Taxpayer funding premises for private business

wombat

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How come if you are on social welfare from the public purse you can be described as a sponger by some, and yet if you are a medical consultant you can swing out of the public purse quite handily and an area I'd really like to see some data on is the usage of public hospital facilities and how consultants pay towards such machinery, depreciation and replacement costs.
Not sure what difference any of that makes to medical services. They say 20% of consultant posts are unfilled so it doesn't seem to be such an attractive job at present.
 


wombat

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That doesnt explain building private business premises for them , particularly in a location where space is at a premium.
I'd say it does, I'm sure the project team would be happy to eliminate anything they could from the project.
 

Lumpy Talbot

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I wonder maybe would there be some benefit to asking the lateral question- which would be why exactly do we find ourselves ferociously recruiting for consultants?

How many consultants does the health sector need in Ireland? Would it not be cheaper to change that paradigm by undercutting the market for consultants by improving conditions for the nearest grade of medico in the public sector and squeeze the private consultancy market a bit?
 

wombat

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I wonder maybe would there be some benefit to asking the lateral question- which would be why exactly do we find ourselves ferociously recruiting for consultants?
Its a good example of forgetting what a health service is supposed to achieve which is successfully treating sick people. There is no need to hire any consultants, in fact, it would be a really good way to help clear waiting lists. We could hire more nurses so that patients could die in more comfort.
 

ruman

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Its a good example of forgetting what a health service is supposed to achieve which is successfully treating sick people. There is no need to hire any consultants, in fact, it would be a really good way to help clear waiting lists. We could hire more nurses so that patients could die in more comfort.
That's ( mostly) not applicable in a childrens hospital though. Minimal parking for parents bringing sick children, almost certainly no room for a maternity hospital and insufficient room for certain helicoptors to land but hey we can build rooms for consultants to treat private patients!

You'd have to assume most of these consultants are also treating public patients so i'd wonder have we built double the capacity of consultant rooms? Presumably ( given the consultant cant be in 2 places at the same time) either the public or private room will be unused result in significant undercapacity!
 

Massey

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This should not be allowed, it reinforces the two tier , "priority boarding," system we have here - which is one of the reasons why the public system is so bad ., If the public system was good , no one would get private insurance.
 

wombat

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The basic problem with medical consultants is that the good ones cost a lot of money and if they can't earn it here they will earn it elsewhere. It would be interesting if there was a doctor posting who could explain whether the shortages are in certain specialities or are they across the board and if geography plays a part.
 

wombat

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You'd have to assume most of these consultants are also treating public patients so i'd wonder have we built double the capacity of consultant rooms? Presumably ( given the consultant cant be in 2 places at the same time) either the public or private room will be unused result in significant undercapacity!
No idea why the contracts include the mix for public/private practice but I'd guess its a way of reducing public wages.
 

ruman

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No idea why the contracts include the mix for public/private practice but I'd guess its a way of reducing public wages.
But increasing public waiting lists.

Its a gift from the taxpayer to private business. The lack of critical commentary in the media is disgraceful and Brutons justification of it is disturbing.
 

ruman

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The basic problem with medical consultants is that the good ones cost a lot of money and if they can't earn it here they will earn it elsewhere. It would be interesting if there was a doctor posting who could explain whether the shortages are in certain specialities or are they across the board and if geography plays a part.
Realistically you're not going to get the good ones to come to places like Drogheda, Navan etc. Given our population size we have far too many hospitals and there's an element of " empire building" among managers and senior medics in some of these smaller hospitals.

Its unikely you'll generate sufficient opportinities for decent training in many of those hospitals. The solution clearly is consolidation and closing many of them but politics prevents this, we see a similar situation with universities.

I'm doubtful that increasing pay by even 10-20k will make much difference given working conditions are pretty poor. There seems to be an unwllingness amongst junior doctors to question senior medics who as a group have substanial power and bear some responsibility for the poor working conditions and poor state of the health service. Its too easy to blame it all on HSE managers.
 

Northsideman

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So our taxes will be building private rooms for medical consultants in the new "public" childrens hospital. What next Paschal building a new HQ for AIB!

"Mr Bruton also told the Dáil that eight private outpatient consulting rooms will be part of the €1.7 billion project under construction. He insisted that the private provision of care “is not a major element of this project” and “going to be at a very low level”.

Just think of it as FGs contribution to Social Housing only this time for already wealthy medics, just part of their new all inclusive love everyone tree hugging spinned up image.
 

Massey

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Realistically you're not going to get the good ones to come to places like Drogheda, Navan etc. Given our population size we have far too many hospitals and there's an element of " empire building" among managers and senior medics in some of these smaller hospitals.

Its unikely you'll generate sufficient opportinities for decent training in many of those hospitals. The solution clearly is consolidation and closing many of them but politics prevents this, we see a similar situation with universities.

I'm doubtful that increasing pay by even 10-20k will make much difference given working conditions are pretty poor. There seems to be an unwllingness amongst junior doctors to question senior medics who as a group have substanial power and bear some responsibility for the poor working conditions and poor state of the health service. Its too easy to blame it all on HSE managers.
Especially if there are no publicly funded private facilities in these hospitals.
 

ruman

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Especially if there are no publicly funded private facilities in these hospitals.
Maybe we should build free houses for consultants as well?

I mean they get their expensive education paid for and business premises built yet all we get in incessant whining and threats to run off to the US/UK.
 

ruman

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Apparently we're also indemnifying them for private work. Seems to be some of sort of glorified social welfare scheme for highly paid medical consultants!

Free education
Private business premises built
Free insurance

Anything else the taxpayer is funding these private business for?

I'd be curious to learn more about usage of equipment and charges if any are being applied to consultants using public equipment for private clients.

 

Massey

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Its about a €40,000 charge for consultants to bill private patients in public hospitals.
 

ruman

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Its about a €40,000 charge for consultants to bill private patients in public hospitals.
Will that charge apply in the private rooms of the new childrens hospital one wonders. Stephen Donnelly suggested there would be a seperate entrance (Harris doesnt know apparently! ).

Does it grant access to public equipment?

I'd send the revenue in, clear benefit in kind implications.
 
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Massey

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Will that charge apply in the private rooms of the new childrens hospital one wonders. Stephen Donnelly suggested there would be a seperate entrance (Harris doesnt know apparently! ).

Does it grant access to public equipment?

I'd send the revenue in, clear benefit in kind implications.
You could do that, not sure how effective that would be.

The issue with the childrens hospital is that many consultants pay 40-80 k for the right to bill in public hospitals, as well as this the hospitals get hundreds of millions from these patients in effect double billing as most have already paid for these beds through taxes.
The two tier system suits no one and every one, in effect people are paying on the double for the same healthcare, however get rid of it and you can add 5% at least to income tax. The morals of a priority boarding vs incometax raises for everyone.
 

ruman

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You could do that, not sure how effective that would be.

The issue with the childrens hospital is that many consultants pay 40-80 k for the right to bill in public hospitals, as well as this the hospitals get hundreds of millions from these patients in effect double billing as most have already paid for these beds through taxes.
The two tier system suits no one and every one, in effect people are paying on the double for the same healthcare, however get rid of it and you can add 5% at least to income tax. The morals of a priority boarding vs incometax raises for everyone.
I've no idea where you have pulled that 5% figure so its pointless disputing it without any back up being provided. What i will say is our spending on health is already above the OECD average so that doesnt stack up unfortunately.

The are huge administrative inefficincies in the public/private hybrid. Removing private consultants entirely from public hospitals should be the long term aim. Certainly in the case of the childrens hospital there is no justification for them having a presence. They arent working in private practice for charity it is because of the large profits available , profits that exist at least to a certain extent due to a taxpayer subsidy.

Its unacceptable and its great to see it finally being questioned in the media.
 

Massey

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I've no idea where you have pulled that 5% figure so its pointless disputing it without any back up being provided. What i will say is our spending on health is already above the OECD average so that doesnt stack up unfortunately.

The are huge administrative inefficincies in the public/private hybrid. Removing private consultants entirely from public hospitals should be the long term aim. Certainly in the case of the childrens hospital there is no justification for them having a presence. They arent working in private practice for charity it is because of the large profits available , profits that exist at least to a certain extent due to a taxpayer subsidy.

Its unacceptable and its great to see it finally being questioned in the media.
if we have no private practice, all 50% of the population who pay for priority boarding in public hospitals or are treated in private hospitals , plus the thousands of public patients treated in private hospitals will have to go to the public system as public patients, as a result queues will double, and taxes will increase.

Begrudging has created a crisis in our healthcare system where hundreds of these "super duper" "mega bucks" consultant positions are empty.
 

ruman

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if we have no private practice, all 50% of the population who pay for priority boarding in public hospitals or are treated in private hospitals , plus the thousands of public patients treated in private hospitals will have to go to the public system as public patients, as a result queues will double, and taxes will increase.

Begrudging has created a crisis in our healthcare system where hundreds of these "super duper" "mega bucks" consultant positions are empty.
Queues wont double, they will be the same however patients will be seen based on need rather than financial means.

These are private businesses, do you think the taxpayer should pay indemnity insurance for other professions, solicitors/ accountants etc? Maybe build an office for Arthur Cox in the department of Justice? Plush office for the Head of BOI beside Paschal!

I havent mentioned pay. Start another thread with that subject if you want.
Again consultants can work wherever or whenever they want if they want to run ,private business dont expect the taxpayer to subsidise it.

Our healthservice is in crisis due to poor management and gross inefficincies part of which is as a result of the extra costs incurred by the additional administrative burden of running a two tier health service.
 
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