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How would you sort out Hospital A&E Crisis - Long waiting times- trolleys in corridor's etc

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  • Administrators Posts: 13,975 Admin ✭✭✭✭✭Big Bag of Chips


    24/7/365 might sound ideal but in reality is not going to work. The high number of DNA (Did not attend) appointments during the day is shocking, and contributes in no small part to huge waiting lists. If you're not going to attend an appointment at least let the hospital know so that the appointment can be offered to someone else.

    If a patient won't attend an appointment at 2pm on a Wednesday afternoon, they're unlikely to come in at 3am on a Saturday morning.

    Edit: I can imagine the calls to Joe Duffy. "They sent me an apt for 4 o'clock in the morning, Joe"

    Post edited by Big Bag of Chips on


  • Registered Users Posts: 2,026 ✭✭✭Sheep breeder


    On your seventh point in a lot of A and E the biggest percentage is as you say drink, drugs, Enda Kenny’s natives on medical cards, who take up a lot of the time and don’t care about genuine sick people. On your fourth point a friend son is a pharmacist and he was saying the amount of drugs that go out over the counter that won’t be taken in the full course and most of the people getting them are on a medical card and are there best customers by a country mile. If little Jonny and biddy has a runny nose off to the doctor and into the chemist for more drugs. To see the local doctor if not urgent it’s a three to four day waiting list for an appointment.



  • Registered Users Posts: 13,372 ✭✭✭✭Geuze


    Yes.

    The staff headcount has grown by 21% in four years, 2019 to 2023.

    The population has grown by 6.5% over the same period.



  • Registered Users Posts: 12,465 ✭✭✭✭mariaalice


    I was making the point that more qualifications does not make a better doctor which what you seem to be implying, there is a amount of art and intuition in medicine which no amount of education and qualifications can teach someone.



  • Registered Users Posts: 12,465 ✭✭✭✭mariaalice


    How does our health spend and health employment compare to other OEDC countries?

    Ageing populations have greater health care needs.



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  • Registered Users Posts: 13,372 ✭✭✭✭Geuze


    We overspend on healthcare, relative to the age profile of our population.

    The main reason for this is that our prices for healthcare are so high.

    So in return for a given spending, we get less volumes of healthcare.



  • Registered Users Posts: 13,372 ✭✭✭✭Geuze



    In 2011, our hospital price levels were 81% higher than the EU28 average.


    The hospital price levels are out of line with our living standards:




  • Registered Users Posts: 13,372 ✭✭✭✭Geuze



    One anecdote of how we spend so much is that GP in France charge 26.50.

    Compare that to here!!!!

    Another, we paid double what the UK paid to administer the COVID vaccine.



    Here is some 2017 data from the OECD:





    As a result of high prices, our volumes are not high:





  • Registered Users Posts: 13,372 ✭✭✭✭Geuze



    Notice how we spend as much per person as much older societies. We are close to French spending, yet with a younger population:









  • Yes, it is three tier, not two tier. Medical card have access to certain services other users don’t, and they pay little or nothing. Well insured patients have more choice of doctors/hospitals, but believe me it’s useless in certain conditions, whilst those struggling & working, not enough to buy gold plated insurance and mainly relying on public system but paying full GP fees etc, they have no comfort blanket at all.



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  • Registered Users Posts: 11,794 ✭✭✭✭Andy From Sligo




  • Registered Users Posts: 29,256 ✭✭✭✭Wanderer78


    many medical card holders only really have access to public services, some of which have long waiting lists, or services that dont actually exist, many of these, possible most, have in fact been a part of the workforce, some still are, some of course have been long term unemployed, and also baring in mind, even the unemployed pay taxes in the form of consumption based taxes....

    ...yup, this is also vey badly effecting those who have private health care insurance

    ...the whole thing is a mess, with very few, if anyone, truly receiving appropriate care....

    where!

    Post edited by Boards.ie: Paul on




  • I’m “lucky” now to have a GP only card due to having MS, at least I get his services free.



  • Registered Users Posts: 29,256 ✭✭✭✭Wanderer78


    ...i think we need to get away from this so called 'free' to, im sure you worked bloody hard all your life, and are still consuming, so, far from free..

    look after yourself, id imagine ms is no fun...

    ...paid access is a disaster, the amount of people that bloody work hard, that simply cant pay to access their gp, is pretty damn high, thats not a functioning system!

    Post edited by Boards.ie: Paul on


  • Registered Users Posts: 995 ✭✭✭iColdFusion


    I think the government need to be doing permanent deals with all the available private healthcare facilities to use up all the available capacity in the country, it happened during covid and should be continued to have some sort of functioning health service, it wont be cheap but building extra hospitals isn't cheap either *cough* Children's Hospital *cough*

    On that point im pretty sure they also need to build a few new apartment blocks to offer to staff if they want to have any hope of staffing the new children's hospital..



  • Registered Users Posts: 29,256 ✭✭✭✭Wanderer78


    this effectively means moving back towards a more public system overall, best of luck with trying to convince free market zealots with that one!

    ...yes this is what happened during covid, and yes it needed to happen, and yes it effectively worked, but again, best of luck with doing that, largely due to the above!

    its always been known that curved buildings cost a fortune to build, so dont build them, build less curved ones!

    yup, more apartments, again, best of luck with achieving that anytime soon.....



  • Registered Users Posts: 11,794 ✭✭✭✭Andy From Sligo


    I dont know what glitch happened - but this is what I was answering to with "a lot of good ideas there" :


    24/7/365 service. Scheduled working rosters for everyone in the health services, from admin to consultants.

    An elderly relative had to wait from Thursday afternoon to Weds as an inpatient, to get a scan. Meanwhile hospital almost closed down at the weekends. Such a waste of a bed.

    Cancer treatments to run 24/7 also. None of this bank holiday and weekend everything stops lark.

    Care home and recovery units for those who are no longer sick, but need to regain strength to get back home, rather than blocking up hospital bed for surgeries.

    Stop newly qualified doctors and nurses heading abroad straight after graduation. Part of their education package should include a contract that requires them to work 3 years in the health service here before heading away.

    Employing more nurses aids to assist in chores like changing beds, showering, assisting patients in feeding etc.

    And obviously, make pay more attractive to the nursing profession. Not so much to attract the wrong type for the wrong reason, but at least enough to cover day to day life.



  • Registered Users Posts: 29,256 ✭✭✭✭Wanderer78


    no glitch at all, but thank you...

    how does forcing people to stay here, resolve our issues, seriously?



  • Registered Users Posts: 11,794 ✭✭✭✭Andy From Sligo


    Overheard once in a hospital waiting room few years ago between one woman to another that it was cheaper for her to go to A&E with a list of of her ailments and get referred to the various consultants via A&E, rather than her going to her GP.



  • Registered Users Posts: 29,256 ✭✭✭✭Wanderer78


    yea thats pretty fcuked alright, id say theres plenty of similar stories out there



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  • Registered Users Posts: 11,794 ✭✭✭✭Andy From Sligo


    RTE Upfront:

    Marie speaks about her husband Tommy who died in University Hospital Limerick after spending over 30 hours on a trolley.

    https://www.facebook.com/RTEOne/videos/372278818718597/



  • Registered Users Posts: 11,794 ✭✭✭✭Andy From Sligo


    re elderly taking up beds on wards (or bedblockers which I am not keen on the term) - do the hospital actually do any kind of audit on the wards to see how many elderly patients are only there because members of their own family refuse to have them home to look after them , or the fact being is that there are no relatives / families alive any more or not around , or cannot get into a nursing / convalescent home or moved to another hospital so they end up staying on the ward instead? - if that was sorted then some room/beds available on the ward and less people waiting on trolleys waiting for a bed on the ward. Sounds too simplistic I suppose, but management at the top are paid shed loads to manage so why are they not coming up with solutions for issues like this?



  • Registered Users Posts: 29,256 ✭✭✭✭Wanderer78


    elderly care is very complex, like all of the rest of the problems, many families simply dont have the ability to provide the care, hence the outcome, its a monumental fcuk up, thats also wrapped up in our overall housing problems.....



  • Registered Users Posts: 1,141 ✭✭✭airy fairy


    It reduces the heavy workloads of nurses and doctors, currently we are recruiting from other countries to help the services and still cannot fill places.

    Why should we not keep those who we support and train, (and educate with fairly low college fees being paid, plus grants) Let them pay back a little to the state before they go? Our hospitals are fine to train in, why not good enough to work in for a set time?

    The more doctors and nurses we have in the system, the more patient turnaround.



  • Registered Users Posts: 1,141 ✭✭✭airy fairy


    It's not simplistic to think that there should be a recovery unit available,or care home, when an elderly person needs care after a hospital stay. Unfortunately, nursing home spaces are like hens teeth. Some relatives are waiting weeks for beds in homes for their loved ones, waiting for someone to die to get a space. It's worse that's getting though. So can't see beds freeing up in hospitals any time soon.



  • Registered Users Posts: 11,794 ✭✭✭✭Andy From Sligo


    Sixth, reduce the general temperature by one degree throughout the hospital. That would have a fortune on heating, which can be put into hiring a few nurses, even part time.

    Definitely agree , reduce heating to save costs which then can be spent elsewhere . The amount of times I have been to visit people in hospital or been in hospital myself and they are roasting. The radiators red hot to the touch and windows open then letting the heat escape instead of the radiators/heating controlled better.

    I understand you have sick people in bed dressed only in their PJ's and other thin clothing and elderly patient that would feel colder, but I often think dont germs and bacteria survive in hot places? - they love the heat and to spread in the heat. Maybe cooling it down a bit will also help with keeping germs to a minimum too?



  • Registered Users Posts: 12,465 ✭✭✭✭mariaalice


    We live in a society where we are free to have any opinion we like and that is at the heart of our democracy and most Western democracies.

    Who can speak? and who can take part in discourses in society? is it only those who are experts?



  • Registered Users Posts: 28,939 ✭✭✭✭AndrewJRenko


    Indeed, we're all free to hold opinions, speak and take part in discourses.

    But let's not kid ourselves that these are serious, informed discourses. User experiences are very interesting, and an important part of any service design or policy improvement process. User solutions are generally nonsense, because the users have no idea of the constraints, limitations and resources involved.

    Which thread was it where somebody came up with the super clever innovative genius idea that nurses should be using tablets to update patient records, something that the HSE have been doing for more than five years now.

    I'm not being rude, but as a general point - yiz really haven't got a clue about what the solutions would be.



  • Registered Users Posts: 10,986 ✭✭✭✭Tom Mann Centuria


    Not being rude either but a clarification. I'm not sure what hospital updates Nursing records using tablets. I'd guess the Dublin hospitals and maybe some of the larger regionals. My hospital (officially 285 inpatient beds with an ED, MAU and Maternity services) does not, we still uses all paper records. In fact the 5 years ago that you speak of we were still on windows 7 PCs. The hack was the only thing that moved us on.

    Oh well, give me an easy life and a peaceful death.



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