The current hospital / A&E crisis

BattleCorp

https://www.boards.ie/discussion/comment/120121506#Comment_120121506

We can probably cover the cost. What we can't cover is the shortage of doctors.

Free GP care will make things much worse because we don't have enough GPs as it is. Free GP care will increase the number of people going to their GP thereby crushing the system and making it very difficult indeed to see a GP.

Only a clown would think this is a good idea.

Dav010

https://www.boards.ie/discussion/comment/120124223#Comment_120124223

It’s an all waffle. €300-€800m is not going to cover unlimited free access for 5m+ people to GPs, that averages out at €60-€160 pp per year. Considering one private visit costs more than the lower figure, there is zero chance GPs would agree to it. There would be a huge exodus from the GMS scheme to private practice.

kirk.

Does it ever work trying to shoehorn any changes into the existing systems , GPs and hospitals.

Would they be better off building new primary care centres staffed with foreign doctors and nurses if necessary

€20 a call or whatever and incentivise them to deal with issues without referring patients onwards for basic issues

Supply them with equipment and indemnity so they can do their job

Dav010

https://www.boards.ie/discussion/comment/120124476#Comment_120124476

There are open positions for GPs to come here and be paid more than your example, what makes you think they would then come here for less?

kirk.

https://www.boards.ie/discussion/comment/120124496#Comment_120124496

I didn't mention salaries ?

Presumably we need to offer more to entice them here

Isn't improving primary care better than trying to add hospital beds

Dav010

https://www.boards.ie/discussion/comment/120124543#Comment_120124543

€20 a call?

kirk.

https://www.boards.ie/discussion/comment/120124561#Comment_120124561

Token payment from the user to keep numbers down

You took me up wrong there

kirk.

It's clear we can't provide the "5000 hospital beds" with the staff available

Then the hospital unions and consultants etc start swinging into action as soon as changes are mooted , all under the guise of patient safety

Dav010

https://www.boards.ie/discussion/comment/120124571#Comment_120124571

Not free GP care?

If someone has a medical card/entitled to free Gp visit, you can’t charge them for visiting a GP unless they do so as a private patient, in which case the “token” will be a lot more than €20.

kirk.

https://www.boards.ie/discussion/comment/120124596#Comment_120124596

They implemented a charge for medical card prescriptions

Surely they charge medical card patients a fee for the new primary care service

The existing out of hours service was centralised round here , the premises are already there just not the service or the staff

Anyway you seem to be circular debating so I'll leave it there

arctictree

I assume they will double the places in uni for trainee doctors too?

JP Liz V1

If staff shortages, over worked staff and bed shortages were not enough now we have patients killing each other (30 year old violently attacking and killing an 89 year old at a Cork hospital ward)

NIMAN

https://www.boards.ie/discussion/comment/120144108#Comment_120144108

But it would be a stretch to blame this on the government to be fair.

threeball

The GP's and insurance companies have a huge case to answer regarding the issues in our hospitals. Half the people that go to a GP get refered onto A&E whether they need to or not.

Issues a GP would gladly have dealt with 15yrs ago they won't touch with a barge pole now. Some of it is down to just getting as many bodies through their doors as possible with the bigger issue being that the insurance companies have terrified them that they won't be covered should they make a bad call. So they pass the buck on everything from any ill child to stitches and sprains.

The primary care system needs to be properly resourced to take care of breaks, sprains, minor concussions etc to keep them out of the main hospitals and the GPs need to step up and actually give a diagnosis and care to their patients instead of just writing subscriptions and being a gatekeeper to the A&E.

Jarhead_Tendler

https://www.boards.ie/discussion/comment/120111150#Comment_120111150

I was going by Board members sorry

No of course they should not It just wouldn't fill me with confidence. No easy fix it appears otherwise we wouldn't be in this mess.

Dav010

https://www.boards.ie/discussion/comment/120144309#Comment_120144309

Just to clarify, given the number of medical card patients GPs see, getting as many as possible through the door isn’t a motivation, payment is associated with registration rather than number of visits. A considerable number of clinics are closed to new patients. Also, GPs are complaining they are overwhelmed, not that they aren’t seeing enough patients.

Secondly, clinicians pay indemnity insurance, insurers don’t refuse cover over “bad calls”. In terms of resourcing, it is not the case that Clinics do not want extra resources and staff, there are a lot of positions advertised, which unfortunately have no applicants, particularly in rural practices.

Cluedo Monopoly

I was talking to a nurse at the weekend. She said 6 nurses had left her section in the last 3 months. Gone to Australia and Canada.

Graces7

https://www.boards.ie/discussion/comment/120144870#Comment_120144870

Wondering if those who go overseas stay there for the long term or not?

BattleCorp

The hemorrhaging of staff in the HSE is so bad that a memo went out this week stating that there would be permanent employment for all Health and Social Care Professional (HSCP) graduates from the class of 2023 if they passed an interview.

And they are also working with the colleges to ensure that the graduates are aware of the career opportunities that the HSE has to offer and is also providing them with the support to help them best prepare their application and also to prepare for interview.

Graces7

https://www.boards.ie/discussion/comment/120144309#Comment_120144309

Slight amendment to your excellent post. Many get referred to A and E by phone without being seen by their GP at all.

Graces7

I spent most of last weekend abed and otherwise in the corridor outside a and e, with many many others. Having been assessed as needing urgent treatment. Still excellent treatment by the beleagured wonderful a and e staff as by the ancillary care workers. They are stars and deserve better. will be in touch with my TD.

If I were a healthcare worker I think I would find Canada way too cold for me in winter, and Australia way too hot in summer. Maybe I’d alternate countries with seasonal work 😁

I know of one person who went to Oz, trained as a consultant and returned to Ireland to raise his family, and very happy to be home.

trishabon

Pharmacists can be very helpful with medication knowledge and advice on whether or not to attend a gp. I had to wait 10 days for an emergency phone consultation. A practice overwhelmed with medical card patients, as I am. Moved home about a year ago and having great difficulty with hse to transfer to a practice 2 blocks away.

Cluedo Monopoly

Hospital overcrowding 'out of control' with 651 patients awaiting beds (irishexaminer.com)

Hospital overcrowding 'out of control' with 651 patients awaiting beds.

“It is clear that hospital overcrowding is out of control once again. The level of overcrowding in some of our emergency departments warrants a national response.

“The INMO has been in contact with the new Chief Executive Officer of the Health Service Executive seeking an urgent meeting in the next 24 hours ahead of what will be an extremely busy bank holiday weekend for our members."

27 of those waiting on trolleys today are under the age of 16.

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It's happening throughput the year now and FFG are doing nothing to resolve it. Staff are at their wits end.

Cluedo Monopoly

https://www.boards.ie/discussion/comment/120367316#Comment_120367316

Of course it's the fault of successive FFG governments. The consultant on Drive time yesterday said the solution has been spelled out many times over the past 10 years - more bed capacity. FFG have failed to deliver and the problem is only getting worse.

I don't vote SF by the way. I voted FG for 20 years before 2016.

stargazer 68

You can throw hundreds of staff and hundreds of bed at the hospitals but it's not going to cure the issue imo. The issue is step down care and home care packages - there just aren't enough.

Our population are living longer and when the elderly end up in hospital there is nowhere for them to go so they remain in acute hospitals far longer than they need to and far longer than is beneficial to them.

Goldengirl

https://www.boards.ie/discussion/comment/120367756#Comment_120367756

The solution is both, your post and Cluedo's.

Major staffing issues and overhaul needed.

Like we need more houses to buy and rent. Which feeds into the staffing issues.

Successive governments have let us down.. FF, FG, Lab, Greens.

All incapable of dealing with health and housing. They just don't understand it.

Education and Finance are the best run departments .(nothing to do with Norma I hasten to add!) Why is that?

Because so many teachers and business people in the political system/civil service.

We need encouragement for people from more diverse occupations in our political system.

Cluedo Monopoly

https://www.boards.ie/discussion/comment/120370891#Comment_120370891

I agree with your post but actually there is ample evidence to show that the Dept of Education is one of the poorest performing in the public service. It's supposed to be a complete bureaucracy and doss house. Look at the school bus programme and junior cert results in November for recent examples. Foley was a shambles during Covid.

Goldengirl

Yes Foley. Otherwise ran pretty well.

was nearly going to start a new thread, but this one can be resuscitated, unlike the poor gentleman who was found literally off his trolley on the floor in UL Hospital in a state of rigid mortis. The man had been admitted with a severe respiratory infection due to immune suppression to manage his otherwise successful kidney transplant. He was an active person, his medical condition did not stop him going places and doing things, and had potentially plenty of life left in him if he had been looked after properly, which didn’t happen. It’s just not good enough to say staff were too busy to spot a dying patient.