The HSE is a huge failure, pointless tinkering around the edges

Disillusioned democrat

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Of late the IT seems to have become a liberal rag, but for the first time in a long time I have read something I whole heatedly agree with.

https://www.irishtimes.com/news/health/politicians-and-hse-to-blame-for-our-health-service-debacle-1.3345090

My own experience of the HSE was one of excessive empire building, cronyism and bureaucracy. It's structure was defined by a retired banker who spend 9 months touring Health Boards on a "change management" mission (5 star hotels and all expenses paid), then when he retired the management teams of the boards all conspired to ensure the "important" issues of their own self importance was addressed as a priority, then "their" peoples' jobs were secured and finally - 36 months later - people started to consider patients and healthcare provision.

The HSE was established for the right reasons but in the wrong way - it's structurally not fit for purpose, so all the tinkering around individual hospitals waiting lists, doctors contracts, etc., is just noise and won't resolve the big ticket issues like overall value for money or consistent service levels.
 


Analyzer

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Don't be surprised if the Brussels bloc decides to create an ESE for education at some point in the future.

They love instutional overbearance and centrslised control. They have not admitted to the current mess being ineffective.

By the way, the role of Meehaul 'the developers money was just resting in the wife's account' Martin in all of this, seems to be frequently forgotten.
 
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Roll_On

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Absolutely ineffective but that's to be expected as the largest arm of a dysfunctional state. 2017 was a record year for tax revenue. €50bn all in all.
That is a MASSIVE sum of money to run a country of a mere 4.5million people which only has intermittently functional public services, all of which are extremely low tech compared to the rest of the world (tax discs on windshields, hello is that 1988 calling??). There's only a limited military, basic health care provision which often fails patients, the streets are piggy dirty, there's no cops on the streets, waste management is privatized, we're only spending megre sums here in there on incrementally improving Victorian era infrastructure, which is degrading faster than it's being replaced.

Where has our €50bn gone? Would we be better seeking the services of a very good fund management firm, say €40bn a year to run the services we have now, surely the talent exists to deliver hardly anything which such massive resources.
 

hammer

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With all the new staff expected into the public service over the next few years that spending is only going in one direction.

Also the reversal of FEMPI !!
 

Analyzer

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It is a great country to do state funded largesse in....

And next up....the PRAVDA tax will be given to a print media duopoly who cannot make a profit paying Tintan the Fool 80 grand to write two articles a week that always amount to predictable drivel, & telling us that the livestyle purchases of rugger wives should set the tone for consumption behaviour.

The statists are on an ego binge of their own competence.

The HSE is not the outlier. It is the template for how the clowns in charge want to run the institutional state. The want to make every form of statism bigger, more largesse ridden, less accojntable and more over extended.
 

Disillusioned democrat

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Absolutely ineffective but that's to be expected as the largest arm of a dysfunctional state. 2017 was a record year for tax revenue. €50bn all in all.
That is a MASSIVE sum of money to run a country of a mere 4.5million people which only has intermittently functional public services, all of which are extremely low tech compared to the rest of the world (tax discs on windshields, hello is that 1988 calling??). There's only a limited military, basic health care provision which often fails patients, the streets are piggy dirty, there's no cops on the streets, waste management is privatized, we're only spending megre sums here in there on incrementally improving Victorian era infrastructure, which is degrading faster than it's being replaced.

Where has our €50bn gone? Would we be better seeking the services of a very good fund management firm, say €40bn a year to run the services we have now, surely the talent exists to deliver hardly anything which such massive resources.
Success for Irish politicians and senior public servants is guaranteed by their ability to make a robust defense as opposed to point out their achievements - this is nowhere more obvious than in our own Taoiseach and erstwhile Minister for Health.

Potentially the electorate are to blame for being slower to reward success than we are for pounce on failure - it's seems it's better to succeed at doing nothing than to fail at doing something worthwhile.

The HSE was designed from the top-down as opposed to the bottom up, and then, to make matters worse, they bolted on the two tier/collocated health system at the same time and yet retained the "political" element of the health service where people still feel it appropriate to call their TD or minister when there's a whiff of a crap A&E unit being downgraded.
 

Analyzer

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Absolutely ineffective but that's to be expected as the largest arm of a dysfunctional state. 2017 was a record year for tax revenue. €50bn all in all.
That is a MASSIVE sum of money to run a country of a mere 4.5million people which only has intermittently functional public services, all of which are extremely low tech compared to the rest of the world (tax discs on windshields, hello is that 1988 calling??). There's only a limited military, basic health care provision which often fails patients, the streets are piggy dirty, there's no cops on the streets, waste management is privatized, we're only spending megre sums here in there on incrementally improving Victorian era infrastructure, which is degrading faster than it's being replaced.

Where has our €50bn gone? Would we be better seeking the services of a very good fund management firm, say €40bn a year to run the services we have now, surely the talent exists to deliver hardly anything which such massive resources.
Thank you. That is badly needed.

It is the complete opposite of the relentless nonsense from the mainstream Irish media.
 

Golden Phoenix

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Don't be surprised if the Brussels bloc decides to create an HSE for education at some point in the future.
It's here already, going back to the 1930's.

It's currently called "Education & Training Board", formerly "Vocational Education Committee".

And it's every bit as dysfunctional as the HSE.
 

agamemnon

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Of late the IT seems to have become a liberal rag, but for the first time in a long time I have read something I whole heatedly agree with.

https://www.irishtimes.com/news/health/politicians-and-hse-to-blame-for-our-health-service-debacle-1.3345090

My own experience of the HSE was one of excessive empire building, cronyism and bureaucracy. It's structure was defined by a retired banker who spend 9 months touring Health Boards on a "change management" mission (5 star hotels and all expenses paid), then when he retired the management teams of the boards all conspired to ensure the "important" issues of their own self importance was addressed as a priority, then "their" peoples' jobs were secured and finally - 36 months later - people started to consider patients and healthcare provision.

The HSE was established for the right reasons but in the wrong way - it's structurally not fit for purpose, so all the tinkering around individual hospitals waiting lists, doctors contracts, etc., is just noise and won't resolve the big ticket issues like overall value for money or consistent service levels.
Totally agree.

A few years ago, and a couple of years after the establishment of the HSE, on a couple of occasions, I met one of the former Chiefs of one of the defunct Health Boards. It was in the course of a leisure activity which took place during the daytime during normal working hours. He was a supercilious ***** and proud of the fact that he retained his pay and conditions under the new HSE setup while having no real function or work to do and no oversight or supervision of what he was even nominally supposed to be responsible for.

It's hardly surprising it went down the tubes!
 

Analyzer

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In this country anything that works effectively, seems to do so in spite of the instutional state.

The last two decades have seen a relentless push for statist control over mire aspecrs of society. And in particular a push for more money out of working people.

And nobody seems to ask for it to stop, in a seripus determined manner.
 

SayItAintSo

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With all the new staff expected into the public service over the next few years that spending is only going in one direction.

Also the reversal of FEMPI !!
If people want a 24/7 service or anything close, it will require a lot more staff even allowing for changs in work practices.
 

bokuden

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Of late the IT seems to have become a liberal rag, but for the first time in a long time I have read something I whole heatedly agree with.

https://www.irishtimes.com/news/health/politicians-and-hse-to-blame-for-our-health-service-debacle-1.3345090

My own experience of the HSE was one of excessive empire building, cronyism and bureaucracy. It's structure was defined by a retired banker who spend 9 months touring Health Boards on a "change management" mission (5 star hotels and all expenses paid), then when he retired the management teams of the boards all conspired to ensure the "important" issues of their own self importance was addressed as a priority, then "their" peoples' jobs were secured and finally - 36 months later - people started to consider patients and healthcare provision.

The HSE was established for the right reasons but in the wrong way - it's structurally not fit for purpose, so all the tinkering around individual hospitals waiting lists, doctors contracts, etc., is just noise and won't resolve the big ticket issues like overall value for money or consistent service levels.
FG have just turned the health service into a basket case. They have done this because they want to force eberyone to go private. If people die in the process, well thats a price worth paying. fgers support this.
 

hammer

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FG have just turned the health service into a basket case. They have done this because they want to force eberyone to go private. If people die in the process, well thats a price worth paying. fgers support this.
Rubbish.

We should all go public and then see what happens.
 

hammer

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Did I read a few years back that somewhere like Tralee Hospital had 30+ porters.

There was an emergency, no porter could be found and a nurse had to wheel a patient somewhere.

The Union were up in arms :(
 

Disillusioned democrat

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FG have just turned the health service into a basket case. They have done this because they want to force eberyone to go private. If people die in the process, well thats a price worth paying. fgers support this.
Can't disagree there - FG's "miracle" recovery was basically fueled by imposing 1st world taxes while providing 3rd world services.

However I think the blame needs to be shared equally across ALL politicians, even the independents who champion an A&E in every village or who get their feckless cousin a job as a grade 7 administrator.

FF oversaw the whole establishment of the HSE - they appointed the first board and watched as a national body was carved up into regional fiefdoms again despite running 100% against the initial core principals of the HSE.
 

Disillusioned democrat

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What's actually required to fix this, though?

The HSE needs to be designed from the bottom up - based on patients' care needs BUT based on a realistic budget.

Politicians need to be kept well and truly OUT of the process - all decisions need to be made on a clinical effectiveness and value for money perspective and budgets need to be allocated on a 5 year basis.
 

bokuden

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Can't disagree there - FG's "miracle" recovery was basically fueled by imposing 1st world taxes while providing 3rd world services.

However I think the blame needs to be shared equally across ALL politicians, even the independents who champion an A&E in every village or who get their feckless cousin a job as a grade 7 administrator.

FF oversaw the whole establishment of the HSE - they appointed the first board and watched as a national body was carved up into regional fiefdoms again despite running 100% against the initial core principals of the HSE.
Agreed. It's been a disaster long in the making. FF basically outsourced health to the PDs/Mary harney who really ramped up the "money follows the patient" model.
 


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