The game seems to be keep shuffling the health minister so he can always say well Iāve only just started itās going on what now? Since before Micheal Martin created the hse anyway because that was a solution to the health shit show at the time. Is martin the last fella that tried actual reform btw? Obviously he made it even worse but has anyone else tried a leg in there?
Also Coveney is the man in waiting for Kennys job they sent Leo in there to soften his cough
Health is an impossible job to do well.
It is because it requires major overhaul. Tough gig to take on, striking hse workers bringing health service to a standstill. Howād you ride out that storm?
We need joined up thinking, greater efficiency and a greater focus on primary care.
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the socialist Labour Government created the NHS in England
It can be done
Itās funny - all the various parties involved in the health service claim we need joined up thinking but they all think the problem is being caused by one of the other parties, and not them - no sirree.
Said it on here before. They should get in an overseas expert and appoint him to the role. Not affiliated to any party with a defined tenure so no reason to play politics to stay on. As long as the incumbent needs to be elected again hard decisions will never be taken
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Plenty of these primary care centres in pipeline but its a struggle to get financing in place I believe. Bank credit available but investors to provide equity input harder to come by.
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Health sector seems to be pretty tough to make money in? Despite the sky high fees people need to pay it seems like things like nursing homes etc struggle to make a profit.
Established nursing homes make plenty money really. Tough gig alright though. Constant battle to keep overheads under control and retain staff. Lot of them were built from 2000 to 2008 as there was massive tax breaks attaching to them and a lot of these didnāt have expert management required and struggled to get up to required capacity. Lot of them are being bought out by larger operators now though who would run multiple facilities.
The primary care centres are tricky. Because itās not much more than a commercial premises at its core with loads of different business renting space in it. Lot of it seems to be driven by doctors coming together but that has its own complications.
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First thing youād do is ban all public consultants from doing private work in office hours ie 8-5 mon-fri. Bill them for the use of all use equipment at an market rate for any work done in hospital outside that time.
Incentivise external private providers of elective day case surgery, (plenty of them in the UK), indemnify them for operating on hse patients, and make sure they stand behind them against local cartels with award of guaranteed work (they would have to set up, equip, and staff at their own cost, but would do so if guaranteed contracts were in place). The standard of work should be subject to scrutiny, both internal and external audit, and overseen by the IMC, with providers being given temporary registration once vetted.
This would clear operating space for emergency and major procedures, which is what inpatient hospitals should be doing anyway, appropriately funded, and also staff and inpatient beds.
The govt should clear out a swathe of local administrators, and have an old school single hospital administrator, matron, and medical director in place.
Consultants should be well paid, but their public work volumes should absolutely clear, and not just be done, but be seen to be done.
The medical and nursing staff at all levels should be cut a bit of slack when itās quieter ,as a quid pro quo for when itās hammered.
The govt/hse should ask to link with the NHS group purchasing scheme, paying to be a part of it if necessary, to prevent the blatant drug and device scalping that goes on in Ireland.
None of this is that hard to do. Need to work with people, not against them.
The salaries of a significant percentage of irish consultants is obscene, which is grand if they are full time private, but not if they are using public jobs to both oil the private work, and to minimise their indemnity.
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What do you think about the idea in England to have GPs located in hospitals to prevent the overload of A&E with people who shouldnāt be there. For things like flu?
There was a feature on prime time there a while back which showed a program that was going on in Kilkenny I think where a group of local GPs and the local A&E were working together to reduce waiting times. Essentially for less serious issues your GP could triage you and give you a referral to appropriate dept in hospital
E.g. if you presented to GP with suspected broken wrist he would give you a letter sending you straight for X ray. Instead of going to A&E and waiting for a few hours for someone to see you and make that decison. Apparently had made a huge difference to the queues and waiting time.
No idea why it wasnāt adopted more widely as it appears common sense.
Would also make sense for public A&E to outsource all breaks etc to the likes of the VHI clinics. Pay the couple of hundred euro fee on the patient behalf and get them out of public system. Has to be costing more to treat them publically when you take the negative impact on other patients into account
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Regina Doherty with a nice summary of her talents here.
Itās a good idea by and large. One of my best pals is an ex gp, and is now head of the greater Manchester ambulance service, and I speak to him about it sometimes. As long as the GPs pull their weight. Some are fairly disenfranchised and just while away their shift. The big problem here apparently, is loads of elderly and frail, or recovering people, with little or no home support, and nowhere for them to go to recuperate. Loss of the traditional family support plays a huge role in this. This means that they sit in a hospital bed at vast expense, and an acutely ill person who needs one, canāt get one. This is a nigh on impossible problem due to the scale. In Ireland, it should be easier to sort out a bit better, as it is smaller scale.
What no one will say, as they would be shrieked down by the liberal elite, is that there should be a fee, even a fiver, to see any GP, and double it to go to A and E. This should be mandatory for all. It is uncomfortable, and the press would find the odd person who suffered/died possibly as a result, but many more are suffering and dying due to the A and E consultants being completely swamped.
In the UK they work their asses off , and more.
Last time I went to A and E in Ireland, Iād done my meniscus playing sport. For whatever reason, the consultant said heād see me himself. Whilst I waited, he was, on public time (at least 15 mins), dictating a private solicitors report backing up a womanās claim , and Iām not joking here, that she had a whiplash injury, not because she had actually crashed, but because she had had to brake to avoid someone. I can still hear him in a nasal whine āthe force of pushing hard on the brake pedal was transmitted up through her spine and into her neck, resulting in what is commonly known as a whiplash injuryā
I have never forgotten it.
A partner in our small businessā wife is an A and E consultant. She is Cambridge educated, clear eyed, resilient and lovely. She works at the A and E at stockport. There are 5 full time consultants. The a and e there saw 545,000 patients last year. And the management are absolute cunts. She went off with stress as a result, and nothing has changed.
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Sweet Jesus.
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Do you think the A&E system is better in Ireland or UK? Couldnāt be worse than here surely?
There is a fee for both GP and A&E in Ireland (A&E is free I think with referral from GP) and itās made fuck all difference.
I donāt know how they get people to work in the emergency departments over here. Doctors I can understand as itās a rotation they need to do as part of training so no choice. But why nurses work there is beyond me when you get paid exactly the same for doing any other nursing role.
I had experience of this very recently and couldnāt understand the inefficiency. Went to Shannon Doc with the little one after she hurt her wrist. Doctor examined it, said it was swollen and would need an x-ray. Went onto the hospital, where we waited an hour and 20mins for a triage nurse to see her and decide she needed an x-ray. Surely a GP referral for something like that can be taken at face value.
Exactly. Bannanas. Iād guess there is a power struggle in there somewhere.
Is there no VHI/Swift call clinic in Limerick? Well worth paying the few extra quid IMO