Sorry, I donât take people into the conversation if they sit back and choose not to help. These best medical minds you speak of, have they offered their expertise to help out in any way? Who are they?
Irrelevant.
Of course it is. Like their expertise if they choose not to share it.
Irrelevant because itâs nothing to do with my point.
Are only people who sacrifice their medical career to run for public office with no guarantee of success now allowed to be classified amongst best medical minds?
Your making a valid argument. But your arguing with someone whoâs made a completely different point.
Marie OâConnorâs book âEmergencyâ is very good. Hard to escape the conclusion that the power of the consultants is the biggest problem. They drove the whole centralisation thing where smaller hospitals were closed en masse or shrunk to irrelevance, primarily so that they would have the concentrated patient population needed to justify their lucrative specialisations. Canât do that in the smaller hospitals. There was precious little evidence to support their argument that centralisation would lead to better healthcare. And sure enough it was a giant clusterfuck that is now being reversed in dribs and drabs.
That sort of power is basically impossible for politicians to oppose, even if they did want to, which thy donât. Becoming an enemy of the consultant types is bad for you on many levels. Real change would require massive public demonstrations sustained over a long period of time. But private healthcare serves as a sort of safety valve, just about preventing people from getting angry enough to force major reform. Unless thereâs huge support behind him/her, no ambitious minister is going to try to ride out the storm that would ensue.
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I donât know which is better, or worse. Irelandâs problem is not patient numbers though, it is lack of beds, which is scandalous as they dance on the head of a pin trying to hand 13 billion back to apple.
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The biggest difference any minister could make without having to engage in structural reform is actually fairly straightforward. Just fight for patient involvement in decision making. Itâs ludicrous that the end user has so little influence on service provision as is the case in healthcare. More than anything itâs a vestige of a different, more authoritarian age that has largely vanished elsewhere but still remains in medicine. If patients have real input into the nature of service provision youâll get a better service. Otherwise youâll get a service ran in the financial and status interests of the elite consultants.
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They could start with changing the entry requirements for medicine. One of the biggest problems with the medical profession is that theyâve got it into their heads that they are the elite because they crammed to get 600 points in the leaving and therefore canât be told anything least of all by the daws of politicians who only got teaching or arts or the poor civil servants half of whom didnât go to college at all.
I presume there is a cut off point above which any reasonably intelligent person could prosper at medicine, probably around the 450 points mark. Let anyone who makes this figure and who excels at the HPAT into a random selection for medicine and youâd have much less of the preciousness and God complexes that currently disfigure the profession.
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Where in the Public services do the users of the services get an input into the running of the services? Health is not the only service that donât get input from the users of the service.
According to Shane Ross, Simon Harris is going to âkick assâ when he meets the head of the HSE today. Somehow I donât think that Simon Harris knows how to kick. The head of the HSE will run rings around him.
Expect lots of âactionâ, âcommitteesâ, âsteering groupsâ & âplansâ
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Yeah that happens for sure, but in medicine itâs not unique to the public sector. The private sector has the same dynamic. Itâs a unique feature of the medical profession generally. The authority of expertise obviously has to be respected but that has to be balanced by stakeholder interests. In medicine, decisions that are clearly to the contrary of the general welfare are taken all the time because the professional guild is often untouchable. It is closed off to public influence in a unique way.
Which as a matter of public policy is indefensible. No user group in any sector is as intensely focused on the service than the sufferers of serious illness. Obviously the passengers canât fly the plane, so to speak. But patient groups are generally extremely well informed about the condition itself, and are acutely aware of the economic limitations on what is possible. Their input is not only desirable itâs essential if you are to have a health system that is ran for the patients and not the doctors.
The health service is very well funded apparently. Itâs where the money goes thatâs the problem. Close to 80% of HSE total cost goes on wages/salaries. NHS is something like 60% We pay over the odds for medications. It leaves little money for actual health care. There are more middle managers in the HSE than GPâs in this country. If you increase investment, front line services will get last dibs on it. Too many grubby hands in the pot.
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Oh ffs
Ireland spends a fortune on health.
Ask yourself why it requires two people in Vincentâs public to operate some machines but one in the Blackrock clinic?
Ask yourself why someone will receive a Union sanction for doing something slightly outside the T&Cs of their employment.
Itâs a system not run for the users, but the people who work there. âSocial partnershipâ was pure bribery to Unions. Fuck all reform delivered but the mugs paying taxes in this country paid for it.
That 13 billion isnât ours, but even if used, would be pissed up the wall just as quickly as it comes into the government coffers. Maybe if we did actually get it though, the government could get some actuaries in to value the public sector pension hole this country is in and we could finally put it on our books.
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arenât you a blueshirt?
The TFK way 
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Our little lad had to spend a night in Wexford general before Xmas to be observed with bronchiolitis in a cubicle the size of a toilet cubicle in a pub with Mrs Mac sleeping on the ground underneath the cot. Thankfully we have VHI through work so the costs were covered. The notice came last week that they had covered the costs of âŹ1,100.
How the fuck it cost that much is beyond me. 350 of the fee was the consultants charge. He saw us for all of 4 mins and did his level best to talk us into going home for the night as the child would âprobablyâ be OK. The rest of the fee was for the overnight accommodation and nurses (1) cost.
I know they charge over the top for medical services but this seemed like complete overkill. I can only assume that insurance companies are being burdened with costs to save the government a few quid. But madness if this money goes to pay the wages of HSE people.
So itâs wrong to grift your insurance? Just checkingâŚ
Huh?