Back to the future - HSE becomes Health Boards again

hiding behind a poster

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The "mob" can see the cost and the outcomes.

The Irish two tier system is the second or third most expensive in the world yet has among the worst outcomes in the EU based on mortality, waiting time and patient satisfaction surveys
You've numbers to back that up?

, we have massively paid consultants with unclear distinctions between public and private practices and hoards of middle managers making work for themselves.
Last time I looked we were struggling to fill consultant vacancies, yet you claim they're massively paid?
 


Pyewacket

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The "mob" can see the cost and the outcomes.

The Irish two tier system is the second or third most expensive in the world yet has among the worst outcomes in the EU based on mortality, waiting time and patient satisfaction surveys, we have massively paid consultants with unclear distinctions between public and private practices and hoards of middle managers making work for themselves.

Where does the begruddgery come in?
That is a bit of a BS factoid. If Ireland had the same population and demographics as larger European countries, it would be the most expensive. You cannot make a legitimate critique of the Irish health system and it deserves criticism by distorting the facts.

With an aging population, which is not economically active and paying tax but needs health care, yes it is an expensive system. You have fewer younger tax payers, who do not use the system to the same extent as the older population of non tax payers, funding provision. Unless you change Ireland's demographics by killing off the oldies and making women have ten kids each, you will not change that.

Ireland's health care system is inefficiently managed, largely thanks to gobshyte politicians like Mary Harney and pig ignorant bureaucrats.
 

ruman

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Are we to infer from this that the HSE has, effectively, been declared a complete failure and that we should have stayed with the Health Boards all along?


I worked on a few IT projects in the public healthcare sector and witnessed the bizarre launch of the HSE, led by a former banker no less, who went on a 12 month roadshow to sell the idea of the HSE and watched as new empires were formed, new roles created as jobs for the boys and gals and watched as national project after project went over budget and failed...not it seems it was all for nothing.

Is this a genuine initiative to try to tackle the healthcare crisis once and for all or just a cynical way to break the endless series of national controversies into smaller, regional, bite-sized, controversies so they don't get so much air time?
The principle was sound in creating the HSE but implementation was a disaster , rather than removing layers of admin we added to it.

Irelands tiny , we need to shut most of the small hospitals and look at a very small number of large hospitals that are easily accessible. This 6 HSE's idea will be a disaster.
 

ruman

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You've numbers to back that up?



Last time I looked we were struggling to fill consultant vacancies, yet you claim they're massively paid?
They are well paid by EU standards even more so when private earnings are taken into account. Recruitment problems are as a result of poor working conditions and training. Also some locations simply arent attractive, shut them down.
 

Orbit v2

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Ah - the "we all partied" excuse.
:unsure:
Like Irish Water, the principle is sound, it's the execution was flawed.

Centralised or decentralized doesn't really matter -
That was my point really.
it's the outcomes that REALLY matter, but for decades now the HSE has been a pre-retirement home for many of the old guard of the Health Boards, many of whom got jobs they were unsuited for by the nod and wink system that used to work where TDs and councilors got jobs for kids in their constituencies and then who went on to management roles, etc.

Now the HSE should have been massively positive - common systems, BKMs, shared services, etc., pools of clinicians and centers of excellence with the critical mass of patients to make them effective - but still local politics intervened....hospitals in every town and so many red circle jobs that NO common practices could ever exist.

The Irish people don't get to vote on this - we didn't get a referendum to decide how we wanted the system run, so you can feck off with the "nation of headless chickens".
The "headless chickens" comment wasn't entirely serious but was directed at the policy makers who actually think this kind of tinkering makes much of a difference.

Having said that, it is genuinely a complex system. It suffers a lot from the Joe Duffy liveline factor, where the latest crisis is played out and the HSE management react rather than plan things strategically.
 

Baron von Biffo

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[...]

Having said that, it is genuinely a complex system. It suffers a lot from the Joe Duffy liveline factor, where the latest crisis is played out and the HSE management react rather than plan things strategically.
The Whineline factor coupled to media sensationalism tends to whip up hysteria that's impossible for politicians to resist.

Sometimes it just leads to wastefully throwing money at the perceived problem. Few if any controls are put in place because hysteria demands an instant response. The symphysiotomy compensation scheme where it emerged up to a third of applicants had never had the procedure and the 'Positive Action' scandal where funds were just looted showed where that leads.

A more serious problem is the case of the unnecessary cervical smear tests offered to damp down media led panic. The strain on capacity caused by the political rather than medical testing may well have caused more harm than the original problem.
 

Patslatt1

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Let me guess, the Dept of Health /Dept of Finance/Dept of An Taoiseach called in some Consultants from some Big Financial Services Company(EY,Accenture,Deloitte ,Standard Charter,Goldman Sachs ........) and they recommended this for a fee of €5- €10m.So now the future is 6 CEOs and 6 replication/duplication of management layers and pen pushers that will cost more than present HSE , but the outcome for failures and foul-ups will still be the same as present HSE.Pass the buck,pass the responsibility and no one will get fired for gross negligence/failure. Same old, same old but more expensive than present Shambles.
Decentralisation can cut bureaucracy and definitely improves flexibility in most cases. An interesting approach of a big Japanese company was to decentralise to improve flexibility and recentralise to cut costs in a few cycles. A big successful Chinese appliance company relies heavily on teams that are in charge of most aspects of each product.
 

Patslatt1

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Decentralisation can cut bureaucracy and definitely improves flexibility in most cases. An interesting approach of a big Japanese company was to decentralise to improve flexibility and recentralise to cut costs in a few cycles. A big successful Chinese appliance company relies heavily on teams that are in charge of most aspects of each product.
 


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