Donnelly forces Paul Reid out.

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.

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.

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...

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 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.

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.

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.

Yes, check the news going back over the past 2 years, you'll find all you need to know about the shambles the HSE is, Google will suffice but lots of archive info on various news sites.

I'm actually being generous when I say ineptitude 😉

This is not a debating society I'm afraid, posters can if they choose to refute my claims which I'll say again, the HSE is a shambles and was led by someone who was cleary out of his depth

Riddle me this, how about you list off the achievements over the past three years, shouldn't take long.

So again, No prove to back up anything you say. It is not up to anyone to disprove you allegations.

Unfortunately, the level of contribution from you turns what is a genuine discussion into nothing more than a slagging match.

Listening to the contributions, on radio, from Reid and the minister, it is clear that a row was brewing around authority, responsibility and demarcation between the CEO of the HSE and the minister. That is a row Reid was not going to win. His choice was to stay, taking responsibility when things go wrong but having his authority constantly overruled by the minister, or move on to pastures new. He choose to move on.

@Dempo1 "Riddle me this, how about you list off the achievements over the past three years, shouldn't take long. "

Managing two crises , Covid and Cibber attack , are surely to his credit. But I am not going to waste time debating with you when you clearly have no facts to back up your outrageous allegations .

Not at all sure what a cibber attack is but presumably you mean Cyber attack, are you aware at all about how shockingly bad the HSE"s IT systems were, indeed perhaps your also not aware, Paul Reid was warned the HSE was extremely vulnerable to cyber attack as far back as 2019 and in essence ignored the warnings.

I'm still awaiting the list of glowing achievements by Paul Reid, I'd not expect any such list from Donnelly in fairness.