Public service pay cut?

AndrewJRenko

Dav010 wrote: »

Then fire the public servants and outsource to private contractors whose contracts depend on performance. Unfortunately we know this will not happen as the unions will strike, so the status quo remains with untouchable dead weights.

Must be great to know that when you outsource to private contractors, you never have any untouchable dead weights or staff slacking off or anything like that.

salonfire

AndrewJRenko wrote: »

Non-HSE hospitals get to cherry pick. They get to pick the nice, clean, simple, routine cases that they know exactly how long will take and how much profit they will make out of it.

That's a great idea!! You're exactly the young innovative go-getter we need in the civil service.

Outsource the routine and lift the burden of these cases from the HSE resulting in a slimmed down hse with fewer admin staff for example. Let the private sector deal with it.

Dav010

AndrewJRenko wrote: »

Non-HSE hospitals get to cherry pick. They get to pick the nice, clean, simple, routine cases that they know exactly how long will take and how much profit they will make out of it. If you don't meet the criteria, like my overweight in-law who's knee replacement at the Beacon was cancelled, they just push you back onto the public health service to pick up the slack.

It's easy to avoid waiting lists when you pick and choose your customers.

BTW, if you talk to the doctors and the unions, they'll tell you that the HSE employees run the hospital. Don't listen to what vested interests on any side tell you.

Why was your overweight in-laws knee replacement cancelled?

salonfire

salonfire wrote: »

That's a great idea!! You're exactly the young innovative go-getter we need in the civil service.

Outsource the routine and lift the burden of these cases from the HSE resulting in a slimmed down hse with fewer admin staff for example. Let the private sector deal with it.

This company will presumable not make a profit and the ceo and owners won't make millions

AndrewJRenko

Dav010 wrote: »

Why was your overweight in-laws knee replacement cancelled?

Because the Beacon decided that they didn't want to take him on, despite it being scheduled for months ahead. Cherry picking.

AndrewJRenko

salonfire wrote: »

That's a great idea!! You're exactly the young innovative go-getter we need in the civil service.

Outsource the routine and lift the burden of these cases from the HSE resulting in a slimmed down hse with fewer admin staff for example. Let the private sector deal with it.

What a brilliant idea

https://www.ntpf.ie/home/home.htm

Dav010

AndrewJRenko wrote: »

Because the Beacon decided that they didn't want to take him on, despite it being scheduled for months ahead. Cherry picking.

Have you considered there was a medical reason that had nothing to do with money? His/her weight perhaps, which can made prosthetic surgery more difficult, affect recovery and prognosis for the prosthesis. Did your in-laws insurer refuse to cover the surgery in a private clinic based on clinical assessment?

Ask yourself, what financial benefit is there for a private hospital to bump a patient back to the public system. Kinda seems counterproductive, wouldn’t you think?

AndrewJRenko

AndrewJRenko wrote: »

Must be great to know that when you outsource to private contractors, you never have any untouchable dead weights or staff slacking off or anything like that.

Have to laugh at the argument that outsourcing is cheaper. The cc where a friend works for as a dog warden outsourced their legal representation in full after the last of their directly employed solicitors retired.

The result is that less fines for stuff like fly tipping, motoring offences, control of dogs act etc are not being brought to court for non payment, because the outsourced solicitors bill per charge brought, eating up the legal budget of various departments, which is resulting in lost revenue.

As an example, they recently fined a farmer under two different parts of the control of dogs act as well as housing fees, where his dog strayed and was impounded after being found on his neighbours land and this time accused of killing sheep belonging to the neighbor.

The farmer is refusing to pay as it's the third time in the last twelve months that they have been fined for their dog straying, not having a license and the cost of housing the dog in the pound while waiting for him to reclaim his dog after being picked up by my friend.

When the cc had their own solicitors, the cost of going to court for such a situation was a nominal flat charge to my friends department regardless of how many charges were being brought. With the outsourced solicitors, the cost per charge is 700 Euro, so a total of 2,100 Euro in fees to fight a case for a total in fines and housing fees of 450 Euro.

Now while 450 Euro might seem like a small amount of revenue to be lost, it's one case of many similar ones where a decision has to be made to decide whether to go to court, hoping that the judge rules in their favor and they get the fines paid, or just write it off because they have bigger cases where they need to spend their legal budget on.

AndrewJRenko

Dav010 wrote: »

Have you considered there was a medical reason that had nothing to do with money? His/her weight perhaps, which can made prosthetic surgery more difficult, affect recovery and prognosis for the prosthesis. Did your in-laws insurer refuse to cover the surgery in a private clinic based on clinical assessment?

Ask yourself, what financial benefit is there for a private hospital to bump a patient back to the public system. Kinda seems counterproductive, wouldn’t you think?

The financial benefit is that they don't get caught with the cost of dealing with complex medical problems due indeed to his weight. So they dump complex, tricky cases back on the public health system while they cover the neat, straightforward, profitable cases.

Cherry picking.

Dav010

AndrewJRenko wrote: »

The financial benefit is that they don't get caught with the cost of dealing with complex medical problems due indeed to his weight. So they dump complex, tricky cases back on the public health system while they cover the neat, straightforward, profitable cases.

Cherry picking.

You understand that private hospitals charge the patient/insurer for dealing with those complex medical problems? If you had ever read a copy of an insurers invoice from a private hospital, you would see that the payment for the bed is the eye watering part, not the procedure. So to say they only pick the simple cases, is a bit daft.

AndrewJRenko

Dav010 wrote: »

You understand that private hospitals charge the patient/insurer for dealing with those complex medical problems? If you had ever read a copy of an insurers invoice from a private hospital, you would see that the payment for the bed is the eye watering part, not the procedure. So to say they only pick the simple cases, is a bit daft.

They're on a fixed price with the insurer for defined procedures like this.

Dav010

AndrewJRenko wrote: »

They're on a fixed price with the insurer for defined procedures like this.

Procedure yes, hospital stay no, if there are costs which the insurer does not/will not cover , the patient pays, nothing is for free.

AndrewJRenko

Dav010 wrote: »

Procedure yes, hospital stay no, if there are costs which the insurer does not/will not cover , the patient pays, nothing is for free.

And this patient probably wouldn't have the resources to cover additional fees - so they drop him like a hot potato.

Cherry picking.

Dav010

AndrewJRenko wrote: »

And this patient probably wouldn't have the resources to cover additional fees - so they drop him like a hot potato.

Cherry picking.

I suspect they are more than happy to provide services to those who can pay associated fees. If that is cherry picking those who pay for private treatment, yes I suppose they do, but most tend to understand that with private hospital procedures, it appears some do not though.

Wanderer78

Dav010 wrote:

I suspect they are more than happy to provide services to those who can pay associated fees. If that is cherry picking those who pay for private treatment, yes I suppose they do, but most tend to understand that with private hospital procedures, it appears some do not though.

The whole private hospital and insurance system is starting to collapse, for various different reasons, we re ending up in a situation whereby many simply cannot get the care they require, our health system is now so bad, we ve effectively had to shut our economy in order to protect it, there's something seriously wrong there!

Dav010

Wanderer78 wrote: »

The whole private hospital and insurance system is starting to collapse, for various different reasons, we re ending up in a situation whereby many simply cannot get the care they require, our health system is now so bad, we ve effectively had to shut our economy in order to protect it, there's something seriously wrong there!

Covid, by chance?

Wanderer78

Dav010 wrote:

Covid, by chance?

Of course covid has stressed all systems to the point of collapse, and we re not the worst off, have a look at what's happening in Brazil and India. But covid has proven our health systems are not fit for purpose, and radical change is required, urgently, post covid, but are we ready to accept that!

Dav010

Wanderer78 wrote: »

Of course covid has stressed all systems to the point of collapse, and we re not the worst off, have a look at what's happening in Brazil and India. But covid has proven our health systems are not fit for purpose, and radical change is required, urgently, post covid, but are we ready to accept that!

Yes, I’ve wondered that myself about the Public Service/Hospitals. Just in case you hadn’t heard why private hospitals are at reduced capacity at the moment.

https://www.thejournal.ie/private-hospitals-beacon-surge-capacity-5329147-Jan2021/

Wanderer78

Dav010 wrote:

Yes, I’ve wondered that myself about the Public Service/Hospitals. Just in case you hadn’t heard why private hospitals are at reduced capacity at the moment.

The whole system is a bust, we just have to face up to this post covid, and that won't be an easy conversation, and I don't think we know what to do next with it, but radical change is required immediately, our whole economy is at risk now

Dav010

Wanderer78 wrote: »

The whole system is a bust, we just have to face up to this post covid, and that won't be an easy conversation, and I don't think we know what to do next with it, but radical change is required immediately, our whole economy is at risk now

At last.

And Public Servants should not be protected from whatever that change entails, including job loses and pay cuts.

Wanderer78

Dav010 wrote:

And Public Servants should not be protected from whatever that change entails, including job loses and pay cuts.

.... And this is where the dumpness starts! Fact check, increase in unemployment in its entirety is bad for an economy! Decrease in income, is bad for an economy, as it decreases the money supply, slowing economic growth! We need to find out where every penny is going in the system, and radically change how its spent. There's clearly far too many high earners in the system, and not enough Indians, I.e. We need to radically change how that money is spent, we probably also need to increase the overall budget. We have done the cutting approach, it has clearly failed, this is in fact the adult conversation we need to have going forward.

Health care staff, particularly front line staff, are more than likely gonna require significant amount of time off post covid, either we give them this time off, or they'll simply take it, via sick leave, we need to prepare for this reality now, and yes, that will be needed to be done with pay, more adult stuff!

Dav010

Wanderer78 wrote: »

.... And this is where the dumpness starts! Fact check, increase in unemployment in its entirety is bad for an economy! Decrease in income, is bad for an economy, as it decreases the money supply, slowing economic growth! We need to find out where every penny is going in the system, and radically change how its spent. There's clearly far too many high earners in the system, and not enough Indians, I.e. We need to radically change how that money is spent, we probably also need to increase the overall budget. We have done the cutting approach, it has clearly failed, this is in fact the adult conversation we need to have going forward.

Health care staff, particularly front line staff, are more than likely gonna require significant amount of time off post covid, either we give them this time off, or they'll simply take it, via sick leave, we need to prepare for this reality now, and yes, that will be needed to be done with pay, more adult stuff!

I had hoped there was a chink of light coming into the discussion, but no, it wasn’t to be.

So “radical change is required” in Public services like health care, as long as it does not include changes to remove staff and reduce pay costs?

Wanderer78

Wanderer78 wrote: »

.... And this is where the dumpness starts! Fact check, increase in unemployment in its entirety is bad for an economy! Decrease in income, is bad for an economy, as it decreases the money supply, slowing economic growth! We need to find out where every penny is going in the system, and radically change how its spent. There's clearly far too many high earners in the system, and not enough Indians, I.e. We need to radically change how that money is spent, we probably also need to increase the overall budget. We have done the cutting approach, it has clearly failed, this is in fact the adult conversation we need to have going forward.

Health care staff, particularly front line staff, are more than likely gonna require significant amount of time off post covid, either we give them this time off, or they'll simply take it, via sick leave, we need to prepare for this reality now, and yes, that will be needed to be done with pay, more adult stuff!

Dav010 wrote: »

I had hoped there was a chink of light coming into the discussion, but no, it wasn’t to be.

So “radical change is required” in Public services like health care, as long as it does not include changes to remove staff and reduce pay costs?

or i should truly say, decreasing the budget of the health system is dangerous for the health system, and the economy in its entirety

Hotblack Desiato

Geuze wrote: »

We know that productivity is higher, and waiting lists shorter, in non-HSE hosps.

Well of course they are. Private hospitals specialise (no A&E, the minor injury clinics are not the same thing at all) and use high fees to regulate demand and make profits.

Something goes wrong during your boob job, you'll wake up (if you wake up) in a public A&E

Dav010 wrote: »

Why was your overweight in-laws knee replacement cancelled?

Obese people have a much greater risk of life-threatening complications with general anaesthesia. So they decided the public system should take the more risky cases.

Wanderer78 wrote: »

But covid has proven our health systems are not fit for purpose

Whether it is or isn't isn't down to Covid. There isn't a health system in the world, public or private, which could withstand Covid being let rip with no business closures or restrictions on gatherings, etc. in place. Nobody would be willing to pay the immense cost of having such massive excess capacity in place which then goes unused until a once in a century global crisis occurs!

Wanderer78

Hotblack Desiato wrote: »

Well of course they are. Private hospitals specialise (no A&E, the minor injury clinics are not the same thing at all) and use high fees to regulate demand and make profits.

Something goes wrong during your boob job, you'll wake up (if you wake up) in a public A&E

Obese people have a much greater risk of life-threatening complications with general anaethesia. So they decided the public system should take the more risky cases.

Whether it is or isn't isn't down to Covid. There isn't a health system in the world, public or private, which could withstand Covid being let rip with no business closures or restrictions on gatherings, etc. in place. Nobody would be willing to pay the immense cost of having such massive excess capacity in place which then goes unused until a once in a century global crisis occurs!

again, more adult talk! theres now sufficient evidence to support, 'the market forces' approach to health care, is a busted flush, this simply doesnt work for such systems, 'global fact'!

yes, covid has indeed exposed every single health care system on the planet, everyone single one struggling with it, but what it has also shown us is that, our health care systems are so exposed, weak, vulnerable, fragile etc etc, in order to protect them, we had to completely shut down our economies, hello, hello!

we also need to get over how all of these things are actually paid for, having such exposed systems, is now exposing our whole economies, do we really wanna play russian roulette with all of this???? we need to accept that in order to get out of all of this vulnerability, we must in fact take on enormous amounts of debt, and more so, public debt, because defaulting to the private sector to do so, will more than likely fail catastrophically, this is all the critical adult conversations we now need to have

more facts:

"People are entitled to ask how Germany has 35 ICU beds per 100,000 people, Austria has 28, yet Ireland has only 5 per 100,000? Taxpayers have a right to know what’s going on within the system."

AndrewJRenko

Dav010 wrote: »

I suspect they are more than happy to provide services to those who can pay associated fees. If that is cherry picking those who pay for private treatment, yes I suppose they do, but most tend to understand that with private hospital procedures, it appears some do not though.

It's not about the cost of a couple of extra bed nights. It's about not having the full range of services available to deal with what happens when complex cases go wrong - full range of ICU and diagnostics, full range of consultants on call 24/7.

I recall during our days in Holles St meeting the very disappointed mums of potentially complex multiple birth cases, who were dumped out of Mt Carmel back onto the public system, because Mt Carmel couldn't meet their needs. Cherry picking.

They cherry-pick the clean, straightforward cases, and leave the complex ones to the public service - so it's not surprising that a superficial analysis may look like they are more efficient, but you're not comparing like with like.

wrangler

Wanderer78 wrote: »

Of course covid has stressed all systems to the point of collapse, and we re not the worst off, have a look at what's happening in Brazil and India. But covid has proven our health systems are not fit for purpose, and radical change is required, urgently, post covid, but are we ready to accept that!

Years of poor management has contributed to all of that, subsidised by our taxes. That can't continue.
All money generated in our economy originates in the private sector.
In case you haven't noticed, this sector isn't entitled to their vaccines yet, they are also worse affected by the lockdown.
So when the day to pay comes, where will the civil service go then to get a payrise and months paid sick leave as referred to here.
Sadly the selfemployed work way longer hours than any frontline or civil servant and will be the first port of call to finance those payrise and paid sick leave.

Wanderer78

wrangler wrote: »

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Years of poor management has contributed to all of that, subsidised by our taxes. That can't continue.
All money generated in our economy originates in the private sector.
In case you haven't noticed, this sector isn't entitled to their vaccines yet, they are also worse affected by the lockdown.
So when the day to pay comes, where will the civil service go then to get a payrise and months paid sick leave as referred to here.
Sadly the selfemployed work way longer hours than any frontline or civil servant and will be the first port of call to finance those payrise and paid sick leave.

the majority of the money supply comes from the private sector, which is a serious problem, its actually causing a serious amount of our problems. we need to move this back towards a more balanced public/private model, but not all of our money supply comes from the private sector, we still regularly borrow from the bond markets, and those debts end up on the public balance sheets. tax payers dont actually pay directly towards public expenditure, we re effectively paying back the debts the state borrows from, thats where the whole misleading begins with balancing budgets comes from, its actually dangerous to do so, we become over reliant on the private sector money supply, i.e. credit.

havent looked at our debt levels lately, but i suspect most could be coming from the public sector, as im sure private borrowing has dropped significantly, could be wrong though

wrangler

Wanderer78 wrote: »

the majority of the money supply comes from the private sector, which is a serious problem, its actually causing a serious amount of our problems. we need to move this back towards a more balanced public/private model, but not all of our money supply comes from the private sector, we still regularly borrow from the bond markets, and those debts end up on the public balance sheets. tax payers dont actually pay directly towards public expenditure, we re effectively paying back the debts the state borrows from, thats where the whole misleading begins with balancing budgets comes from, its actually dangerous to do so, we become over reliant on the private sector money supply, i.e. credit.

Public service doesn't generate any income for the country, If we're paying back money it's for loans that were given to pay the public service years ago.
The state of the country is the way it is because the civil service has it that way. Like the health service, finance is badly managed too ...... need only look at the new childrens hospital.
There's no accountability in teh civil service and you can't lose your job no matter how bad you are. That's a bad combination

Wanderer78

wrangler wrote: »

Public service doesn't generate any income for the country, If we're paying back money it's for loans that were given to pay the public service years ago.
The state of the country is the way it is because the civil service has it that way. Like the health service, finance is badly managed too ...... need only look at the new childrens hospital.
There's no accountability in teh civil service and you can't lose your job no matter how bad you are. That's a bad combination

i suspect most civil servants are paid for their work, so im not so sure about your statement there! again, the public sector does indeed play a part in the money supply, when it creates bonds, no idea where you re going in regards loans from years ago, our government creates bonds on a regular basis, this is common across the world, our economies couldnt function without the bond markets, we would be entirely reliant on the private sector money supply, i.e. credit markets, if that was the case. i will agree with some of your comments though