challenging time for Hospitals

Hans Bricks

Boggy Turf wrote: »

Having worked with the HSE, you would not believe the level of waste and bureaucracy within the "organisation". The levels of zero value add middle management boggles the mind. The unions block any reform but the only solution is widespread redundancies for excessive back office staff and rebuild the system from scratch. There are also many vested interests with political connections e.g I saw tens of millions wasted on renting portacabins at exorbitant prices where they could have built extensions or new buildings for fractions of the cost. It wont happen.

+1. I worked in one of Dublin's major hospitals up until recently. You would not effing believe the wages that all the PAs were on. Glorified e-mail correspondents. Not to mention an overly bloated HR department where everyone is on grade V 42k salaries at minimum.

I had to leave for the private sector just out of shame. Even the department I worked in had over paid wages given some of the job titles.

foggy_lad

Tom Mann Centuria wrote: »

If you become a manager in the NHS, that is no longer clinical, with zero patient care, you are a manager. If you do the same in Ireland you are still a nurse, and counted as such. This not only scews nursing numbers, but also average wage stats for nurses.



On the wider subject, flu this year is rampant in Irish hospitals putting enormous strain on the already struggling health service.

Maybe the minister should be looking at this then instead of telling lies and fairy stories about how this year is worse than any other year for flu and other illnesses.

Really what is needed by the government(all governments) is to spend a proper amount on mental health and addiction services but there is no votes in spending money on lunatics and junkies.

A proper Drunk tank system should be set up in those hospitals experiencing issues with drunks and junkies where people are confined in a seperate area on a matterss with a security guard and can be physically restrained if required using the mental health legislation.

On a different note, years ago our GP would put in a few stitches if you needed them or relocate a finger or thumb if required but there is no way any GP will ever do that sort of work today particularly with Medical card patients! AMybe their insurance forbids it but these days they prescribe less potent medicines and refer most minor issues which they once dealt with to A&E

Graces7

LexieOnRale wrote: »

If I need to attend a+e, i always try go to GP (50 euro) or out of hrs dr (60 euro) as if I have a letter from them, I don't need to pay 100 euro. If i go straight to a+e without a letter, it's 100 euro unless I'm admitted, then you're just charged per night.

It's no secret the service is completely abused by people attending with conditions more suited to their own GP or out of hrs doctor. If people had to weigh up the costs between Drs and casualty then I'm pretty sure we'd see a reduction. If a person (medical card or not) attends a+e but doesn't meet the criteria, they should be subject to the full price.

Who is going to assess and judge , please? I chatted with several there who had been sent by their GP, one old man who had been told A and E would be quiet as it was the holidays!

I am not going to accuse anyone..... BUT this year not being able to even get a phone call through to Southdoc for 3-5 hours? Let alone see a doctor.

If you are in pain?

And suppose you send someone away and it emerges they are really ill and die?

It is a minefield and not cut and dried.

Graces7

Mehapoy wrote: »

The solution to this is surely staring everyone in the face then, get a GP service into each hospital to look after these cases, coughs, flus etc. do a triage and if you're condition isn't bone breakage, heart problems etc. see the GP get your persription and go home... or is it truly that the problem is more acute than this and not as easily answered?

WOndering what the GPs would think of that ? No reason why on of the drs on duty could not do that though,

What works in some places is the smaller Local Injuries Unit that is within existing faciliites,open most of the day and deals with cuts and broken bones etc with very little waiting time.

Graces7

foggy_lad wrote: »

Maybe the minister should be looking at this then instead of telling lies and fairy stories about how this year is worse than any other year for flu and other illnesses.

Really what is needed by the government(all governments) is to spend a proper amount on mental health and addiction services but there is no votes in spending money on lunatics and junkies.

A proper Drunk tank system should be set up in those hospitals experiencing issues with drunks and junkies where people are confined in a seperate area on a matterss with a security guard and can be physically restrained if required using the mental health legislation.

On a different note, years ago our GP would put in a few stitches if you needed them or relocate a finger or thumb if required but there is no way any GP will ever do that sort of work today particularly with Medical card patients! AMybe their insurance forbids it but these days they prescribe less potent medicines and refer most minor issues which they once dealt with to A&E

This..

freedominacup

foggy_lad wrote: »

On a different note, years ago our GP would put in a few stitches if you needed them or relocate a finger or thumb if required but there is no way any GP will ever do that sort of work today particularly with Medical card patients! AMybe their insurance forbids it but these days they prescribe less potent medicines and refer most minor issues which they once dealt with to A&E

When did gps stop doing this? As late as a couple of years ago our physio would never bring someone requiring stitches to a and e. Straight to caredoc, job done.

Wanderer78

More austerity! Too many people on this planet!

snowbabe

beggars_bush wrote: »

There are around 1000 private nursing home beds that could be used to move along patients ready to leave hospital but not able to go home yet

That wasn't my experience when my mum was in hospital. She ended up staying in hospital 3 months,we were offered after she was apparently ready to be discharged a bed in a nursing home miles from where my dad lives with no chance of himbgetting there,we refused that and suddenly a home a bit closer became available. There are not thousands available to hospitals.The whole system is broken,it cost the HSE 1,400 a week for my mums 3 week stay in a nursing home. The reason she took up a bed for so long was because we were waiting to be granted care hours..She was unable to come home without care hours in place. Iwrote to the health minister and explained that 4.200 would pay for alot of care hours.I have to say he did help out and got things rushed through,a letter was sent from his office and it got sorted pretty quick. Unfortunately ,this is an everyday occurance up on the wards,people waiting weeks for nursing home beds to become available,when people are downstairs on trolleys. The whole system is broken,but I have faith that Harris will do something with the poison chalice he's been given

Boggy Turf

snowbabe wrote: »

The whole system is broken,but I have faith that Harris will do something with the poison chalice he's been given

I doubt it very much. It needs a stronger character than Harris and full backing from the Dáil and a willingness to take on the unions. Leo is capable but made zero progress. Enda will not rock the boat, has always feared the unions and has never shown any strategic vision.

rainbow kirby

My mum was 48 hours on a trolley in Tallaght after she had a stroke 11 months ago. A fcuking stroke and it took that long to get a bed. Absolutely ridiculous stuff.

People give out yards about the NHS and how overstretched it is but they do a much better job than the Irish health service.

Boggy Turf

Hans Bricks wrote: »

+1. I worked in one of Dublin's major hospitals up until recently. You would not effing believe the wages that all the PAs were on. Glorified e-mail correspondents. Not to mention an overly bloated HR department where everyone is on grade V 42k salaries at minimum.

I had to leave for the private sector just out of shame. Even the department I worked in had over paid wages given some of the job titles.

Yep it's the elephant in the room alright but politicians rarely mention it. The unions are super strong amongst these back office groups too, probably because they know they are getting away with murder and instantly shut down any criticism or reform attempts.

The back office senior managers are the worst though, they swan around with major notions and actually do/achieve very very very little (apart from keeping golf courses busy midweek)

snowbabe

Boggy Turf wrote: »

I doubt it very much. It needs a stronger character than Harris and full backing from the Dáil and a willingness to take on the unions. Leo is capable but made zero progress. Enda will not rock the boat, has always feared the unions and has never shown

Agree ,but I still hope he will do something,unfortunately,system broken for years so wont be easy to remedy at all.

jackofalltrades

Watched the RTE News one day, where they got a consultant on to give his thoughts on the Health Service.
He flat out said that more money wouldn't solve the problem.
He then when on to say what's needed is reform in working practices.

Are the public really ready to support a government reforming the health services and accept a serious amount of industrial unrest as a result?
I think the answer is no, and while it is nothing is ever going to change.

The last time I was in hospital I remember seeing loads of people barely hanging on lying in trollies.

It was depressing stuff. I don't know how doctors and nurses don't jump out the window

givyjoe

jackofalltrades wrote: »

Watched the RTE News one day, where they got a consultant on to give his thoughts on the Health Service.
He flat out said that more money wouldn't solve the problem.
He then when on to say what's needed is reform in working practices.

Are the public really ready to support a government reforming the health services and accept a serious amount of industrial unrest as a result?
I think the answer is no, and while it is nothing is ever going to change.

Public support for reform really doesn't matter, whatsoever. It's support, or rather acceptance from Health Workers that work practices need to be changed and that it isn't going to be a case of "we'll change, but pay us more for it".

Kimbot

In fairness I heard on one news report today that the government are been called upon to make more money available to hire more nurses. This will not solve the crisis because the health service is overstaffed and anytime I have been in a hospital in the past 4-5 years the waiting is generally down to lack of Drs not nurses as theres plenty of nurses about and even sitting down having a gossip etc.

Parchment

jonnycivic wrote: »

In fairness I heard on one news report today that the government are been called upon to make more money available to hire more nurses. This will not solve the crisis because the health service is overstaffed and anytime I have been in a hospital in the past 4-5 years the waiting is generally down to lack of Drs not nurses as theres plenty of nurses about and even sitting down having a gossip etc.

Have to disagree - i worked for 3 years in one of the busiest A&E departments in country. The days were a blur as we were all so busy.

Tom Mann Centuria

jonnycivic wrote: »

In fairness I heard on one news report today that the government are been called upon to make more money available to hire more nurses. This will not solve the crisis because the health service is overstaffed and anytime I have been in a hospital in the past 4-5 years the waiting is generally down to lack of Drs not nurses as theres plenty of nurses about and even sitting down having a gossip etc.

They can't recruit nurses, they've tried, and failed.

If you're waiting for a Dr, guess what, so is the nurse. Sitting down? Whatever next.

westcoast66

I just don't understand why they cant train more doctors. Ever heard of an unemployed doctor? Its probably the one course where there is 100% employment prospects.

Venom

Tom Mann Centuria wrote: »

They can't recruit nurses, they've tried, and failed.

If you're waiting for a Dr, guess what, so is the nurse. Sitting down? Whatever next.

The problem is whats offered to nurses over here is a joke compared to what they can get from the UK, US, Australia and Middle East.

d2ww

westcoast66 wrote: »

I just don't understand why they cant train more doctors. Ever heard of an unemployed doctor? Its probably the one course where there is 100% employment prospects.

We do train them... to take their freshly printed qualifications with them on their way to Australia, Dubai etc.

notsoyoungwan

westcoast66 wrote: »

I just don't understand why they cant train more doctors. Ever heard of an unemployed doctor? Its probably the one course where there is 100% employment prospects.

We are training plenty doctors. Then we're exporting them because pay and conditions are better elsewhere- Canada, Australia, New Zealand etc.

TheDoc

LexieOnRale wrote: »

When people can walk into an accident and emergency with an issue that's neither accident nor emergency, it of course compromises the resources for actual accidents and emergencies. When people can avail of this service free of charge there isn't really any deterrents or incentives to use GP or the out of hours care dr.

What I find hilarious is that it's not some new phenomenon.

I remember two visits as a teenager (so talking over 10 years ago) which were emergencies related to football incidents. One was a suspected fractured jaw and the other a suspected fractured ankle.

I was lucky enough that my grandparents lived around the corner from Beuamount, but it was something like 14 hours in A&E for my ankle and 13 hours for my jaw.

It's no recent or new phenomenon, as much as records or numbers might be broken, A&E's have been a state for well over a decade.

TheDoc

jackofalltrades wrote: »

Watched the RTE News one day, where they got a consultant on to give his thoughts on the Health Service.
He flat out said that more money wouldn't solve the problem.
He then when on to say what's needed is reform in working practices.

Are the public really ready to support a government reforming the health services and accept a serious amount of industrial unrest as a result?
I think the answer is no, and while it is nothing is ever going to change.

Remember Stephen Donnelly making points early on in his tenure that he was absolutely astonished at the process improvement strategies within the HSE, and gobsmacked at the reports provided by consultants who were hired to initiate process improvement.

As you say, there is literally no stomach for proper reform in most Public spaces, so until a government is elected with a massive public backing and support to go through them all with a sledgehammer, it will be all band aids and good sound bites with no tangible change

When you look at our political landscape, its purely built for the short term and securing the parties future or the candidates re-election. So no one is ever going to really bother their whole with real change.

Jammyc

Plenty of sides to this but to clarify one thing that's being repeated:

Emergency Departments are not overcrowded, hospitals are overcrowded.
If your house was full of people at home and more people were coming in the door that's open 24/7/365, of course everyone is going to be in the doorway.

More beds and nurses are whats needed but they won't come without better working conditions. Same goes for medical staff, tough to keep doctors in the country when they can receive superior training, better working conditions and better pay abroad. Take examples such as Tallaght who don't pay overtime for Doctors required to work before rostered hours i.e. coming in for a 7am ward round Mon-Fri when your start time is 9am.

oneilla

Graces7 wrote: »

True but not quite the whole story.

I was in A and E over the holidays. The problem believe me was very real and a medical emergency.

Our local after hours service was in the news as being so overloaded they were taking 3-5 hours even to answer the phone. The ambulance paramedics who were stars. said that the GP would just have sent me to A and E anyways . I had tried to access them
And getting a GP appointment? They seem to send so many to A and E who surely could be treated at home.

This is the norm with this out of hours service.

Bu the way, the A and E service is free to medical card holders AND to anyone referred by a GP, which is open to question.

The place was in chaos. Seemed no one in charge. I do not think they are understaffed,, Just disorganised.
Reception staff were rude to the point of abuse

Waited for many hours to be seen and then only as I was in a state of collapse and made waves.

The last time I had been in A an d E was nearly 3 years ago with a smashed wrist and there was no waiting etc. The atmosphere was totally different

One of the main problems now is that folk with flu are going to A and E rather than seeing their GP or coping at home. Place was full of coughing and sneezing and I came home infected.

I wonder why? I would not go near A and E unless there was no other way. I waited 24 hrs with the broken wrist .

The only part of HSE that seems to be working is the ambulances. I know they get criticised but they were stars.

A very salient point. I have gone to GPs many times with an issue and they're often quite content to refer me to A&E. The GPs in my area now only do short hours and one in particular only has a receptionist in the mornings two or three days a week so near impossible to get an appointment in any sort of reasonably speedy fashion.

ChikiChiki

Same problem crops up every year. This story will die off (along with a few patients who couldn't get beds or were turned away) and we will have the same problem next January and the January the following year. Nothing will change as long as these fcuking unions run the show.

Implementation of efficient working practices and reform is what is needed. Too many dead weight layabouts sitting in the back offices of the HSE on high salaries doing next to nothing who will run screaming to the union man once they get a whiff of change.

The HSE needs a huge change programme. It would be costly and take a few years to implement but the medium to long term benefits would be worth it. As it stands it is a out of control monstrosity of an organisation.

suicide_circus

It's not rocket science.

The HSE was created to streamline the health boards. But not a single pencil pusher was made redundant. In fact, the number of senior managers in the HSE now exceeds the numbers before the recession: http://www.irishtimes.com/news/health/hse-senior-staff-numbers-exceed-economic-crash-levels-1.2916739
The unions who piss and moan about conditions in the health service are the same ones who would have gone on all out stike had compulsory redundancies been made.
Minister for Health most be the most poisoned chalice of a job in the country. The HSE is a money blackhole surrounded by vested interests.

Tom Mann Centuria

It's not a winter thing anymore, for the last 2 years there have been beds on corridors on wards more or less all year round, I think I remember about 2 weeks in July where there wasn't a patient on the corridor.

Recovering people after operations on a corridor, this is reality. Drum into older patients to ring the call bell to avoid falls, except on the corridor there are no call bells. Maintaining people's dignity when attending to their personal care except there are no curtains on a corridor and any screen you can get hold of means other beds can't get by on corridors so you can't use them. I can go on if you want, not that I want to.

222233

I think they need to start sending the private patients out to the private hospitals more often. Anytime I have been admitted or sent for a procedure the first option mentioned by the GP is the main public hospital, I would always opt for the private hospital when possible and usually end up there, but it's never brought up to begin with it's always a public hospital.

What I'm saying is that GP's could send people to a lot of places other than public hospitals, the swift care clinics are excellent for MRI's etc.


Also way too many people with many many clipboards in public hospitals, they need to have a look at the private hospitals and see why their system works so well and apply that system to a much more saturated hospital and allocate less funding to stationary..

tayto lover

I went to my doctor for my annual check-up two weeks ago. 50 euro just to see him and 20 euro to get bloods done. I go once a year at his request as my family has a history of stroke illness.
The waiting-room was full of people with sniffles, people waiting on certs etc.
75% of them by my reckoning didn't need to be there and the vast majority had medical cards. I think I was the only one that actually paid in the hour I waited.
If this pattern is continued into the waiting-rooms of hospitals then it's no wonder the entire system is clogged up. A lot of people could recover in their own beds at home especially from colds, flus and minor injuries.

Something needs to be done about medical cards too. Limit the number of visits they cover and we would see an immediate reduction in A&E and doctor's surgeries.

Mouseslayer17

Too many people on medical cards

222233

Mouseslayer17 wrote: »

Too many people on medical cards

I don't necessarily think that would effect the influx of people into hospitals though, if you had a medical card you would be more likely to present at a GP before an illness gets serious enough to require admission, no? Seeing as the visit is free.

Whereas if your paying 50€ and you become sick chances are you might sit out until it gets bad enough to need a GP and maybe hospitalisation

Yourself isit

It doesn't look like the centres of excellence worked.

Icsics

tayto lover wrote: »

I went to my doctor for my annual check-up two weeks ago. 50 euro just to see him and 20 euro to get bloods done. I go once a year at his request as my family has a history of stroke illness.
The waiting-room was full of people with sniffles, people waiting on certs etc.
75% of them by my reckoning didn't need to be there and the vast majority had medical cards. I think I was the only one that actually paid in the hour I waited.
If this pattern is continued into the waiting-rooms of hospitals then it's no wonder the entire system is clogged up. A lot of people could recover in their own beds at home especially from colds, flus and minor injuries.

Something needs to be done about medical cards too. Limit the number of visits they cover and we would see an immediate reduction in A&E and doctor's surgeries.

Exactly, medical card visits should be limited. My dr now charges €60, the sec told me it was to offset the increase in med card holders. During a 2 hr wait last week I didn't see one person pay up, I was the only one. Next stop pharmacy & everyone before me is paying the nominal amt for huge bags of medicine...I paid €30 for my little bag.

naughto

griffin100 wrote: »

Thank god we have Liam Doran and his nurses to rescue us by threatening to go on strike. Imagine how poor the HSE would be if we'd no unions to protect our interests. God bless them all.

I hope you never end up in hospital with these Liam Doran nurses looking after you. Cos if you do I no where the neddle will go with a comment like that.

Wheeliebin30

1 in 2 have medical cards.

****en joke.

steddyeddy

1. Only long term sick should have medical cards.

2. I'm going to sound like a broken record but from my brief time as a lab biochemist in the HSE I can say more money won't fix the problem. You have frontline staff like docs, nurses and various clinical scientists working under the most god awful conditions. On the other hand there were countless civil servants creaming off a substantial wage while doing feck all. Numerous instances of jobs for the boys and family. There was an incident a few years back where all temp clerical positions in regional HSE offices were filled by children of managers. You're paying to keep a lot of unfireable civil servants in the job in terms of tax and quality of service. You need a politician with a spine to deal with this.

Lucyfur

My baby was sent to a+e by an out of hours doc over Christmas. While in the main a+e area I heard a man registering and when asked what his symptoms were he replied "I have a cold this past 4 or 5 days". Seriously. A fcuking cold.

Dyr

Tom Mann Centuria wrote: »

If you become a manager in the NHS, that is no longer clinical, with zero patient care, you are a manager. If you do the same in Ireland you are still a nurse, and counted as such. This not only scews nursing numbers, but also average wage stats for nurses.



On the wider subject, flu this year is rampant in Irish hospitals putting enormous strain on the already struggling health service.

the flu is just harris cover story for the media

f**k all doctors available and f**k all ambulances available.

Dyr

tayto lover wrote: »

The waiting-room was full of people with sniffles, people waiting on certs etc.
75% of them by my reckoning didn't need to be there

why do you go to the GP when you're obviously already a qualified medical practitioner?

tayto lover wrote: »

and the vast majority had medical cards.

Apparently you're also some kind of sherlock holmes type too

tayto lover

Bambi wrote: »

why do you go to the GP when you're obviously already a qualified medical practitioner?



Apparently you're also some kind of sherlock holmes type too

And I can also tell that you have a medical card too

Corruptedmorals

Clerical is a big problem too. Lots and lots of high-up types and managers but the frontline clerical is starved. Staff are stretched and thrown around other departments to cover, long term sick leave is not covered, holidays and regular sick leave throws the whole place upside down. Patients suffer from that too though obviously not as dramatically. Long queues to register because they've no staff, departments closed or on voicemail, huge backlogs of important paperwork such as referrals, results, and always mistakes being made and things falling through the net due to sheer workload and stress. Many hospitals relied on jobsbridge and now that that's ended they'll hire...but at the new lower grade of grade 3. Which starts at the princely sum of 21k and takes years to rise much above it.

Frontline admin come in for dogs abuse from the public too which higher end on 4 times the salary are protected from. A&E receptionists take the brunt but anyone who deals with patients directly gets it daily.

Wheeliebin30

The worst decision this country ever made was not been able to sack people in the public sector unless they murdered a colleague.

Job for life has created a mess right across the public sector.

Dyr

tayto lover wrote: »

And I can also tell that you have a medical card too

Sorry matey, you're wrong yet again, I'm strictly VHI. .

No one in their right mind would rely on the public health service in this country unless they had no choice

steddyeddy

Wheeliebin30 wrote: »

The worst decision this country ever made was not been able to sack people in the public sector unless they murdered a colleague.

Job for life has created a mess right across the public sector.

Job for the kids, job for life and job for friends. Someone needs to go through the civil service with strong laxative.

diomed

I was on a hospital trolley last year for a night. It was great. It was a bed.
It is not like a Tesco trolley.

uck51js9zml2yt

Harris wants to make diagnostics available until 8pm ..Till spring. Do people not need them after 8 and in the summer?
Always amazed me walking through hospitals at night to see all this very expensive equipment sitting idle.

In comparison, I was in the Mater private for heart surgery a year ago. A man came in at 9pm for a scheduled procedure at 11pm.

My 40k bill was justified. Roughly €40 per hour!

wil

Nikolai Fit Rhinestone wrote: »

Harris wants to make diagnostics available until 8pm ..Till spring. Do people not need them after 8 and in the summer?
Always amazed me walking through hospitals at night to see all this very expensive equipment sitting idle.

In comparison, I was in the Mater private for heart surgery a year ago. A man came in at 9pm for a scheduled procedure at 11pm.

My 40k bill was justified. Roughly €40 per hour!

I have asked this same question many times.
Unfortunately there is no private for kids.

My child was in Crumlin for very urgent investigation that then necessitated an MRI. it was a Friday afternoon of a bank holiday weekend and if they hadn't got him in by 4 we would have to wait till the following Tuesday.

We have a health system ruined by pen pushers, accountants and so called experts. They spout figures talk sh te and fix nothing. I've seen third world countries provide better than we have here.

And now we are supposed to swallow crap about old people and flu as the latest reason for more superlatives of the worst kind. How about the self same people blaming themselves for their inability to figure out how far a stretched elastic band can stretch before it snaps. Medical staff are at their limits day in day out, it's no wonder so many have left and it's a struggle to get replacements.
For all people think of the HSE in the UK, and people complain about it all the time, but compared to here its far far better.

It's winter, it's flu season, it's holiday season. Let's have another long heated debate about centres of excellence.:rolleyes:

What our health system needs is more centres of mediocrity, to deal with the every day humdrum nuisances of everyday health issues.

Graces7

tayto lover wrote: »

I went to my doctor for my annual check-up two weeks ago. 50 euro just to see him and 20 euro to get bloods done. I go once a year at his request as my family has a history of stroke illness.
The waiting-room was full of people with sniffles, people waiting on certs etc.
75% of them by my reckoning didn't need to be there and the vast majority had medical cards. I think I was the only one that actually paid in the hour I waited.
If this pattern is continued into the waiting-rooms of hospitals then it's no wonder the entire system is clogged up. A lot of people could recover in their own beds at home especially from colds, flus and minor injuries.

Something needs to be done about medical cards too. Limit the number of visits they cover and we would see an immediate reduction in A&E and doctor's surgeries.

Interesting way to assess. You have no way of knowing.

One thing with a former GP was that she used to try to get me to drive 40 miles just to collect a repeat prescription in bad weather. So there is one answer. My current GP sends simple repeats by post. NB drs do get paid to see medical card patients.
A dr HAS to see a patient to give a certificate also.