Donnelly forces Paul Reid out.

Muppet 1 - 0 Highest Paid Public Servant

The HSE has been trying to close A&E in Navan Hospital for over a decade (and Donnelly has loads of reports on his desk explaining why it's unsafe) but a spineless populist politician with a postgrad degree in dog grooming or somesuch believes that he knows better than his medical experts.

So are we looking at a shameful victory for populism over solid medial advice?

Or is it an elected TD with a democratic mandate correctly pulling rank over a stroppy public servant - and to hell with the consequences?

Gant21

One less cowboy in town.

https://www.boards.ie/discussion/comment/119255916#Comment_119255916

Actually, the cowboy remains seated at the cabinet table.

lawred2

https://www.boards.ie/discussion/2058251978/donnelly-forces-paul-reid-out

the medical experts that preside over the systematic mess that is the HSE?

https://www.boards.ie/discussion/comment/119255947#Comment_119255947

Medical experts do their job with the resources that they're allocated. It's managers who mismanage the HSE.

Nody

https://www.boards.ie/discussion/2058251978/donnelly-forces-paul-reid-out

By definition the elected TD is always correct in the sense they are there to deliver the policy of the country based on the democratic process and setup. That policy may be wrong from an information perspective but ultimately that's their head on the block as well in the next election accordingly by the voters (I got no opinion really on the issue per say).

Jim2007

https://www.boards.ie/discussion/2058251978/donnelly-forces-paul-reid-out

Since it's know a medical decision but an administrative one, I'd say it's Muppets: 2.

Madeoface

Pulled a massive salary, didn't change anything in the hse. Spouting guff from day 1. Still claiming 'private sector experience' when he was actually in telecom eireann as a boy and merely stayed on when it was floated. Leaving the hse organisation in a better place or worse off?

Floating off on a giant pension. Spoofer.

I don't think the minister is much better but I think some new blood, perhaps with a medical professional background will be good for the hse. Who knows, sure Robert Watt might try his hand here now lol....

Spanish Eyes

https://www.boards.ie/discussion/comment/119256692#Comment_119256692

Funny, Watt was the first name I thought of as a replacement. He'd like the moolah too, provided it is more than he gets now.

macvin

so the OP has some personal issue with donnelly and also does not understand what is actually happening at Navan hospital, so blurts out some bs so that he can give himself the feeling of pissing on his leg (warm feeling- but nothing happens)

ujjjjjjjjj

The muppet show continues apace.....

https://www.boards.ie/discussion/comment/119256759#Comment_119256759

Presumably you're one of the many savants who opts to go running to his local TD's "clinic" whenever he's feeling under the weather.

Economics101

Both Donnelly and Reid are stuck with managing a badly-designed system: heavily subsidised by the taxpayer and largely free at free at point of use, like the UK NHS in these respects. Continental European health services are largely insurance-based (social insurance mostly), and seem to avoid our horrendous delays for treatment. Until this nettle is grasped, no point in slagging off Reid or Donnelly.

Sam Russell

Why do public hospitals run car parks? Why do public hospitals look for VHI (or other health ins) when they offer no services for their charges to the VHI? Why do they deliberately leave low priority patients wait for hours in A&E instead of offering a call back when they are likely to be seen? Why do they keep patients in A&E for extended periods waiting, when they could be let go home with an appointment to return (in the morning, say)?

Any experience of A&E is of a very badly organised service, where patients are not the centre of service. Maybe, high priority gets dealt with expeditiously, but outside of those - well ....

Madeoface

https://www.boards.ie/discussion/comment/119256815#Comment_119256815

I couldn't agree whatsoever with that get out of jail card. They are / were supposed to lead the system and change it. Why else was Reid paid 400k plus, to say he can't? What did he push to fix it, including funding model?

The easiest option was to appear on TV every day during covid quoting stats that any junior bureaucrat could have done, instead of grasping the nettles he was supposedly paid for.

Why did all around him quit too? Poor dears...in the immortal words of Paul Calfe, he was a bag of shiate...

amacca

https://www.boards.ie/discussion/comment/119257795#Comment_119257795

You make some excellent points imo

asdfg87

https://www.boards.ie/discussion/2058251978/donnelly-forces-paul-reid-out

I expect Paul knows full well that the HSE is unmanagable so he got the opportunity and who can blame him, he got the opening and said i'm out of here. I expect the salary he got in the last few years means he can fully retire if he chooses.

I do not think the HSE can be fixed until the admin and front line are separated, of course the admin in hospitals needs to stay on front line but general office management practices as in private sector needs to be the way forward.

wrangler

There's a mindset in the PS to do nothing, A public servant said to me lately if a young fellow had his job he'd be destroyed. Nothing'll be improved they don't give a damn

Sam Russell

I think the problems in the HSE remind me of a very old joke.

A car full of tourists asks a local at a cross road as to how he is to get to (tourist spot). Local looks up and down the four roads, stokes his chin, thinks a bit and then announces to them 'Well, if it were me, I would not start from here!'

The HSE is not a good place to start reorganising it if the aim is a modern efficient health service. It needs to be broken up (it already is broken) and the new health service built from the smaller bits.

Look at how complex organisations like supermarkets and airlines operate and pick the good models from them.

A list of the things to look out for: Good efficient computer systems, unified throughout the organisation. Simple management structures. Well designed logistics so needed supplies are always available as they are needed and purchased centrally or locally to minimise cost of purchase and distribution while guaranteeing availability where needed. Standardise major ticket items and make maintenance a part of the management of these items. Make sure speciality roles are covered - airlines need pilots so always have enough, and airlines also take aircraft safety utterly seriously as no-one will fly in a dodgy airline with 'incidents'. Complex organisations need to keep their complexity to a minimum, as doing so allows a huge reduction in operating costs and a huge improvement in efficiency, and promotes good outcomes for those it serves.

Do any of those points look as if they exist in the HSE?

horse7

https://www.boards.ie/discussion/comment/119256692#Comment_119256692

Glad you said in telecom and not worked there.😁

jcon

https://www.boards.ie/discussion/comment/119261066#Comment_119261066

Its unmanageable in its current form

Dempo1

https://www.boards.ie/discussion/comment/119255956#Comment_119255956

Quite a Few Medical experts are infact at the Highest management level within the HSE including sitting around the CEO"s desk (just saying) 😉

https://www.boards.ie/discussion/comment/119267636#Comment_119267636

Would they be the same medical experts who recommended that an unfit for purpose A&E Department be shut down? If so, how do you reckon they feel about a clueless, balding halfwit overruling their expert recommendation purely on the basis that it may help the Government to save a couple of seats in the Meath Constituency?

Dempo1

https://www.boards.ie/discussion/comment/119267690#Comment_119267690

O I'm not getting into this argument, just pointing out there's medical experts at the very top of the HSE

rock22

I'm not sure I want to get into a discussion about the health service because i think we could be here for ever But...

@Sam Russell said "The HSE is not a good place to start reorganising it if the aim is a modern efficient health service. It needs to be broken up (it already is broken) and the new health service built from the smaller bits.

The health service was broken up. The HSE was formed because 'every commentator' ands politician agreed that iit needed to be united into a single organisation.

@Sam Russell Look at how complex organisations like supermarkets and airlines operate and pick the good models from them.

In comparison to the health service, these are not complex organisations. However the health service does take a lot of practice from the airline industry, such as accreditation and quality control. ( I am saying they are not complex organisations because they have only a small limited number of processes, i.e. to sell an item or to move a passenger from a to b. The care pathways in health care are much more complex, varied and interconnected)

@Sam Russell A list of the things to look out for: Good efficient computer systems, unified throughout the organisation. Simple management structures. Well designed logistics so needed supplies are always available as they are needed and purchased centrally or locally to minimise cost of purchase and distribution while guaranteeing availability where needed. Standardise major ticket items and make maintenance a part of the management of these items. Make sure speciality roles are covered - airlines need pilots so always have enough, and airlines also take aircraft safety utterly seriously as no-one will fly in a dodgy airline with 'incidents'. Complex organisations need to keep their complexity to a minimum, as doing so allows a huge reduction in operating costs and a huge improvement in efficiency, and promotes good outcomes for those it serves.

Just on the example you list, would you unify a computer system which controls an MRI machine and a computer that manages patient admissions? There are multiple complex interconnected computer systems in the health service all doing different diverse tasks. Many don't even use proprietary operating systems. The truth is there is no simple system suitable for each task in the health service. However I fully agree with you that well designed logistics, standardisation and reduced complexity are all goals to aim for. In fact i think the HSE has been working in those areas.

Politicians like grand overarching plans and nothing would please them more than to break up the HSE . So that in twenty years they can then united it all again. At each step they will double the size of the administration, That essentially is what has been happening since Michael Martin was minister. ( Does anyone remember all his plans, glossy documents given to every staff member of the health boards and Terry Prone produced videos. It must have cost an absolute fortune. )

as I see it, what is needed is a shift in focus onto service delivery and away from management and organisational structures. When that has been done, for example with the cancer strategy, the service has improved and delivery has been much better.

For all his sins, I do think Paul Reid has been focussing on the service delivery area and he has impressed me.

Sam Russell

I think that all computer systems should be standardised. Not all computer systems should be the same, but the same task should be done be the same system. Payroll, admissions, medical records, appointments - all the basic systems used throughout on each site.

Your dismissal of supermarkets and airlines as not complex operation under measures them. They need to be large, have extensive management systems, and demand extensive logistics and finance systems to support them. Both are highly regulated and require reactive management. Airline delays equate to the trolley count.

Every large business has its alligators that prevent or delay the draining of the swamp.

The old health boards were a disaster in themselves subject to endless political interference, and amalgamating them into the HSE could have worked, but it just made it worse and raised costs, and reduced efficiency. [Remember PayPars?]

rock22

@Sam Russell ""

I think we will have to just agree to differ.

Certainly the HSE can always be improved. But to implement a new organisational structure will put real health delivery back another 20 years. I am arguing that stick with the organisations we have, make them better where we can, and focus our efforts, and finances, on service delivery. Make that more efficient with more frontline staff not middle managers, and reduce waiting lists. Amalgamate services where it makes sense, Create specialised centres, even if only one in the country and patients have to travel for certain procedures.

Splintering the HSE will have management and the politicians focused on structure, promotions, bonuses etc. with the frontline staff forgotten about until there is another crisis. And focusing on service delivery is mainly what Paul Reid and the board of the HSE have been doing. But what we have now is politicians, who are worried about losing votes, wanting to interfere in what is clearly a management and clinical decision.

Dempo1

I don't think Donnelly could manage to break wind let alone force Reid out. There's been a pattern of conveniently timed departures from the HSE and DOH.

Paul Reid was inept from the moment he got the top job and inept throughout the entire pandemic, in essence muddled his way through, using spin, spoofing and bluster and was lucky in some respects he had a small cohort of people in the background who knew their Jobs and actually over saw the Pandemic response. He was also fortunate and despite the brazen contempt shown towards front line staff , they stuck at it and under extraordinarily difficult circumstances.

He has now lost a few who essentially propped him up and anyone looking at the HSE press conferences throughout the pandemic (which would rival film launches) could see how utterly clueless he was.

He claims he's no plans for the future, I laughed at that , but I'm pretty sure a book is on the cards , rights already purchased. Paul Reid will be fine, thank you very much.

Donnelly on the other hand, we'll I'd çrash the site if I was to list off his howlers.

Honestly, at times when I look back , I come to the conclusion we got through this pandemic relatively OK despite the Tragic lost of life and impact its had on 10's of thousands, I shudder to think if we didn't have some brilliant people in the background holding Donnelly and Reids hands , were we'd be.

Spoof, Bluster , BS and spin is all these two offered, Good riddance to one, hopefully the other won't be to far behind the exit door.

screamer

The issue with HSE will never change, a huge juggernaut ploughing away over unionised, over paid and over staffed in the wrong areas and over worked in the important areas. Consecutive health ministers have been unable to effect any reform. So choo choo all aboard the gravy train. Poor front line workers have my sympathy they deserve better.

is_that_so

https://www.boards.ie/discussion/comment/119270031#Comment_119270031

Most ministers have never bothered. The last one to try with very, very mixed results was Harney. Donnelly is really a meddler, second rate and has never been in command of his brief. Hopefully, his tenure will also be coming to an end in December. I wouldn't go too overboard on the praise of frontline staff, they too are vested interests and have played as much of a part in the state of the HSE as everyone else.

As to the thread title, three years of hell is far more of a reason at the core of Reid's departure. Questions over genuine government commitment to Slaintecare is also a likelihood but I think it's just being personally exhausted.

MrMusician18

https://www.boards.ie/discussion/comment/119257795#Comment_119257795

The reason that patients are not sent home is due to risk. The patient could present and describe symptoms of an illness that would result in low priority treatment but actually be high priority.

Send them home and they get a turn an hour later, then it is on the triaging nurse.

You can't send someone away until they have been fully assessed by someone that is qualified to assess.

The issue with a&e is that there are a lot of people presenting that do not need to be there. A&E was empty during COVID because those seat fillers were not there.