What is the actual problem holding back our health service?

seamus

djpbarry wrote: »

Waiting times are definitely a problem, but the quality of treatment available is very good.

Fair point, but would you not agree that all the world class treatment and high tech facilities in the world are completely useless if nobody can access them?
Surely it would be better to treat everyone immediately using 1990s technology than leave people languishing for months on waiting lists for top-notch treatment?

mountai

Yes djpbarry , I AM in favor of bringing PS salaries in line with EU averages.Why should WE, the general public be burdened with costs associated with the corrupt actions of previous administrations??.Our political masters pay themselves far higher salaries than their EU counterparts. Are YOU in favor of paying former Ministers pensions ,excess of 150K for 4 years work??. Should Ray Burke (a convicted corrupt criminal) still be in reciept of 120K PA. As for my own situation --- My income has been slashed by 48% in recent times , I pay 35k in tax and levies but I dont complain. Its time for change and the present Government are unwilling to grasp the nettle and do some REAL reforms , starting with themselves.

Irish Steve

Too many administrators and bean counters doing things like sort out billing to private health companies

Too many beancounters making sure their little tiny piece of the puzzle is cost effective, regardless of the bigger picture that may be badly affected by the changes

Too many people that never should have got into the administrative area in the first place,

"Civil service" mentality, no motivation to make change or perform better, and yes I HAVE seen this in both State and Semi State bodies when working as a contractor.

"Civil service" timekeeping, where things like tea and coffee breaks take on gargantuan proportions (not on the nursing side, but certainly in many areas.

35 hour week, so 5 x 7 hours that are covered, there's 168 hours in a week, so huge chunks that are not covered.

Lack of properly integrated and effective IT systems for Doctors, and hospitals, and other services

Out of date and inappropriate methods of managing appointments and referrals,

No web access for patients to check on their appointments and other matters.

Too many automated voice mail systems that do nothing to improve the service, and duplicate (or more) the work to do a job,

Lack of flexibility in work practices and related areas.

Lack of facilities for respite or low level nursing homes, leading to bed blocking.

Inefficient discharge system leading to delays in discharge.

Lack of clear management structures due to history of public/private/religious structures and control.

Inflexible admission systems that force people to go through A & E for everything.

Inappropiate working requirements and payment to consultants, and even more so to higher management grades.

Lack of a long term plan and direction, due to weak and ineffective politicians at all levels, local and national, having too much influence and control over policy and direction.

Poor cost control and purchasing management, too many small local units with duplication of admin functions.

Poor utilisation of expensive specialist equipment.

Out of date, expensive to run and inappropriate buildings that are no longer fit for purpose.

Too many outdated and inappropriate "religious ethos" issues that hamper timely and appropriate treatment.




I'm sure that not all points apply to all locations, but I will put money on it that all of the above, to a greater or lesser extent are issues that many hospitals and other medical establishments are facing.

How many of the above get fixed is another story, as it will require real determination and commitment across the board from many interested parties to make it happen.

I would be much happier to see "private" medical care happening in private hospitals, but that will mean a significant change to the existing system. For many years, certain income groups had no choice other than to be in VHI. Now, it would be far better if the VHI system was not needed as such, and the money that is at present put into the Public system by VHI became a part of taxation, with the VHI levels of service being provided in the Public system.

Exactly how that happens is not something I can decide, its going to take some real effort by all involved to turn it round.

It needs to happen,

mountai

WELL SAID THAT MAN

djpbarry

BlaasForRafa wrote: »

Why should Irish consultants be paid more than those in the UK, Germany or France?

Why should Irish people be paid more than those in the UK, Germany or France?

BlaasForRafa wrote: »

Are they qualitatively so much better than consultants in those countries? (whose health services strangely seem to work much better than ours)

News to me. The NHS is certainly no better than the HSE. If you've been watching the British news lately, you'll be aware that there is scarcely anyone who would disagree that the NHS is in dire need of reform - it is not at all fit for purpose.

djpbarry

Deise Vu wrote: »

They took a swab from his throat and stuck it into a machine they had in the room. Within a minute, I would say, they got a printout and the paediatrician said it was strep throat, which the lad is prone to but we hadn't mentioned.

They performed a rapid strep test - it's a very common procedure. But, it takes 10-15 minutes to perform properly and the only way to confirm a strep infection beyond doubt is to do a throat culture, which takes at least 24 hours. Sounds to me like your doctor was trying to get rid of you and gave you a hasty diagnosis, which may or may not have been correct.

But anyway, I'm not really sure what your point is - this is a common diagnostic test that many GPs will have access to.

djpbarry

seamus wrote: »

Surely it would be better to treat everyone immediately using 1990s technology than leave people languishing for months on waiting lists for top-notch treatment?

I disagree actually. I think it is of the utmost importance that treatment levels are maintained - 20 years is a long time in medicine.

djpbarry

mountai wrote: »

Yes djpbarry , I AM in favor of bringing PS salaries in line with EU averages.

Why are you singling out PS workers? From where I'm standing, the average worker in Ireland is extremely well paid and pays relatively little tax.

Deise Vu

djpbarry wrote: »

They performed a rapid strep test - it's a very common procedure. But, it takes 10-15 minutes to perform properly and the only way to confirm a strep infection beyond doubt is to do a throat culture, which takes at least 24 hours. Sounds to me like your doctor was trying to get rid of you and gave you a hasty diagnosis, which may or may not have been correct.

But anyway, I'm not really sure what your point is - this is a common diagnostic test that many GPs will have access to.

you claimed the Irish Health ervice was decent. I detailed a personal experience of A&E in the land of the Mafia and Bunga Bunga. The experience was way more professional (we saw a paediatrician) speedy (paediatrician within 15 minutes, immediate strep test, blood test within an hour) flexible (this was on a weekend) and pure bloody relaxing - no queues and we were given a room when we were wating for the bloods.

In contrast A&E is the HSE's cash cow. Everyone knows that if the chaos of Irish A&E was ever sorted the health service would move out of the list of govt priorities and the Govt would stop throwing money at the problem whenever they have it.

djpbarry

Deise Vu wrote: »

you claimed the Irish Health ervice was decent. I detailed a personal experience...

Which proves precisely nothing. I mean, I could detail a personal experience I've had in the UK with the NHS (which was generally positive), but I could also tell you that my chances of seeing a GP at short notice are precisely zero. In contrast, getting a GP appointment in Ireland within 24 hours was rarely a problem.

Deise Vu

djpbarry wrote: »

Which proves precisely nothing. I mean, I could detail a personal experience I've had in the UK with the NHS (which was generally positive), but I could also tell you that my chances of seeing a GP at short notice are precisely zero. In contrast, getting a GP appointment in Ireland within 24 hours was rarely a problem.

I think you will find when people talk about the Health Service they are referring to hospitals and any other services under the direct umbrella of the HSE. GPs are obviously a critical part of the system but they are all private practices working for cash or medical card payments.

I agree the UK GP system is a joke. Quick access to primary care should be an essential part of any health system and in that regard, the irish system is way better than the NHS (cost is another days discussion of course).

mikehammer67

there's an awful lot of hassle for parents when kids get minor injuries
-gp visit and then invariably waiting at A&E, precautionary x-rays,return visits

for minor stuff all the time

i'll say something for consultants

when you finally get to meet them they do their job and make a decision!