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Surplus bureaucrats hiding behind front line staff?


patslatt

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An accountant acquaintance tried to break out the numbers and costs of government front line staff and back office staff from various sources.Because of the difficulty in getting cost figures from opaque government sources,he had to rely on estimates,which gives rise to the suspicion that the government would prefer to keep the public in the dark.

His figures on employment numbers for some key departments break down as follows.

Health services total 130,000 staff of which 75,000 are front line and 55,000 back office,the proportion of back office being 42%. Front line staff include 37,000 nurses and 24,968 doctors and dentists.

Education services total 93,000 staff of which 55,000 are front line and 38,000 back office,a proportion of 41% back office.

He lists back office staff for "Regional Bodies" at 40,100,which includes the army of quango bureaucrats, and for the civil service at 38,400.

Bureaucrats have a common ploy for deflecting spending cuts aimed at bureaucratic overheads: they identify their role as much as possible with the front line service providers,the nurses,doctors,teachers etc whose services are appreciated by the public. Their first line of defence is to say that it is unthinkable to cut nurses,teachers and doctors. If it is pointed out that saving could be made in bureaucratic overheads,they claim that their services are inextricably bound up with the front line.

I'd be interested in the opinion of P.ie readers,especially those with a knowledge of administration,on whether the level of back office staff in the figures should be targeted for cuts in the coming mini-budget. The figure for regional bodies seems especially bloated.
 
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Proposition Joe

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Even worse is the trend towards taking on new front-line staff on full-time contracts, as opposed to the permanent positions that their back-office colleagues enjoy.

So when there's a need to cut numbers, the special-needs teacher or agency nurse are given their walking papers.

Not because the services they provide aren't critically important, more that its just impossible to fire anyone else.
 

Dillinger

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But, they would rather close a hospital or cut Doctors pay, than get rid of the many layers of managers that exist in the Health Service. I deal with these people on a daily basis, there are layer upon layer of managers all doing the same job, yet no one ever questions their roles, it is always the front line that suffers, it is a joke !. My father was telling me, that five people used to run the Mater hospital, it would be interesting to see how many run it today.
 

Clanrickard

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But, they would rather close a hospital or cut Doctors pay, than get rid of the many layers of managers that exist in the Health Service. I deal with these people on a daily basis, there are layer upon layer of managers all doing the same job, yet no one ever questions their roles, it is always the front line that suffers, it is a joke !. My father was telling me, that five people used to run the Mater hospital, it would be interesting to see how many run it today.
A nurse told me that when she started in a hospital in Clonmel there were 6 staff. Now there are 25 yet the same number of beds.
 

bormotello

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Australia – 15%
US – depending from state, between 11.4% and 19.3%
NHS in 2007 had 1,330,544 total and 256,686 of Total clerical and administrative staff

I think that realistic target should be around 20% of non-clinical staff
 

patslatt

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Four layers of management in British India;7 for the HSE!

But, they would rather close a hospital or cut Doctors pay, than get rid of the many layers of managers that exist in the Health Service. I deal with these people on a daily basis, there are layer upon layer of managers all doing the same job, yet no one ever questions their roles, it is always the front line that suffers, it is a joke !. My father was telling me, that five people used to run the Mater hospital, it would be interesting to see how many run it today.
British India which included Pakistan and Bangladesh was run by a small number of highly educated British civil servants. They managed with four layers of management. Yet Ireland's HSE has seven layers.
 

patslatt

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Over 20,000 surplus bureaucrats in the HSE?

Australia – 15%
US – depending from state, between 11.4% and 19.3%
NHS in 2007 had 1,330,544 total and 256,686 of Total clerical and administrative staff

I think that realistic target should be around 20% of non-clinical staff
Your figures imply that with efficient management,over 20,000 bureaucrats and non-clinical staff would be surplus to requirements in the HSE. If an average salary and benefits is say 50,000, then that is a potential saving on redundancies of a billion a year.
 

Dios

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Your figures imply that with efficient management,over 20,000 bureaucrats and non-clinical staff would be surplus to requirements in the HSE. If an average salary and benefits is say 50,000, then that is a potential saving on redundancies of a billion a year.
Makes perfect sense. What will we do when they bring the country to a grinding halt by striking however?
 

slx

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I really cannot understand how hospitals need all these administrators, if you consider what a hospital actually does.

What the hell do all of these people do ?!:confused:

The other issue I find a bit ridiculous in Ireland is the cross-over between Health, Education and Welfare.

E.g. there are many aspects of the HSE that should be within the remit of the Department of Social Welfare, i.e. all the payment of grants, relieving officers etc.

There are also questionable cross-over areas between HSE and Department of Education.

All this stuff allows for bloat and fudging of figures.
 

sparkey321

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His figures on employment numbers for some key departments break down as follows.

Health services total 130,000 staff of which 75,000 are front line and 55,000 back office,the proportion of back office being 42%. Front line staff include 37,000 nurses and 24,968 doctors and dentists.
Pat.

Those figures are not only rubbish but dangerous front line staff does not stop with Doctors, nurses and dentists.

What about physiotherapists, radiographers, social workers, cleaners, porters, lab staff, technicians to operate and maintain all this modern medical equipment.

You are over simplifying an issue that is very complex and by doing so building an image that is completely incorrect and creating allot of resentment.

Admin staff account for approx 16% of the HSE workforce not 42% and whats worse I strongly suspect you already know that.
 

Leftfemme22

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I really cannot understand how hospitals need all these administrators, if you consider what a hospital actually does.

What the hell do all of these people do ?!:confused:
Process Insurance claims, generate miles of reports and costing figures and facilitate a business model foisted upon it to cater for greater private Health involvement (co-location) which by its nature is hugely bureaucratic.
 

patslatt

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Pat.

Those figures are not only rubbish but dangerous front line staff does not stop with Doctors, nurses and dentists.

What about physiotherapists, radiographers, social workers, cleaners, porters, lab staff, technicians to operate and maintain all this modern medical equipment.

You are over simplifying an issue that is very complex and by doing so building an image that is completely incorrect and creating allot of resentment.

Admin staff account for approx 16% of the HSE workforce not 42% and whats worse I strongly suspect you already know that.
To quote the accountant's figures: health services total 130,000 staff of which 75,000 are front line and 55,000 back office,the proportion of back office being 42%. Front line staff include 37,000 nurses and 24,968 doctors and dentists.

The 75,000 front line includes the latter two figures which total 61,968,leaving a balance of 13,032 for other front line workers,physios,radiographers etc. I will quote your numbers to the accountant for a response. Definitions of front line may play a part in differences.

POSTSCRIPT. The accountant has a rigid definition of front line staff,which includes doctors,nurses, "Other patient and client care" (the latter a Department of Health definition). In addition,he allows an arbitrary 10% or 13,000 of the total 130,000 health care staff for the remainder of the front line staff,including porters,physios etc.

He feels that the high cost of employing porters justifies outsourcing the function,joking (maybe?) that Polish porters trained as doctors could be hired for less. He also says that technicians who train front line staff are on contract.
 
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bormotello

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Makes perfect sense. What will we do when they bring the country to a grinding halt by striking however?
Alternative system must be created first.
For example, it can be started from network of VHI hospitals and clinics., which will be financed from VHI. Start it from Dublin, then spread over country. Make it commercially efficient. Transfer all VHI patients into those clinics. Offer to employees better salary in exchange of better performance.
Charges in Dundrum VHI clinic is only 30% higher then in Tallagth A&E(100 vs 60 in children’s A&E), but I never seen any queues and never was waiting more then 20 minutes
Another approach is to make a network of independent clinics. For example, polish have here small network of clinics, where prices are lower, service is better and I presume that they are profitable. Of coarse, their consultants didn’t buy property in D4, this why prices are lower.

When alternative capacity will be around 40% of public services, it will be time to hit.
 

bormotello

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Pat.

Those figures are not only rubbish but dangerous front line staff does not stop with Doctors, nurses and dentists.

What about physiotherapists, radiographers, social workers, cleaners, porters, lab staff, technicians to operate and maintain all this modern medical equipment.

You are over simplifying an issue that is very complex and by doing so building an image that is completely incorrect and creating allot of resentment.

Admin staff account for approx 16% of the HSE workforce not 42% and whats worse I strongly suspect you already know that.
HSE Staffing Levels

Nursing 39%
General Support Services 16%
Medical/Dental 11%
-------------------------
Management/Administration 15%
Health & Social Care Professionals 11%
Other Patient & Client Care 8%
 

Young Ireland

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Alternative system must be created first.
For example, it can be started from network of VHI hospitals and clinics., which will be financed from VHI. Start it from Dublin, then spread over country. Make it commercially efficient. Transfer all VHI patients into those clinics. Offer to employees better salary in exchange of better performance.
Charges in Dundrum VHI clinic is only 30% higher then in Tallagth A&E(100 vs 60 in children’s A&E), but I never seen any queues and never was waiting more then 20 minutes
Another approach is to make a network of independent clinics. For example, polish have here small network of clinics, where prices are lower, service is better and I presume that they are profitable. Of coarse, their consultants didn’t buy property in D4, this why prices are lower.

When alternative capacity will be around 40% of public services, it will be time to hit.
As my wife is Polish we came across such a clinic in Cork and we use it all the time when we need to see a specialiast. Pretty much no problem getting immediate appointment or at worst within a few days. They have no problem with seeing Irish patients too and i have happily used them. Yes they aren't equipped up the wazoo but you get your referrals for scans etc very quickly and diagnosed even quicker. What did it take - a few specialists got together, leased some office space, leases some equipment and awayhey. Typically it cost €140 to see the specialist and a little more if some tests done there. Some of them flew in on a Friday, worked Sat and Sun and back home Sunday night with a tidy sum in the back pocket.

There are multitudes of such medical professisionals in Poland and they make a fraction of what our lads do (not to decry the fine hard work of many, but there are the micktakers), and who would gladly set up shop here - in fact give them all set up grants and let them off.
 

ergo2

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surplus bureaucrats? - no such thing - wash your mouth out with soap for even considering such a ridiculous concept.
 

patslatt

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HSE Staffing Levels

Nursing 39%
General Support Services 16%
Medical/Dental 11%
-------------------------
Management/Administration 15%
Health & Social Care Professionals 11%
Other Patient & Client Care 8%
To quote the accountant's figures: health services total 130,000 staff of which 75,000 are front line and 55,000 back office,the proportion of back office being 42%. Front line staff include 37,000 nurses and 24,968 doctors and dentists.

The 75,000 front line includes the latter two figures which total 61,968,leaving a balance of 13,032 for other front line workers,physios,radiographers etc. I will quote your numbers to the accountant for a response. Definitions of front line may play a part in differences.

POSTSCRIPT. The accountanf has a rigid definition of front line staff,which includes doctors,nurses, "Other patient and client care" (the latter a Department of Health definition). In addition,he allows an arbitrary 10% or 13,000 of the total 130,000 health care staff for the remainder of the front line staff,including porters,physios etc.

He feels that the high cost of employing porters justifies outsourcing the function,joking (maybe?) that Polish porters trained as doctors could be hired for less. He also says that technicians who train front line staff are on contract.
 

patslatt

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QuangoMania

surplus bureaucrats? - no such thing - wash your mouth out with soap for even considering such a ridiculous concept.
=====================================================

Notice the mushrooming in HSE quangos below 1999 onwards. Many of the functions of these quangos could be grouped together. It would be interesting to know what the quangos cost.


Health and Children National Haemophilia Council 2004

Health and Children National Treatment Purchase Fund 2004

Health and Children Irish Expert Body on Fluorides and Health

Health and Children Mental Health Commission 2002

Health and Children Office for Tobacco Control 2002

Health and Children Crisis Pregnancy Agency 2001

Health and Children Dental Council 2001

Health and Children Health Insurance Authority 2001


Health and Children National Children's Advisory Council 2001

Health and Children Pre Hospital Emergency Care Council 2000

Health and Children Food Safety Consultative Council 2000

Health and Children Scientific Committee of the Food Safety Authority 2000

Health and Children Food Safety Authority of Ireland 1999

Health and Children Food Safety Promotion Board 1999

Health and Children Institute of Public Health 1999

Health and Children National Council for the Professional Development


of Nursing and Midwifery 1999

Health and Children St Luke's Hospital Board 1999


Health and Children National Childcare Coordinating Committee 1999



Health and Children Consultative Council on Hepatitis C 1997

Health and Children National Council for Aging and Older People 1997

Health and Children National Social Work Qualifications Board 1997

Health and Children Women's Health Council 1997


Health and Children Advisory Committee for Human Medicine 1996



Health and Children Advisory Committee for Veterinary Medicines 1996

Health and Children National Cancer Registry 1991

Health and Children Drug Treatment Centre Board 1988

Health and Children An Bord Altranais - The Nursing Board 1985


Health and Children Health Research Board 1985

Health and Children Irish Medicines Board 1985

Health and Children Leopardstown Park Hospital Board 1979


Health and Children Medical Council 1978


Health and Children Postgraduate Medical and Dental Board 1978
 

JCSkinner

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skinflicks.blogspot.com
British India which included Pakistan and Bangladesh was run by a small number of highly educated British civil servants. They managed with four layers of management. Yet Ireland's HSE has seven layers.
I came across a huge office of HSE staff with little obvious role or work.
I asked the HSE how many worked in that office (or, to be more accurate, how many people enjoyed paid positions in the place.)
They told me that it was 'commercially sensitive' information!
I've now decided to seek the information under FOI.
 

GDPR

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I really cannot understand how hospitals need all these administrators, if you consider what a hospital actually does.

What the hell do all of these people do ?!:confused:
Why cant' people check in at A&E etc via computer terminal (like airport check in) to get a ticket to be seen as efficiently and quickly as possible? This could work if there was a separate queue for people who are illiterate or whos problems urgently preclude them from using a terminal.
If even illiterate non tech savvy homeless drug addicts can go on a cheap holiday to Santa Ponza then surely most of them could handle a terminal with a graphical user interface designed to be idiot proof ? It keeps employment and efficiency costs down at the airlines. It could keep costs down all over our public service.
Another issue seems to be the movement of patient files on trolleys while the patient is waiting to be seen. Thats another thing I have noticed in hospitals which cause bottlenecks and that could be all computerised (and encrypted) with for example instead of employing several people to gather files and wheel them around, X-Rays and medical records etc could be sent immediately in encrypted secure form through a network from one part of the hospital to the attending doctor/nurse now that various e book readers have come onto the market.
I dont like the idea of putting someone out of a job but the economy is so screwed that we urgently need to cut the non essential jobs. If someone on much lower wages at Ryanair can be trusted to get me onto a plane, I cant see why that same or equivalent person cant be trusted to make sure I have 'checked in' to A&E properly. It is similarly an administration job , the difference is one is paid a fraction of the other.
 

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