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Hospital Groupings being announced today, real reform or meh?


paulp

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Green light today for six hospital groups - Irish News, World News & More | The Irish Times - Tue, May 14, 2013

God knows James Reilly has been a PR nightmare for the government. It would be nice to think that there has been work going on in the background that will lead to real reform in healthcare in this country which result in a better health service delivered.

Today, we'll see the detail behind the hospital grouping, which on the surface at least, seems to make sense.
Concentrate critical activities into bigger hospitals, use smaller hospitals more specific functions rather than each smaller hospital trying to be a jack of all trades.

Today's announcement and the governments delivery on this strategy will show Reilly to be a good health minister or a failure.
 


Analyzer

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If it was such a good idea, why did it take them this long to think of it ?
 

Sync

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If it was such a good idea, why did it take them this long to think of it ?
:roll: I despair. They haven't thought of it now. Can you not read or do you choose not to?

Reilly's been playing for this since during the election. They've been planning it and mapping out the reorganisation until now. Y'know. Like it's a business plan. Like adults would.

The plan on the face of it is a good one. Whether Reilly will be able to actually get the changes through is a different matter.

Many plans to reform our hospital system have been made before and many reports are gathering dust. But this one will be different because the Government is determined that it is implemented
Mmmm. I bet someone can look backwards and find Harney saying something similar.

In any move like this you do the maths and realised that you can improve care to the masses and ensure more lives are saved by centralising services. The minus side of that is that people will inevitably die as a result of the decision (Which as Minister is fine, you can't save everyone and if the plan saves 5000 lives and 5 die then that's totally acceptable).

The test will be what the govt do when inevitably someone in Ballygobackwards dies because the hospital in the field next door doesn't offer the service it used to and they don't make it to the central hospital that does.
 

Levellers

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It will be a dog's dinner whatever shape it takes. Another layer on top of the Department of Health and HSE.
 

Clanrickard

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The test will be what the govt do when inevitably someone in Ballygobackwards dies because the hospital in the field next door doesn't offer the service it used to and they don't make it to the central hospital that does.
They would need to be in place a comprehensive system of first responders in areas where hospitals will lose services just like they do in countries with well functioning health services.
 

Goa Tse

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Meh. This is just more padding, or in medical terms, like putting a band - aid on someone with a gunshot wound to the head. The health service is irretrievably bollocksed, it's a poison chalice to any minister and it'll never be fixed into something resembling what you'd find elsewhere in the developed world.

I'm surprised actually they didn't go in for a name change and come up with a new acronym while they were at it. How about the The Super Hospital Intensive Training Executive, or S.H.I.T.E for short?
 

paulp

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Meh. This is just more padding, or in medical terms, like putting a band - aid on someone with a gunshot wound to the head. The health service is irretrievably bollocksed, it's a poison chalice to any minister and it'll never be fixed into something resembling what you'd find elsewhere in the developed world.

I'm surprised actually they didn't go in for a name change and come up with a new acronym while they were at it. How about the The Super Hospital Intensive Training Executive, or S.H.I.T.E for short?
then in your view, James Reilly has an impossible task so can't fail.
 

Goa Tse

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then in your view, James Reilly has an impossible task so can't fail.
Well I suppose he can't fail if he doesn't bother his fat arse trying in the first place, so yeah.
Nothing's gonna get done about anything, this is just a dog and pony show by the minister and some civil servants, so that they can be seen to be pretending to do something. Then people will forget for a little while, then they pretend to do something again. Repeat as neccesary.
 
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southwestkerry

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Giving this here been Ireland and our tendency not to be about to manage things properly at many a length....
swk
 

ger12

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Two many groupings.
 

nakatomi

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Seems to me the mater is being demoted along with vincents, the ultimate plan would be to have two major hospitals in Dublin - presumably Beaumont and st James?
 

paulp

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paulp

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And two medical schools (or one)?
Dublin East grouping

Dublin East: Mater Misericordiae University Hospital; St Vincent’s University Hospital; Midland Regional Hospital Mullingar; St Luke’s General Hospital, Kilkenny; Wexford General Hospital; National Maternity Hospital; Our Lady’s Hospital, Navan; St Columcille’s Hospital; St Michael’s Hospital, Dun Laoghaire; Cappagh National Orthopaedic Hospital; Royal Victoria Eye and Ear Hospital. (Academic Partner: UCD).
 

Ribeye

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The word "meh" implies total indifference,

This is going to cause chaos and cost a flippin fourtune,

So it ain't real reform, but it's not meh either,

"Aaarrgggghhh" would be my view,
 

HYENA

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Reilly with a clash of cymbals will reveal his mathematical alogarithm, which makes his friends money and deprives everybody else. PS. He borrowed it from mickey Martin and Hunk Harney.
 

damus

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1. There's zero detail on the membership and the precise skills-mix of the interim board of each hospital group apart from the fact that the minimum should be six and the maximum shall be nine, with the professions comprising of but not be limited to clinical; business; social; legal; medical academic and patient advocacy.
2. It seems that the pre-existing voluntary and state boards of each hospital will co-exist alongside and support the interim board of each hospital group, and this will be achieved by common people being on both boards.
3. The chair of each interim board will be appointed by the Minister which is a replay of the Directorate, and the membership of each board will be appointed by the Chair. In other words, a job for the boys!
4. The performance of the interim board will be evaluated by the Chair - so it's self-evaluation!
5. Each hospital group will also have a CEO who's accountable to the Chair of the interim board and hospital trust board.
6. Each hospital group will have a chief clinical director with overall responsibility for the overall delivery of clinical services, with Individual CDs for medicine, perioperative, diagnostics and women and children.
7. Each group shall also have a chief academic officer who's role will be to develop relationships with all linked academic institutions, international organisations and health systems. The CAO will also be responsible on behalf of the group for approving all research, start-ups and clinical trials at the groups clinical sites. Does that mean there will be no REC and that only one person ie, the CAO will approve all research and clinical trials?
8. Each interim board will have a chief director of nursing, chief finance officer, chief operations officer.
9. The CEO, CFO, CDN and COO posts will be filled by expressions of interest from staff in publicly funded health agencies. The Public Appointment Service will recruit the Chief CD from within the Consultant Medical Staff in the group, and the chief academic officer will be by public appointment.
10. Ffs, they're also planning an "international buddy system" for each hospital group which is suppose to help attitudinal change and a more open culture. Each group must identify a leading international medical institution who'll provide on-going expertise, support, organisational mentoring and advice to the group.

Oh yea the document also makes numerous references to the "HSE or it's successor", leading one to assume that there's zero plan to abolish the HSE afterall!

As for the plan to go down the route of hospital trusts, does Reilly's overpaid advisors not know that's there's trusts over in the UK who've already gone in to administration with many others facing the same fate?

Smaller Hospitals:

11. Apparently, model 2 hospitals will have a daytime urgent care centre with a MAU and a local injuries unit.
12. Pre-hospital care needs will be developed with the cooperation of primary care and in particular out of hours GP services and GP's will refer patients to be assessed in the MAU during daytime....where did we hear this before?
13. Patients will self-refer to the local injuries unit.
14. It seems that model 2 hospitals will admit medical patients 24/7.
15. They will also provide day surgery within defined criteria in addition to the vast majority of OPD services.
16. Model two hospitals WILL NOT have any ICU. So wtf happens in the case of a patient deteriorating who subsequently requires ICU support I hear you ask? Well, those patients will require critical care retrieval and transfer to a Model 3 or 4 ICU! Now what happens if the patient isn't actually stable enough to effect the retrieval or transfer? Are paramedics going to have to instruct transferring doctors who will be accompanying the patient in the ambulance to contact the clinical lead in the Model 3 or 4 hospital to receive instruction, when all the model 2 hospital wants to do is to get the critically ill unstable patient requiring ICU support off their campus? Off course, this never happens with neonates who require transport does it!

http://www.dohc.ie/publications/pdf/SecuringSmallerHospitals.pdf?direct=1

http://www.dohc.ie/publications/pdf/IndHospTrusts.pdf?direct=1
 
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