Why is Ireland's healthcare system in shambles?

dxhound2005

Deleted User wrote: »

I'm not talking about fertility ratio or infant mortality ratios. Being born is the most natural thing in the world and in the absence of a truly toxic environment most kids survive.
Ireland spends per capita similar amounts to France or Germany. It shouldn't need to as Irelands "capita" isn't of the same quality as those two countries; it is younger

I mean life expectancy.

dxhound2005

dxhound2005 wrote: »

I mean life expectancy.

Then you are off topic. This is a topic about people presenting themselves to the health service with problems now and the nature of those problems are more chronic as the patient gets older.

dxhound2005

Deleted User wrote: »

Then you are off topic. This is a topic about people presenting themselves to the health service with problems now and the nature of those problems are more chronic as the patient gets older.

I was addressing your assertion that the health service will get worse due to ageing.

dxhound2005

dxhound2005 wrote: »

I was addressing your assertion that the health service will get worse due to ageing.

It will get worse. Either it will consume more to keep the same pool level of care for more people or it will collapse totally without funding to handle the extra demands that are placed upon it.
Fertility ratio or mortality ratio now or next year doesn't excuse their poor performance therefore your comment is off topic.

dxhound2005

Deleted User wrote: »

It will get worse. Either it will consume more to keep the same pool level of care for more people or it will collapse totally without funding to handle the extra demands that are placed upon it.
Fertility ratio or mortality ratio now or next year doesn't excuse their poor performance therefore your comment is off topic.

I would see the high quality of the health service as being a big factor in the increase in longevity in developed countries such as Ireland. Just as low quality is a factor in countries with lower life expectancy. So that points to Ireland having had a high quality health service in the last few decades.

The increase in population has not overwhelmed the service. And I think too much is made of debility among older people. Lots of them are living healthy lives.

dxhound2005

dxhound2005 wrote: »

I would see the high quality of the health service as being a big factor in the increase in longevity in developed countries such as Ireland. Just as low quality is a factor in countries with lower life expectancy. So that points to Ireland having had a high quality health service in the last few decades.

The increase in population has not overwhelmed the service. And I think too much is made of debility among older people. Lots of them are living healthy lives.

I'll let you ponder how you came to that conclusion. Hint: there is a difference between correlation and causation.

Dav010

[Deleted User] wrote: »

I'll let you ponder how you came to that conclusion. Hint: there is a difference between correlation and causation.

Are you saying that quality of/access to healthcare has no baring on longevity/life expectancy?

Dav010

Dav010 wrote: »

Are you saying that quality of/access to healthcare has no baring on longevity/life expectancy?

I'm saying he is conflating two things.

Dav010

[Deleted User] wrote: »

I'm saying he is conflating two things.

I don’t see that, he is rightly observing that having a good healthcare system which people can access, improves quality of life and life expectancy. It certainly isn’t the only factor, but you are wrong to assume that it isn’t an important contributing factor to people living longer.

Mad_maxx

coolshannagh28 wrote: »

The Health sector like other public sectors in Ireland suffers due to constant expansion , in other countries with a Left /Right political split the expansion of public services under Left focussed administrations is tempered by rationalisation when more Right governments take power whereas our historic centre split ensures continual expansion and inefficiency.

Ireland doesn't have a right, not in that context anyway, more public spending is trumpeted by all parties

We love Big Government in this country and all parties answer the call

Dav010

Dav010 wrote: »

I don’t see that, he is rightly observing that having a good healthcare system which people can access, improves quality of life and life expectancy. It certainly isn’t the only factor, but you are wrong to assume that it isn’t an important contributing factor to people living longer.

You are misinterpreting what I said either willfully or otherwise.

A fleet of young cars requires less upkeep and that upkeep is less complicated than for a fleet of old cars.
Same rules apply to people and animals and buildings and anything you can think of.

In 20 years' time(perhaps earlier) the health system will collapse under the strain of older people or taxes will have to be increased with the dependency ratio dis-improving to deliver the same poor level of service.

Ireland's elderly dependency ratio is expected to triple by 2050 according to a report from 2007.

KilOit

It will keep costing more and more since people are living longer but not necessarily healthy lives

dxhound2005

Deleted User wrote: »

You are misinterpreting what I said either willfully or otherwise.

A fleet of young cars requires less upkeep and that upkeep is less complicated than for a fleet of old cars.
Same rules apply to people and animals and buildings and anything you can think of.

In 20 years' time(perhaps earlier) the health system will collapse under the strain of older people or taxes will have to be increased with the dependency ratio dis-improving to deliver the same poor level of service.

Ireland's elderly dependency ratio is expected to triple by 2050 according to a report from 2007.

That is the pessimistic view. But no doubt some people would have said 20 years ago that the service would collapse if the country increased the population by one million people.

We will only know looking back in 30 years time how society managed the upcoming demographic changes.

Dav010

[Deleted User] wrote: »

You are misinterpreting what I said either willfully or otherwise.

A fleet of young cars requires less upkeep and that upkeep is less complicated than for a fleet of old cars.
Same rules apply to people and animals and buildings and anything you can think of.

In 20 years' time(perhaps earlier) the health system will collapse under the strain of older people or taxes will have to be increased with the dependency ratio dis-improving to deliver the same poor level of service.

Ireland's elderly dependency ratio is expected to triple by 2050 according to a report from 2007.

Interesting analogy, but I’m neither wilfully nor otherwise able to see how it applies to healthcare, people are not machines, but certainly improvement in medical diagnostics and machinery, and access to them means diseases are diagnosed and treated more effectively. Were they not available, people would have poorer quality of life and lower life expectancy.

You're still wrong but I don't have the time or inclination to argue with you.

Igotadose

dxhound2005 wrote: »

The increase in longevity over the last few decades has been nothing short of astounding. That would point to a very effective health service.

But, it's happening throughout the western world. It's attributable to
a) importance of exercise and weight control to longer healthy lives
b) cessation of smoking - probably the number one reason for increased lifespans
c) safer automobiles, roads and drivers
d) better economic prosperity in Ireland - wealthier really does mean healthier, better educated too means healthier
e)Reduction in pollution

Ireland's nothing special here, life expectancy is going up in the wealthier Western world.

Wanderer78

Igotadose wrote: »

But, it's happening throughout the western world. It's attributable to
a) importance of exercise and weight control to longer healthy lives
b) cessation of smoking - probably the number one reason for increased lifespans
c) safer automobiles, roads and drivers
d) better economic prosperity in Ireland - wealthier really does mean healthier, better educated too means healthier
e)Reduction in pollution

Ireland's nothing special here, life expectancy is going up in the wealthier Western world.

Sadly, life expectancy is starting to fall in parts of the states, some believing, including myself, due to rising inequality from the way we have designed our economic systems and the ideologies on which they are based, ideologies in which we here in Ireland, have also followed, so we to may find life expectancy declining in certain sectors of society, more likely in lower classes, soon.

Health care systems are complex beasts, but since theres inefficiencies in both the public and private sectors, and other complex issues, we ll probably struggle to create a far superior system, thankfully, all of our politicians and their parties have agreed collectively to trying to.

Strumms

Igotadose wrote: »

But, it's happening throughout the western world. It's attributable to
a) importance of exercise and weight control to longer healthy lives
b) cessation of smoking - probably the number one reason for increased lifespans
c) safer automobiles, roads and drivers
d) better economic prosperity in Ireland - wealthier really does mean healthier, better educated too means healthier
e)Reduction in pollution

Ireland's nothing special here, life expectancy is going up in the wealthier Western world.

The smoking is an interesting one.. an article ok, from 2013 in the independent ....

“The Government rakes in an estimated €2 billion a year in tax revenue from cigarettes but roughly the same amount is spent on treating illness caused by tobacco.”

So all that revenue that the government earn, isn’t getting spent on roads, transport, infrastructure, schools , etc... it’s not even being spent on the broader ‘health’ picture, it’s been spent ‘trying’ to fix the damage that having cigarettes legal and on free sale causes.

Just ban cigarettes, tobacco.

The Irish Heart Foundation has called for more money to be spent on smoking cessation services. It points out that over 100 times more is spent on treating sick smokers than helping them to quit...mad. It’s a very expensive vicious circle, that your average non smoker pays for...

YellowBucket

I've always thought the HSE's slogan should be changed to "HSE - It's good enough for ya!"

That's generally been my experience of the system, rather than the individuals.
You get the sense that it doesn't care at all. Even down to things like posting out arbitrary appointments without any discussion, cancelling things without notice, making people wait for hours and hours because they couldn't be arsed giving people individual appointments and instead just hold a 'clinic' with a hundred people or so all given the same time and date.

The list is endless.

The simple reality as I see it is there's a structural and cultural problem. They seem themselves as a charity doling out alms because we never reformed most of the hospitals from the days when that's what they were. So, patients aren't customers or clients, they're some kind of input to be processed by a bureaucracy. You sit, you wait, you get treated badly, you're served food that's shockingly bad, you're dumped in corridors, files are lost, administrators are unhelpful, there's often nobody to explain anything etc etc.

I also find a lot of hospitals come across more like co-working space for consultants. They breeze in and out and have little or no interaction with the patients or the hospital form what I can see and that applies in both public and private contexts.

I remember dealing with my late mother's issues when she'd cardiac, gynaecological and urological stuff going on at the same time and basically you had to manage the case yourself. Left hand didn't know what right hand was doing. At one stage she had had surgery in a private hospital and was left with a weeping wound for days with no follow up from consultants, no availably of anything and ended up having to go to A&E.

I've an elderly relative at the moment who's getting treatment for long-term cancer in a major Dublin hospital and frankly nobody seems to know what's going on most of the time. You can't contact them. The GP doesn't really know what's happening. You get letters now and then asking her to call into clinics (which are now mostly by phone) and find out nothing.

I'm not faulting the technical treatment, but the patient liaison is non existent / terrible. She's often managing her own case and carrying around her own notes and files and this is a quite vulnerably lady in her mid 80s.

Igotadose

YellowBucket wrote: »

The simple reality as I see it is there's a structural and cultural problem. They seem themselves as a charity doling out alms because we never reformed most of the hospitals from the days when that's what they were. So, patients aren't customers or clients, they're some kind of input to be processed by a bureaucracy. You sit, you wait, you get treated badly, you're served food that's shockingly bad, you're dumped in corridors, files are lost, administrators are unhelpful, there's often nobody to explain anything etc etc.

Well, no surprise since it was all run by the Church in the not so distant past. It's why one of the first things that needs happen to reform the attitude in the HSE, is remove the hooks the Church has into it. Hospitals should be run by doctors, not administrators. No one Church affiliated in any position of influence. Hospitals owned by the State.

Strumms

YellowBucket wrote: »

I've always thought the HSE's slogan should be changed to "HSE - It's good enough for ya!"

That's generally been my experience of the system, rather than the individuals.
You get the sense that it doesn't care at all. Even down to things like posting out arbitrary appointments without any discussion, cancelling things without notice, making people wait for hours and hours because they couldn't be arsed giving people individual appointments and instead just hold a 'clinic' with a hundred people or so all given the same time and date.

The list is endless.

The simple reality as I see it is there's a structural and cultural problem. They seem themselves as a charity doling out alms because we never reformed most of the hospitals from the days when that's what they were. So, patients aren't customers or clients, they're some kind of input to be processed by a bureaucracy. You sit, you wait, you get treated badly, you're served food that's shockingly bad, you're dumped in corridors, files are lost, administrators are unhelpful, there's often nobody to explain anything etc etc.

^^^ my experience to a tee. And what makes is so fûcking worse again, is that we HAVE the care and talent in abundance but not the will or drive to enable them to do their best, their best for the taxpayers who fund and need the services.

Igotadose

Wanderer78 wrote: »

Sadly, life expectancy is starting to fall in parts of the states, some believing, including myself, due to rising inequality from the way we have designed our economic systems and the ideologies on which they are based, ideologies in which we here in Ireland, have also followed, so we to may find life expectancy declining in certain sectors of society, more likely in lower classes, soon.

One of the causes of shorter life expectancy in the US, especially in white males, is suicide. That's been going up, the various economic crises (2008 wasn't all that long ago, and now we have 2020), mean a lot of loss of 'self worth.'

Mental health care in Ireland (which some would argue is an oxymoron, as bad as it is), will be the next crisis point. The HSE largely neglects it, as it doesn't garner catchy headlines like people waiting on trolleys. But, once the longer-term Covid impacts come home to roost and jobs are permanently gone, and there's nowhere to emigrate to that's any better, expect huge demand on Ireland's mental health services, and expect the HSE to bungle it. It's what they do, and the Church influence is very anti-mental health care, too.

Geuze

Igotadose wrote: »

Well, no surprise since it was all run by the Church in the not so distant past. It's why one of the first things that needs happen to reform the attitude in the HSE, is remove the hooks the Church has into it. Hospitals should be run by doctors, not administrators. No one Church affiliated in any position of influence. Hospitals owned by the State.

Most former voluntary hosps have been taken over by the HSE, haven't they?

I don't have the figures.

Can you confirm / clarify?

In education, many people want non-State owned schools. I don't think many people want all secondary schools to be ETB techs?

Geuze

Igotadose wrote: »

Well, no surprise since it was all run by the Church in the not so distant past. It's why one of the first things that needs happen to reform the attitude in the HSE, is remove the hooks the Church has into it. Hospitals should be run by doctors, not administrators. No one Church affiliated in any position of influence. Hospitals owned by the State.

I think you should direct your ire at trade unions, not the former owners of hosps.

Strumms

Igotadose wrote: »

and the Church influence is very anti-mental health care, too.

The church should have precisely zero influence as regards healthcare , or indeed anything else in public life. I'd take advice or input from my local tennis club before that lot.

Geuze

Igotadose wrote: »

Well, no surprise since it was all run by the Church in the not so distant past. It's why one of the first things that needs happen to reform the attitude in the HSE, is remove the hooks the Church has into it. Hospitals should be run by doctors, not administrators. No one Church affiliated in any position of influence. Hospitals owned by the State.

I spent some time in the Mater Private, as a visitor.

Quiet, calm, hi-tech.

If that is an example of a Church-owned hosp, then I want all hosps to be like that!!!

(However, I did hear the nuns sold it???)

Geuze

Strumms wrote: »

The church should have precisely zero influence as regards healthcare , or indeed anything else in public life. I'd take advice or input from my local tennis club before that lot.

I am the opposite.

I dream of a Jesuit education for my children.

James Joyce
Macron



I once taught second-level "Tech" students for a class, they reeked of apathy, the Convent girls in the next class were the total opposite, full of vigour and enthusiasm.


Why anybody would want the State to own and run all schools is beyond me - every school would be an VEC/ETB school.



In healthcare, I suggest a mix of providers: public, not-for-profit, for-profit

But give the whole population access to all providers.

YellowBucket

To be quite honest the issue isn't one of church vs non-church, though I would rather that healthcare were secularly owned and run, but it's just the system itself. The majority of Irish hospitals originate in large part from the Poor Law era and the attitudes really have not changed. They seem to see themselves as charities, not as providers of public service and the attitude that comes across, especially as a public patient, is that you are being 'given' something rather than that you're being provided with a public service paid for by taxes as a member of said public.

For the most part whether the hospital is secular, like CUH or James's or religious like the Mater, you won't really encounter nuns or priests or any of that. It's an issue in services like gynaecology and reproductive health ethics boards and so on, but for most other aspects it's not and the service in my experience can be horrendous in both types of hospital.

Although, that being said, some of the systems I've experience in private hospitals have not exactly wonderful either.

My view of it is there's a cultural problem across Irish healthcare in general and it's an institutional one that is just not being addressed. There's also clearly a problem that's driving staff out of the system too, which needs to be addressed and it's not just money, it's career paths, how people are treated and so on.

McGiver

YellowBucket wrote:

I'm not faulting the technical treatment, but the patient liaison is non existent / terrible. She's often managing her own case and carrying around her own notes and files and this is a quite vulnerably lady in her mid 80s.

Exactly my experience - chaos, no order, no due diligence, they don't know what they're doing.

And they use a lot of paper, letters being sent all the time and all that - it's 2020 why the f* do they send letters around, it's not 1950s.

I'd been sent a confidential HSE internal email printout along with such a letter they are sending to the patients - totally undisciplined and disorganised. If they were doing it electronically this can't happen, but their IT systems are shambles so they have to keep it in the paper, this is like somewhere in Turkey or Africa, it's shocking for western European country

McGiver

Igotadose wrote:

Well, no surprise since it was all run by the Church in the not so distant past. It's why one of the first things that needs happen to reform the attitude in the HSE, is remove the hooks the Church has into it. Hospitals should be run by doctors, not administrators. No one Church affiliated in any position of influence. Hospitals owned by the State.

Yep out with an organisation based on a belief in fairy tales (any kind of, not just the one the Church represents). Religion is a private matter and has no place in governance or administration of the state or its agencies/institutions.