consultants (of which we seem to have too few) can command a salary of up to €200k, and beyond in a few cases. I simply compare that with the salary, expenses, and pension entitlements that can be availed of by a minister who will never have any human lives on his conscience.

When Dr. Reilly was appointed I thought "Thank God! Now maybe we have someone who understands the health service." I missed the point that someone who had spent his years as a GP would not necessarily have any better idea of the operation of the HSE that I, as a marine engineer, would have of how to service a Boeing 707. So Dr. Reilly is a manager, not a specialist, and it is upon that that he should be judged. That should apply to all politicians and civil servants in government, so I am not singling him out from the rest.

If these sort of comment offend or anger you, then I regret that since my purpose was simply to express an opinion, however unjustified. However, as a taxpayer I reserve the right to call the government to account, including individual ministers. If I feel that they are not doing their job in the interests of the people who elected them, then I reserve the right to protest. And not just on Boards.ie

Dozen Wicked Words

The HSE needs to look at the number of "nurses" that no longer actually do any nursing. Even now, week in, week out, in my local hospital, staff who were ward based, wearing a uniform, are now in suits etc, walking round with audits, trialling new forms or introducing other various bits of paperwork for staff to complete thats only function appears to be to reduce the hospitals liability if they are sued.


At least half the wards now have no permanent senior ward sister/charge nurse as they have gone to a mysterious office somewhere in the hospital and only get seen in the canteen. One small example, 4 or 5 years ago the clinical directorates functioned well with 2 managers, now, after a raft of bed and ward closures within the last year, they apparently need 3 managers. (insert some kind of bemused smiley here)

The only positions that look like they are interested in filling is that of the non ward based Clinical Nurse Managers who in reality dont do either of the first 2 words of their job title and the 3rd they do poorly.

OMD

ardmacha wrote: »

They may be top heavy on the management side. But there are far too few consultants.

The Irish PS is characterised by the much higher ratio of managers than other places, but a much lower ratio of specialists be they consultants, professors, economists, programmers or social workers.

I think this is an important point. We have plenty of middle managers. These are the waste of space. It is not the senior managers necessarily.
If you think what are the most important things you need for a hospital then probably the top two would be consultants and hospital beds. Unfortunately it is on these items we fail? Let's cut 10,000 nurses and double the number of consultants. Costs are similar

Welease

OMD wrote: »

I think this is an important point. We have plenty of middle managers. These are the waste of space. It is not the senior managers necessarily.
If you think what are the most important things you need for a hospital then probably the top two would be consultants and hospital beds. Unfortunately it is on these items we fail? Let's cut 10,000 nurses and double the number of consultants. Costs are similar

One very important addition.. there needs to be far more synergy between the required resources and utilisation of beds.. The bulk of my recent stays in hospital have been waiting for days on end for services such as MRI scans etc to become available.. If you cant operate on me until next Friday (and in fact are willing to let me leave daily on my own once i am back by 8:30 pm) then don't have me sitting in a bed for 8 days previously.. Its a colossal waste of time and money..
This is something those middle managers should be controlling, but their control seems limited to their own specific department not cross department which is what the most efficient control of resources will require.