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HSE bashing


ger12

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Feb 25, 2011
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48,254
The HSE gets the blame for almost everything round here. Unfairly IMO. I'm a long long time working on the frontline in Irish hospitals. There have been great improvements in recent years in standards of services and care provided due to the HSE I believe, evidence based best practice being the mantra.

According to the 2009 and 2012 Euro Health Consumer Index, the country's health service is currently ranked 13th out of 33 European health services, ahead of Germany.

This marks a significant improvement since the survey in 2006, when Ireland was listed in 28th place out of 29 nations included.

The Executive was established by the Health Act, 2004 and came into official operation on 1 January 2005. It replaced the ten regional Health Boards, the Eastern Regional Health Authority and a number of other different agencies and organisations. Remember them? You know, when it was who you knew from whichever political party that could bump you up a waiting list.

So Michael Martin, as Minister for Health from 2000-2004, introduced a ban on tobacco smoking, disbanded the health boards and established the HSE, and in particular oversaw serious steps to improve cancer and cardiac services, with e.g. delivery of the first National Cancer Strategy.

As CEO, Professor Drumm (at the time Head of the Department of Paediatrics at University College Dublin and Consultant Paediatric Gastroenterologist at Our Lady's Children¿s Hospital in Dublin) led the largest public service Transformation Programme ever undertaken in Ireland.

Now it hasn't been easy and certainly has it's flaws. I'm not suggesting that the HSE is perfect but I am suggesting as a model, it can work in this country when there is a separation of power between the Government of the day and the body that is responsible for the delivery of health services. Had politicians continued to drive the health service before the establishment of the HSE, we'd continue to have a hospital in every town, with inefficient and fractured services. Not e.g. Centres of Excellence for Cancer Care where an abnormal CXR or breast lump can get you an appointment in a rapid access clinic within two to four weeks.

The failure to ensure a sod has been turned on a NCH is a political failure and a great injustice for this States children.

Moving on to Minister Reilly. The independent HSE board asked to step down, his own chaps replacing them from the HSE and DOH. Then there's the the Health Service Executive Governance Bill. It will enable the Department of Health to have control of the entire health budget from January 2014 onwards. Where to start? I've posted a link to a blog by journalist, broadcaster & policy analyst Sara Burke which makes for serious food for thought regard this Bill.

In financial perilous times such as these, maintaining services are challenging. And the last twelve months have been most difficult as many services have been stretched to breaking point. Perhaps now we should, as a Nation, be discussing exactly what form of health service do we see in the future. Private? Mix of public/private? An NHS style? Everyone equal? You get what you pay for? No sign of the promised White paper on Universal Health Care while we appear to be heading towards a U.S. style system.

Lastly, I'm not a member of any PP, would be known on this site to promote Green policies.


Just more jobs for the boys | SaraBurke.com
Euro health consumer index - Wikipedia, the free encyclopedia
Aviva - Irish healthcare system shows major improvement
HSE.ie - Health Service Executive Website -
The devil without the details | SaraBurke.com
Health Service Executive (Governance) Bill 2012
http://www.oireachtas.ie/viewdoc.asp?fn=/documents/bills28/bills/2012/6512/document1.htm

HSE terminates funding for patient group - Health News | Irish Medical News | The Irish Times - Sat, Apr 27, 2013
Childcare cases taken by HSE increased by 20 per cent last year, data shows - Crime & Law News from Ireland & Abroad | The Irish Times - Mon, Apr 15, 2013
HSE left
Report shows HSE failures in child protection - RTÉ News
HSE to review Midleton ambulance response - RTÉ News
Another HSE scandal - Will this madness ever end? | Irish Examiner
 
Last edited:


Cassandra Syndrome

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The HSE spends the most per capita for any health board on the planet. That's the fundamental flaw.
 

ger12

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Prester Jim

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I don't think the bashing is ever about the frontline staff as a whole or even sections of it, every sane person deeply appreciates the service given.
The bashing is about the HSE leadership, health ministers and management in general.
For me it is about the total lack of vision; are they looking after everyone universally or are they private?
This fast and slow track service is abominable and immoral in my view.
We need to decide on the one method and have it for all and have it put into actions as soon as possible.
 

ger12

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Feb 25, 2011
Messages
48,254
I don't think the bashing is ever about the frontline staff as a whole or even sections of it, every sane person deeply appreciates the service given.
The bashing is about the HSE leadership, health ministers and management in general.
For me it is about the total lack of vision; are they looking after everyone universally or are they private?
This fast and slow track service is abominable and immoral in my view.
We need to decide on the one method and have it for all and have it put into actions as soon as possible.
A Strategy for Cancer Control in Ireland published in 2006 has lead to HSE National Cancer Control Programme.

A Strategy for Cancer Control in Ireland
Cancer services
National Cancer Control Programme · TheJournal.ie

Frontline staff like myself depend on organisations like the HSE to come up with plans such as these, based on best practice, to implement best practice.

The vision shown by Michael Martin in undertaking to reform our healthcare system was and is commendable. The lack of vision in recent years is of serious concern. The two tier health system is becoming a three tier one.
 

Cassandra Syndrome

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Cassandra Syndrome

Well-known member
Joined
Aug 23, 2009
Messages
16,908
I don't think the bashing is ever about the frontline staff as a whole or even sections of it, every sane person deeply appreciates the service given.
The bashing is about the HSE leadership, health ministers and management in general.
For me it is about the total lack of vision; are they looking after everyone universally or are they private?
This fast and slow track service is abominable and immoral in my view.
We need to decide on the one method and have it for all and have it put into actions as soon as possible.
Bingo. That's the problem. Too many chiefs, not enough indians. Everyone knows and appreciates the commitment and work effort of doctor and nurses and the health carers, it's the fat cats at the top doing nowt and badly managing the system that rattles peoples cages.
 

Prester Jim

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Jul 3, 2009
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A Strategy for Cancer Control in Ireland published in 2006 has lead to HSE National Cancer Control Programme.

A Strategy for Cancer Control in Ireland
Cancer services
National Cancer Control Programme · TheJournal.ie

Frontline staff like myself depend on organisations like the HSE to come up with plans such as these, based on best practice, to implement best practice.
I don't deny they have some good ideas, I just doubt their ability to run the HSE as a cogent whole because I doubt they have a proper vision as to how it should be run. Hopefully I am wrong.
I know it seems like laziness to look other places for solutions but, there are systems in other states that do work well or at least better than the HSE does.
We are looking at Finland, NI and other places for models to improve the DoE, why not do the same for the HSE.
There was a lot of talk about the Dutch model or the Canadian model being adopted here.
All efforts quickly seem (from my outside perspective) to become swamped in fights with vested interests or watered down politically because some minister or lobby group sticks their oar in and makes a play to distort the proposed model in their favour.
This is usually private companies, hospitals or health insurance groups it seems.
We all feel ownership of the HSE and feel frustrated that our voice is lost in the din from lobbyists.

As a health insider you must have an opinion about how the future HSE should look and what model we should be aiming at?
 

ger12

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Messages
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Bingo. That's the problem. Too many chiefs, not enough indians. Everyone knows and appreciates the commitment and work effort of doctor and nurses and the health carers, it's the fat cats at the top doing nowt and badly managing the system that rattles peoples cages.
What do you suggest as a way forward? No HSE?
 

Cassandra Syndrome

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Prester Jim

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What I would really love to see is a public discussion process with all bodies, lobby groups, the HSE staff, the public and anyone else involved.
Then I would love a referendum on a couple of definitive working visions that had been fully fleshed out at the debate stage.
Whatever the public decide then becomes IT, the law and the future, inviolable by lobby groups or fidgety ministers married to interest groups or ministers who embody interest groups (wealthy private health company owners).
 

bactrian

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May 11, 2004
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1,232
I don't think the bashing is ever about the frontline staff as a whole or even sections of it, every sane person deeply appreciates the service given.
The bashing is about the HSE leadership, health ministers and management in general.

Pester Jim seems to have it right.

If we look at the report in todays IT


HSE did not report cases of suspected child abuse or neglect - Social Affairs & News from Ireland & Abroad | The Irish Times - Sat, May 11, 2013

"Inspectors have found evidence that vulnerable children are being placed at risk by the failure of social services to notify gardaí of suspected abuse and neglect concerns. "


When you read down the page you will be horrified at the failures of the HSE



However Frontline Staff are praised :

" Staff performance praised
The findings were more positive when it came to performance of staff who, inspectors found, were providing a safe service. The standard of practice and quality of assess ments was good, but inspectors said the system they were working in was not robust and was leading to poor outcomes for some children. "

We should continue to bash the HSE ,but not the Frontline staff. Perhaps we should be enquiring as to why management are not making reports to the Gardai(as is their legal duty) , and perhaps we should be seeing criminal prosecutions of these managers who fail to make these Reports
 

ger12

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Joined
Feb 25, 2011
Messages
48,254
I don't deny they have some good ideas, I just doubt their ability to run the HSE as a cogent whole because I doubt they have a proper vision as to how it should be run. Hopefully I am wrong.
I know it seems like laziness to look other places for solutions but, there are systems in other states that do work well or at least better than the HSE does.
We are looking at Finland, NI and other places for models to improve the DoE, why not do the same for the HSE.
There was a lot of talk about the Dutch model or the Canadian model being adopted here.
All efforts quickly seem (from my outside perspective) to become swamped in fights with vested interests or watered down politically because some minister or lobby group sticks their oar in and makes a play to distort the proposed model in their favour.
This is usually private companies, hospitals or health insurance groups it seems.
We all feel ownership of the HSE and feel frustrated that our voice is lost in the din from lobbyists.

As a health insider you must have an opinion about how the future HSE should look and what model we should be aiming at?
I'm a fan of the HSE, even with its flaws. I moved from the NHS to the Irish healthcare system in the early '90's and was dismayed at the standards and care I encountered here. I'm impressed with the serious improvements, HSE policy driven, in recent years. I am concerned at the Ministers plans to ensure he has full control over the kitty.

The greatest challenge now is maintaining services. And fighting and winning against the vested interests (who now include the Minister judging by this behavior over the last two years).
 

tipp revolution

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Feb 16, 2011
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2,603
well done for sharing your opinions with us ger and with all the bad press the hse gets its nice to hear that the standards are improving and i have personal experience of excellent serviec in top class facilities in hospitals

gp@s need a kick up the jacksie
computerise records in the hse immediately
 

ger12

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Joined
Feb 25, 2011
Messages
48,254
well done for sharing your opinions with us ger and with all the bad press the hse gets its nice to hear that the standards are improving and i have personal experience of excellent serviec in top class facilities in hospitals

gp@s need a kick up the jacksie
computerise records in the hse immediately
Yep, GP services need looking into. My own GP is pretty good and the Doc On Call service is also pretty good but I'm well aware this isn't the case everywhere. Sill 50 quid a visit. :|.

Computers are playing a role. My own unit will be heading that way soon. Have you heard of this?

HSE introduces 'filmless' x-ray system - irishhealth.com
 

Malbekh

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Apr 30, 2009
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The central issue with the HSE dates to its inception in 2005. Amalgamating 10 regional health authorities should have been instigated on the basis of rationalising everything resulting in a massive reduction in staff numbers - particularly with administrative sections - as well as shutting down a number of regional hospitals and the creation of new, larger specialist ones.

In 2005, the country was awash with loot from the property bubble, the funding was there to achieve this, but not the ability or the wherewithal. The fact that the idiot responsible for this, Micheál Martin is leader of FF and the will almost certainly be the next Taoiseach, tells you all you need to know about this country and its politicians.

So no, I don't blame the HSE for the hundreds if not thousands of incompetent staff still employed within, and the useless and wasteful infrastructure imposed on it. I blame the politicians and the senior civil servants for failing in their primary duty to the State and its citizens.
 

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