The current hospital / A&E crisis

The way that health and social care is structured in this country is a shambles. Even calling it a "system" is a stretch. More of an ad hoc mess with nonsense piled on top of nonsense over many decades. The HSE is badly managed but the problem is bigger and more fundamental than the HSE or A&E overcrowding.

We have:

Consultants employed as public servants carrying out private work in public hospitals and in private hospitals. For other public service professionals, this would be a no-no as there would be a conflict of interest but it is accepted as the way things are in medicine here.

Some public hospitals are HSE, some are voluntary and there appears to be a little kingdom mentality. A receipe for poor communication, siloed thinking, inefficiency and "IT issues".

We are still using Victorian era buildings e.g the Eye & Ear, a kip in an unsuitable location.

GPs are private entities yet are part of the public health service via the GMS system

Most nursing homes are private. Now they are looking for more money from the state and threatening to close if they don't get it.

Most homecare is provided by private agencies and home care is not under HIQA's remit i.e. is unregulated. The HSE "manages" homecare packages and acts as a pseudo regulator and is rubbish at both.

Out of hours GP services are provided by private entities. The service for midland counties was to close on 1st January 2023 (the public only heard about this a couple of days previously) but averted at the last minute. Sounds like a successful play for more money with the can kicked down the road, will they be threatening to close again in a few moinths?

Important social services outsourced in a half arsed manner to a large number of NGOs, each of whom needs a chief executive and management team.

All of the above combined is a receipe for disaster and a not my problem, not my job, not coming out of my budget mentality. Also gives opportunities for vested interests to exploit the system for their own benefit/profit while other groups adopt a siege/defensive mentality.

I know andI agree that the hiding of patients has been going on for years . We have been calling it out for years , that is where Trolleywatch came from after all because HSE were only counting patients " waiting in A&E , after they had dispersed extra trolleys all over the hospital.

The extra bed behind the door of every room was added in the Noughties and they try to normalise it as a proper bed space which its not, and us unsafe .

While I agree that there is an awful lot of good people working way beyond what they are paid to do and breaking their hearts and their physical health to try to get everyone through crisis after crisis, there are others who go from meeting to meeting , coffee break to coffee break , talking shxxe and doing nothing to help.

I am sure you know these people too .

It is not just a question of bad management but an ethos of entitlement in that management group that allows them to physically remove themselves from the daytoday problems to such an extent that they forget why they are there .

No manager should be so removed from their clinical area that they cannot see the issues for themselves without having to be told repeatedly and called upon to help , and still nothing unless you mention putting it in writing .

I stayed clinical and moved up in the area I specialised in, where I was valued and did not have to go cap in hand to anybody in administration . I always wanted to stay patient focused and that has its own reward.

I have set my halo aside now as it became too heavy for me in the last year 😉 but am still in and out seeing patients in my new pared down role .

There are so many unsung heroes, from nurses and doctors and porters and cleaning and catering staff , all in giving more than their jobsworth every day . It is a shame that management and the system lets these people and the patients down

Its not just about pay, far from it. The health service is a farce, housing crisis and mental cosy pf living, mental tax rates over the pittance of 40k. Hard to believe any of those working hard in the health service are actually staying in this country. On the other hand, no doubt there's a huge cohort doing very little behind closed doors and getting paid a fortune...

Too many people

I'm no fan of either Martin or Varadkar but its the HSE itself that needs to be reformed if there is to be any hope of changing things.

There are too many people in well paid jobs for life wth a nice pension and a tidy one off payment on reteirment that the rest of us can only dream about.

Now the question is has anyone the balls to go in there and reform it?

Probably not.

It's criminal. Every time I see these two jokers on TV all I can think about is the way work is inside. They should be arrested for treason, but instead, there they are smiling and spoofing as usual.

A pair of cûnts.

Yes still my first port of call as well if it’s in the minor league. Also sixty euros to see a doctor never mind trying to get an appointment. It just seems the surgeries are always clogged with patients and doctors are so over stretched with no time.In contrast I have always found the pharmacists so helpful and they seem to have more time to talk to people.

I assume they have private health cover given their salaries/pensions. Plus Ireland being Ireland who you know etc even if the politician goes public pretty sure they are going to be looked after. The hospital manager wouldn't want the bad publicity of a politician current or former being left on a trolley.

That is totally the wrong message to send and is dangerous. Alot of serious illness start of as nothing serious but then can get serious when not treated early. How are people to know whether something is serious or not?

How is it the wrong message - people visit their gp for all sorts of non urgent stuff that could be dealt with by visiting their pharmacist or using common sense ( especially if they have a free service). I don't think you realise how difficult it is to get to see a gp at the moment if you are actually SICK. In the town I live in if you are sick today you will be lucky to get an appointment in 7 days. The advice the GP receptionists give is you should go to a and e instead whatever your symptoms are - the sad thing is people are taking this advice and clogging up a and e with problems that should be dealt with by a GP.

But in these times when gps are so busy surely it makes sense to stop non urgent stuff.

As I mentioned my GP nobody can get appointments when needed. If I have a sick child with temperature, sore throat etc tomorrow that needs attention and gp receptionist says sorry no appointments until next week what do you recommend I do?

Is it right that the gps appointments are taken up with people with pains in their big toe, don't like the shape of their nose, hypochondriacs with nonsense etc. these appointments were made weeks ago.I don't think it is right given the crisis we are in at the moment.

Do you realise now that for many people their gp service is non existent? It is a HUGE and very worrying issue.

This problem could be coming to your GP practice very soon - you yourself may find it easy to see your GP at the moment but believe me that can change. What would you do if you need to see your GP due to illness and receptionist says sorry no can do?

Oh good god you don't think seeing a sick child is urgent. Have you not heard of strep A recently.

Of course someone that is concerned about a mole should go see their gp. Chronic pain I'm not sure what the gp can do for this person - not alot really. I'm talking about time wasting appointments that could wait or shouldn't be happening at all. If you speak to any gp they deal with alot of time wasters who usually have a medical/gp card and attend their gp with every little issue because it's free.

Of course lack of gp services is contributing to the current crisis.

Interesting article on how University Hospital Waterford (UHW) is avoiding a trolley crisis, (so far...) though I don't know why Pat Leahy in the I.T. insists on calling it 'Waterford hospital' as if we've just the one down here. (For the uninitiated; UPMC Whitfield, St. Patricks, St. Otterans, St. Josephs Dungarvan, St. Vincent's Dungarvan.....