Compulsory arbitration for restrictive practices ("trench warfare") in hospitals could cut waiting lists and save lives

patslatt

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Compulsory arbitration for restrictive practices ("trench warfare") in hospitals could cut waiting lists and save lives

The CEO of the HSE has described negotiations with health care trade unions as trench warfare. Presumably, he was referring to restricitve practices such as reserving the changing of a light bulb for electricians, the power of hospital porters to restrict supplies, the very slow progress on modernising IT systems, operating controls and business processes,the inefficient rostering of staff hours etc. The impression is that the health service is run for the benefit of the employees and overly bureaucratic management layers rather than serving the public.

Given the waiting lists at crisis levels of hundreds of thousands (higher apparently than in the entire NHS in the UK AFAIK), the government needs to take whatever measures necessary to sort it. A good initiative would be the introduction of compulsory arbitration of restrictive practices. That wouldn't cost a lot to enforce and would still give trade unions and professional associations plenty of scope to defend their positions if defensible.

Resistance to enforcement would no doubt occur and would have to be penalised by docking pay, sending home workers without pay and summary dismissal as a last resort. Management would have to be given full legal discretion on deciding if resistance in the form of working to rule was a pretence of working at full capacity.It will be difficult to change the trench warfare mindset even as patients are suffering and dying as a result of it.
 


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Only nurse, doctors and medical staff should be employed by a hospital.

All others should be contracted out to service providers.
 

hiding behind a poster

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Resistance to enforcement would no doubt occur and would have to be penalised by docking pay, sending home workers without pay and summary dismissal as a last resort.
By definition, summary dismissal cannot be a last resort.
 

Craggyjack

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The CEO of the HSE has described negotiations with health care trade unions as trench warfare. Presumably, he was referring to restricitve practices such as reserving the changing of a light bulb for electricians, the power of hospital porters to restrict supplies, the very slow progress on modernising IT systems, operating controls and business processes,the inefficient rostering of staff hours etc. The impression is that the health service is run for the benefit of the employees and overly bureaucratic management layers rather than serving the public.

Given the waiting lists at crisis levels of hundreds of thousands (higher apparently than in the entire NHS in the UK AFAIK), the government needs to take whatever measures necessary to sort it. A good initiative would be the introduction of compulsory arbitration of restrictive practices. That wouldn't cost a lot to enforce and would still give trade unions and professional associations plenty of scope to defend their positions if defensible.

Resistance to enforcement would no doubt occur and would have to be penalised by docking pay, sending home workers without pay and summary dismissal as a last resort. Management would have to be given full legal discretion on deciding if resistance in the form of working to rule was a pretence of working at full capacity.It will be difficult to change the trench warfare mindset even as patients are suffering and dying as a result of it.
I am of the opinion that HSE management "on the shop floor" are too vulnerable to subtle (sometimes overt) intimidation when real change is required. I've seen loads of examples where more senior levels of management (including HR managers) fail to support change because of the risk of damaging industrial relations.....

Having said all that, the mechanisms available such as Conciliation, Joint Review Groups, Arbitration, etc which are set out in PSA/HRA are probably adequate in that the arbitrator is unlikely to interfere in management change which is rational.

On a relate perspective, I've often thought that unions have nothing to lose by resisting change when referring issues to third-parties. Perhaps the referring party should be required to lodge a certain financial m with the third-party which is forfeited in the event of the arbitrator deciding there is no merit in their case. This might reduce the tendency to "chance their arm" or stimy proposed change.
 

patslatt

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I am of the opinion that HSE management "on the shop floor" are too vulnerable to subtle (sometimes overt) intimidation when real change is required. I've seen loads of examples where more senior levels of management (including HR managers) fail to support change because of the risk of damaging industrial relations.....

Having said all that, the mechanisms available such as Conciliation, Joint Review Groups, Arbitration, etc which are set out in PSA/HRA are probably adequate in that the arbitrator is unlikely to interfere in management change which is rational.

On a relate perspective, I've often thought that unions have nothing to lose by resisting change when referring issues to third-parties. Perhaps the referring party should be required to lodge a certain financial m with the third-party which is forfeited in the event of the arbitrator deciding there is no merit in their case. This might reduce the tendency to "chance their arm" or stimy proposed change.
The unions wouldn't refer "trench warfare" issues to compulsory arbitration because that would backfire.

The mechanisms you refer to can't be working if the CEO regards negotiations with unions and professional associations as "trench warfare". What's lacking is methods to compel reforms and changes to work practices. It looks like managers' prerogative to manage has been undermined. Maybe managers could damage their careers by demanding reforms. Compulsory arbitration with appropriate strong enforcement measures could restore the balance of power needed to manage.
 

ShoutingIsLeadership

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A new "Pat's trolling" forum is needed...preferably treated the same way as the NI forum.
 

damus

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I am off the opinion that we need Gerry Robinson to go in and to effect change management starting with the buffoon's in the DoH/HSE and then working our way downwards to local level...and it starts with weeding out and firing senior managers (and I use that word very loosely without naming names) who've zero relevant qualifications, experience or skill-sets for the job.
 

patslatt

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I am off the opinion that we need Gerry Robinson to go in and to effect change management starting with the buffoon's in the DoH/HSE and then working our way downwards to local level...and it starts with weeding out and firing senior managers (and I use that word very loosely without naming names) who've zero relevant qualifications, experience or skill-sets for the job.
At the time the HSE was created, the Minister of Health Harney, the government and the entire political opposition completely ignored the obvious need for compulsory redundancies in the consolidation of county health boards. A generous redundancy programme could have removed underperforming staff but the politicians pandered to the unions as usual. Ever since, the HSE has been stuck with executive and employee deadwood.

If failures in delivery of health care and affordable housing continue and an economic recession occurs, Irish politics could become polarised in the next few years between hard left and hard right.
 

Gibby

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At the time the HSE was created, the Minister of Health Harney, the government and the entire political opposition completely ignored the obvious need for compulsory redundancies in the consolidation of county health boards. A generous redundancy programme could have removed underperforming staff but the politicians pandered to the unions as usual. Ever since, the HSE has been stuck with executive and employee deadwood.

If failures in delivery of health care and affordable housing continue and an economic recession occurs, Irish politics could become polarised in the next few years between hard left and hard right.
Which would suit the politicians down to the ground, endless opportunities for them to keep the party going for themselves.

Why don't you start a thread about taxpayers money being wasted in the dail/senate patslatt, you know, start at the top and work your way down for a change?
 

wexfordman

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At the time the HSE was created, the Minister of Health Harney, the government and the entire political opposition completely ignored the obvious need for compulsory redundancies in the consolidation of county health boards. A generous redundancy programme could have removed underperforming staff but the politicians pandered to the unions as usual. Ever since, the HSE has been stuck with executive and employee deadwood.

If failures in delivery of health care and affordable housing continue and an economic recession occurs, Irish politics could become polarised in the next few years between hard left and hard right.
To be fair, any mention of redundancies would have scuppered the setup.of the hse, the unions simply would not countenance it, even though it probably killed 70% of the justification for setting up the hse in the first place.

Further evidence that the public sector is run first and foremost for the employees rather than the customer.

BTW, was it not mm that setup the hse ?
 

patslatt

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To be fair, any mention of redundancies would have scuppered the setup.of the hse, the unions simply would not countenance it, even though it probably killed 70% of the justification for setting up the hse in the first place.

Further evidence that the public sector is run first and foremost for the employees rather than the customer.

BTW, was it not mm that setup the hse ?
Harney was Minister of Health on the HSE's startup. The overly centralised model could be useful for crude cost control but managers weren't free to manage the unionised labour force and achieve the best results. Managers' prerogatives to manage in the health care system are poor, with many managers themselves unionised. Unionised management is an oxymoron.
 


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