What changes can be expected from the creation of regional health care groups and decentralisation of HSE functions?

Patslatt1

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The whole point of the abolition of health boards was to achieve economies of scale through centralisation of expensive high tech medicine and efficiencies in administration numbers and costs. While creation of the centres of excellence in cancer care was a notable achievement, the HSE's creation resulted in inflexibility at regional and local level as well as communications difficulties typical of over centralisation which required additional bureaucracy to communicate across layers of bureaucracy.
It will be interesting to see if the new regional groups of hospitals and health services can achieve economies of scale in very expensive high tech medicine despite the decentralisation and if they will be better managed as decentralised units with more responsibility for their own administration. Will the hospitals aim for integration to save on costs or will they be autonomous? Will a great majority of HSE administration and management staff have to move to the regional groups as employees as the HSE becomes a consultancy service to the regions? Will they demand compo for the moves? Will the role of the Department of Health increase? Will creation of group medical practices which are supposed to play an important role receive more attention?
 
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ruman

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We can expect more HSE managers, payrises to compensate staff and no improvement in service.
Its possible services might disimprove but i would certainly expect admin costs to rise.

This is a stone age organisation that still handwrites medical records. Shut the thing down.
 

Patslatt1

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The stated policy of government is to change the HSE function from management and admin to consultancy. The HSE could prove better at the consultancy than management. In practice, the change could be glacial but it needn't be given that the doctors have a low opinion of the HSE and should have more influence within the regional decentralisation.
 
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Patslatt1

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The stated policy of government is to change the HSE function from management and admin to consultancy. The HSE could prove better at the consultancy than management. In practice, the change could be glacial but it needn't be given that the doctors have a low opinion of the HSE and should have more influence within the regional decentralisation.
More interest in trivia than this important topic?
 

nonpolitic

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This proposal, if handled correctly, presents an opportunity to re-shape elements of the health sector. Regionalising it again makes sense as on a micro level it should be easier to identify issues and needs.

This is using the assumption that some service provision methods are not suited to a one size fits all approach. What is suitable for Blackrock, Blanchardstown or Limerick City may mot be suitable for Letterkenny, Tralee or Athlone.

Where a nationwide approach is needed is in the management of personnel, procurement or any other service common to all parts of the health sector nationwide.
 

ruman

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This proposal, if handled correctly, presents an opportunity to re-shape elements of the health sector. Regionalising it again makes sense as on a micro level it should be easier to identify issues and needs.

This is using the assumption that some service provision methods are not suited to a one size fits all approach. What is suitable for Blackrock, Blanchardstown or Limerick City may mot be suitable for Letterkenny, Tralee or Athlone.

Where a nationwide approach is needed is in the management of personnel, procurement or any other service common to all parts of the health sector nationwide.
Ireland is tiny. There is zero need to differentiate in regions given their minute size. All it will do is lead to more HSE managers. Patient service will not improve but costs will increase.
 

Patslatt1

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This proposal, if handled correctly, presents an opportunity to re-shape elements of the health sector. Regionalising it again makes sense as on a micro level it should be easier to identify issues and needs.

This is using the assumption that some service provision methods are not suited to a one size fits all approach. What is suitable for Blackrock, Blanchardstown or Limerick City may mot be suitable for Letterkenny, Tralee or Athlone.

Where a nationwide approach is needed is in the management of personnel, procurement or any other service common to all parts of the health sector nationwide.
Management of personnel should be left to local hospitals with a veto power by the regional group HR. You don't want to impose many employees from a distant HQ.
 

Patslatt1

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Ireland is tiny. There is zero need to differentiate in regions given their minute size. All it will do is lead to more HSE managers. Patient service will not improve but costs will increase.
Health care is the biggest industry in the economy, so even a regional population of half a million generates a lot of revnues in a great variety of health services.The centralised HSE model has failed, so it is logical to try decentralisation. The UK's NHS is the most centralised system but it has set up regional groups.
 

ruman

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Health care is the biggest industry in the economy, so even a regional population of half a million generates a lot of revnues in a great variety of health services.The centralised HSE model has failed, so it is logical to try decentralisation. The UK's NHS is the most centralised system but it has set up regional groups.
We had decentralisation prior to the creation of the HSE. The NHS is not a model we should be aping however. We are an EU country and there are some very well functioning EU health systems with a similar level of spend as ours.

Centralisation/ decentralisation will make little difference. Implementing it however will be lucrative for consultants and create more highly paid HSE management jobs.
For medical staff and patients it wont make any difference. It seems to be a case of politicians wanting to be seen to do sonething yet without an idea of why they are doing it.
 

Dedogs

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The whole point of the abolition of health boards was to achieve economies of scale through centralisation of expensive high tech medicine and efficiencies in administration numbers and costs. While creation of the centres of excellence in cancer care was a notable achievement, the HSE's creation resulted in inflexibility at regional and local level as well as communications difficulties typical of over centralisation which required additional bureaucracy to communicate across layers of bureaucracy.
It will be interesting to see if the new regional groups of hospitals and health services can achieve economies of scale in very expensive high tech medicine despite the decentralisation and if they will be better managed as decentralised units with more responsibility for their own administration. Will the hospitals aim for integration to save on costs or will they be autonomous? Will a great majority of HSE administration and management staff have to move to the regional groups as employees as the HSE becomes a consultancy service to the regions? Will they demand compo for the moves? Will the role of the Department of Health increase? Will creation of group medical practices which are supposed to play an important role receive more attention?
ill tell you whatll happen mate theyll shut any hospital thats not in dublin thats what!!!!! same as the post offices....
 

Craggyjack

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New stationery. Maybe a name change for the different regional organisations. No real improvements in efficiency or cost management.
 

Patslatt1

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We had decentralisation prior to the creation of the HSE. The NHS is not a model we should be aping however. We are an EU country and there are some very well functioning EU health systems with a similar level of spend as ours.

Centralisation/ decentralisation will make little difference. Implementing it however will be lucrative for consultants and create more highly paid HSE management jobs.
For medical staff and patients it wont make any difference. It seems to be a case of politicians wanting to be seen to do sonething yet without an idea of why they are doing it.
German corporations buy medical services for employees from private hospitals and health care providers. The government subsidises low income peoples' care. The problem with that model is that it is too like the American model and makes cost control difficult and companies' cost structures uncompetitive.
Holland has regional monopoly health insurers that are tightly regulated. Cost control is a problem.
Canada has monopoly health boards in each province and the system worked well since startup in the 1970s but shortages of doctors are occuring. Some doctors believe there is a need for more private sector involvement. This has been prevented in the past by a rule that private sector doctors must operate outside the provincial system, a rule designed to control costs.
 


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