Nurses

Purple

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I heard a discussion this morning on RTE radio about the HSE's drive to recruit Irish nurses from the UK and further afield. Liam Doran was not in the discussion. Is he ill?
 
Met him once at Fota - he was in the group ahead of ours. Heard they put on prawn sandwiches in the clubhouse especially for him...
 
I heard a discussion this morning on RTE radio about the HSE's drive to recruit Irish nurses from the UK and further afield. Liam Doran was not in the discussion. Is he ill?

More wurkers = less pay increases for existing wurkers = Liam's absence ;):rolleyes:
 
Met him once at Fota - he was in the group ahead of ours. Heard they put on prawn sandwiches in the clubhouse especially for him...
I think until we find out what's happened to him you should refrain from such derogatory comments. Are you not worried about him as well??
 
I think until we find out what's happened to him you should refrain from such derogatory comments. Are you not worried about him as well??

Deeply worried. Difficult to know though as he gives out so much I'd wonder if he is permanently unwell? Perhaps he had one too many prawn sandwiches. Or even worse, a dodgy bottle of champagne?
 
If anybody has been watching my posts they will see that I warned of what would happen by the government's deliberate failure to replace retiring nurses. Unfortunately, it has come to happen. We need 500 nurses immediately. Only a few years ago I remember my daughter qualifying as a nurse and out of 151 nurses who qualified there were 148 employed in the UK by the following week. The HSE was forced to employ agency nurses (at higher costs) rather than give fulltime jobs to graduates. Ludicrous! Yes! barefaced ludicrous at that.

In the UK Irish nurses were offered generous relocation allowances, fulltime contracts, free access to courses (that they would have had to pay for here), a better quality of work environment etc. And the government thinks that these nurses will return to Ireland? Return to what? Increase in working hours from 37 to 39, a lesser hourly rate, lesser holidays, cut-rate overtime, work another half hour daily at nil pay, less access to courses that the nurses will have to pay for.

Lads, have your laugh, Doran from slow beginnings as a trades union representative has mushroomed into a fierce truth-teller. And even we cannot argue with the truth. Do you think authorities in the UK are stupid enough to let go of Irish Nurses? This is a no-brainer.
 
I met a UK recruiter at a jobs fair in Dublin. She said that they would take every newly qualified midwife in Ireland that they could get and would still be short
 
I met a UK recruiter at a jobs fair in Dublin. She said that they would take every newly qualified midwife in Ireland that they could get and would still be short

Vanessa, you are right. The tragedy here is that we are training nurses/midwives for the export market. The cost on the taxpayer is horrendous. But, we are getting what we put up with.

At Christmas several hospitals set up recruitment stands at our airports to try and entice nurses return to Ireland. That recruitment process was a failure. I notice this time the HSE is looking for full time nursing staff and not 2 year contracts. Furthermore, nurses who work here tend to accept positions in the private sector where the pay and condditions are better. There has been a drain of nursing staff to private hospitals.

The whole set up has been well below par for cost. Agency nurses cost much more than a hospital staff nurse. Furthermore, agency nurses while good at their profession are paid hourly and give an hourly return. Fulltime staff nurses give much more. What I am pointing out are no-brainer situations. Have we got anybody with brains running the country?
 
Furthermore, nurses who work here tend to accept positions in the private sector where the pay and conditions are better. There has been a drain of nursing staff to private hospitals.
If pay and conditions are better in the private sector and they can still compete with the public sector then we should be looking at the structural inefficiencies in the Public Sector which make them uncompetitive. When those are addressed the resources will be there to give pay increases.


The whole set up has been well below par for cost. Agency nurses cost much more than a hospital staff nurse. Furthermore, agency nurses while good at their profession are paid hourly and give an hourly return. Fulltime staff nurses give much more. What I am pointing out are no-brainer situations. Have we got anybody with brains running the country?
Contract staff to not get the same T’s & C’s and full time permanent nurses and, crucially, they do not have a job for life and do not accrue pension entitlements. Taking that pension cost and the lack of labour mobility into account I find it hard to believe that the real total cost of contract staff is higher.

If we are training more nurses than we can employ then we should reduce the number we train.
 
If pay and conditions are better in the private sector and they can still compete with the public sector then we should be looking at the structural inefficiencies in the Public Sector which make them uncompetitive. When those are addressed the resources will be there to give pay increases.


Contract staff to not get the same T’s & C’s and full time permanent nurses and, crucially, they do not have a job for life and do not accrue pension entitlements. Taking that pension cost and the lack of labour mobility into account I find it hard to believe that the real total cost of contract staff is higher.

If we are training more nurses than we can employ then we should reduce the number we train.

1. Nurses are moving to the Private Sector because (a) They get better pay (b) They have to work less unsocial hours. Nurses are not stupid, you know. "Uncompetitive" situations have nothing relevant to my points. Listen to the radio ads re some private hospitals, great if you get sick 8am - 5.00pm Monday to Friday etc you're sound. The Public Sector picks up the slack here and saves the Private Sector considerable money by seeing and accepting patients 24/7. Let's call a spade a spade here.

2. Contract Staff must be paid for holidays, bank holidays, night duty, unsocial hours, weekend work etc too. Whatever way you look at it the price of Contract Staff by far exceeds the cost of Staff Nurses. Incidentally, a Contract person can abandon ship at the end of the day while Staff Nurses bring their experience with them from hour to hour i.e they can't wash their hands of ongoing patient situations.

3. When my daughter completed her nursing degree only a few years ago, she and nearly 100% of newly qualified nurses headed for the UK almost immediately where they were treated well, paid relocation allowances, given free access to Nursing courses that would have cost them here, better working conditions etc etc. If we reduce what we train we'll have nobody to tend to our ageing population. As you can see we almost have that terrible situation already. Even our health people admit there is now a serious shortage of nurses.

But, the Private Sector will save us! Gawd, I can't wait. Wait until the private insurance companies take over all our hospitals as is planned and Purple Auld Stock you'll have what you wished for. And . . . then God help us all . . . I am very frightened . . . Whatever you do, don't get sick . . . the accountants will save us - (Insert a Swear word here).
 
I don't accept that contract staff are more expensive in the long run as they do not accrue pension entitlements.

The Belgian healthcare system is regarded as amongst the best in the world. There are some public hospitals but most are private. They all compete with each other. The public get an excellent service.
If the state could deliver an excellent healthcare service I'd be all in favour of them doing it but they have demonstrated again and again that they are not competent to do so.
If there were no private hospitals then they state would have to provide more. Every euro spent there is a euro that the state doesn't have to spend. Private healthcare is a massive subsidy of the public system.
 
I don't accept that contract staff are more expensive in the long run as they do not accrue pension entitlements.

The Belgian healthcare system is regarded as amongst the best in the world. There are some public hospitals but most are private. They all compete with each other. The public get an excellent service.
If the state could deliver an excellent healthcare service I'd be all in favour of them doing it but they have demonstrated again and again that they are not competent to do so.
If there were no private hospitals then they state would have to provide more. Every euro spent there is a euro that the state doesn't have to spend. Private healthcare is a massive subsidy of the public system.

(a) If you don't accept that contract staff are more expensive in the long run I have the figures. I don't accept that the weather this summer is so bad, but it is. The truth is always the truth and you get that from me. Contract nurses must also be credited with their service for future employment. The clerical support for contract nurses by far exceeds the support for Staff Nurses.

(b) The Belgian healthcare system, the Dutch healthcare system, the British healthcare system are all better than ours. So is most others. Although the Brits complain about their healthcare system they have GP visits, hospital care, prescriptions etc for 10.00 per year. I hear people say the Brits have the population to support this. I am not convinced that with a bit of thought, our government could go down this direction.

(c) Other healthcare systems have (i) private hospitals (ii) public hospitals. They are separate. We have private use by consultants in public hospitals (bloody criminal!).

(d) I look forward to the day that the Gardaí will be bringing drunks, drug abusers etc to private hospitals for help. I can't wait to see chained
prisoners of serious crime brought to private hospitals for care.

(e) Perhaps sometime we can have private hospitals that have an accident and emergency service 24/7?

(f) We have health insurers boasting that you can now be treated in your own home instead of a hospital and a visiting nurse/doctor will be supplied. Great if you have a known illness - too bad if you are being treated for the wrong illness. Is this method 100% safe? Today I asked five nurses and none could give me any guarantee of safety of this method.

(g) I read on the newspapers today that the amount of patients now waiting on trollies is greater than ever. There's something wrong somewhere and you do not have to be an artist to draw conclusions.

Our population will get what it wished for soon enough by handing over the healthcare to the finance people of health insurers. I wonder do they know for what they are wishing?
 
Leper,

We both agree that the healthcare system is a shambles.
We both agree (I think) is that the core problem is not funding.

You are strongly opposed to private hospitals in general and private A&E departments in particular.
Can I ask you why this is? Do you think we would have a better system if there were no public hospitals?
I don't understand how you think a person visiting a private A&E department, thereby not visiting a public A&E and not consuming that public service does not constitute a saving to the state. The same goes for a person opting for a procedure in a private hospital. We can argue that a two-tier system is unfair but that's a different point.

I don't care what system is in place, public, private or a mix of both, as long as it works. I have no faith in the people who run our public system. I include the medical establishment, both doctors and Nurses; they are as part of the problem as the managers and administrators. I do not mean individual nurses or doctors but their representatives, the medical establishment, who have opposed change and improvement for generations.

What we have doesn't work. Throwing money at it hasn't worked. Why not try something different, why not look at the best systems among our neighbours and duplicate what works?
If the Unions are really interested in delivering a world class system for the public and not just feathering their own nests then they would cooperate fully without looking for their pound of flesh.
 
Leper,

We both agree that the healthcare system is a shambles.
We both agree (I think) is that the core problem is not funding.

You are strongly opposed to private hospitals in general and private A&E departments in particular.
Can I ask you why this is? Do you think we would have a better system if there were no public hospitals?
I don't understand how you think a person visiting a private A&E department, thereby not visiting a public A&E and not consuming that public service does not constitute a saving to the state. The same goes for a person opting for a procedure in a private hospital. We can argue that a two-tier system is unfair but that's a different point.

I don't care what system is in place, public, private or a mix of both, as long as it works. I have no faith in the people who run our public system. I include the medical establishment, both doctors and Nurses; they are as part of the problem as the managers and administrators. I do not mean individual nurses or doctors but their representatives, the medical establishment, who have opposed change and improvement for generations.

What we have doesn't work. Throwing money at it hasn't worked. Why not try something different, why not look at the best systems among our neighbours and duplicate what works?
If the Unions are really interested in delivering a world class system for the public and not just feathering their own nests then they would cooperate fully without looking for their pound of flesh.

1. I never said our healthcare system is a shambles. Yes, it could do with improvement and in many instances has shot itself in the foot and will have to come to terms with its shortcomings. But, generally it is a good service. Ask anybody who had serious heart surgery, cancer surgery, etc.

2. I am not opposed to private hospitals. Private hospitals are like private schools, there is a demand for them for one reason or other.But, our private hospitals should be forced to give a 24/7 service and be available for the Gardaí dropping off drug abusers, alcohol abusers too. People get sick outside 9 to 5 you know!

3. The management, medical people, nurses, general staff of public hospitals are easy targets for ridicule. Strangely, it is the people who ridicule them most are the people usurping authority for their own means. How often have you heard a politician say "The back room staff are the cause of the healthcare's problems"? (Medical and Nursing staff are generally referred to as Frontline Staff). Yet, it is the same politicians who are looking for immediate answers to his/her Parliamentary Questions, constituents enquiries etc. Staff working in hospitals would be better used if they had no politicians queries to process. Private hospitals are not answerable to politicians queries.

4. "As long as it works" - You think a private healthcare system works in Ireland? How many people had "tummy tucks," "sagging asses" etc treated in private hospitals under private health insurance? Who pays for this through private health insurance? Answer:- Us and through continuously rising membership fees. You get your GP to write a report that your sagging ass is causing you medical problems and you've got what cannot be otherwise described other than an Extensive Beauty Treatment and paid for by the membership.

I know we have deviated from the title here so let's deviate some more:-
If IKEA is a heaven for flat-pack Ireland. Ireland as a country is a Scamster Heaven. Ask yourself the following questions:- How many people have Medical Cards who should not have them? How many people are working and simultaneously illegally drawing unemployment benefit? How many people are in receipt of Deserted Spouse Allowance and are no more deserted than Times Square? While we're at it . . . how many people obtained 3rd Level Grants who are not entitled to them?

We have two Irelands, those who scam and the PEFT Brigade. [PEFT = Pay Every effing thing]. Our Dept of Social Welfare went after some scammers last year to have their inspectors branded as Nazis and "SS" by the leading opposition party. 3rd Level Grants are seen as fair game by those who can get their accountants to "doctor" the books. I won't even mention the Medical Card Scheme.

We are unlikely to see any abuser of the 3rd Level Grants, crooked Medical Card holders, Social Welfare defrauders brought to justice, outside of very few exceptions. But, the illicit practices recur and its fingers up to anybody who tries to take them to task. But, we as a public pay up, shut up, and do nothing.

So Private Hospitals are going to save us? - I admire your innocence. [Trades Unions are there to represent their members and for nothing else].
 
Leper,
I'm not suggesting that Private Hospitals will solve our problems, not within the current structure anyway. I'm saying that public hospitals won't either.
 
If anybody has been watching my posts they will see that I warned of what would happen by the government's deliberate failure to replace retiring nurses. Unfortunately, it has come to happen. We need 500 nurses immediately. .

Do we? According to the OECD, Ireland has the third highest number of practicing nurses per 1,000 of population in the OECD and this number has increased by 1% since 2000 http://www.oecd-ilibrary.org/sites/9789264183896-en/03/03/g3-03-01.html?itemId=/content/chapter/9789264183896-30-en&_csp_=e92c9913836e5fffbbecfc400984a40b

We've more nurses than the Nordics, except for Denmark. We've almost double the number of nurses than the EU average. Clearly Irish nurses aren't as productive as foreign nurses, so why have we special pay deals and recruitment campaigns for nurses? Especially since, according to the OECD,
nurses in Ireland have relatively high salaries; higher than in e.g. the UK or Norway.
http://www.oecd-ilibrary.org/docserver/download/4211011ec032.pdf?expires=1438882268&id=id&accname=guest&checksum=543DA9F59D1566788C762A3E5653B02C

Perhaps rather than focusing on throwing money at a problem – always the Irish response – we should look at importing foreign work practices into our health service, to bring it up to EU standards. It's not unreasonable in the current economic situation to expect nurses to be at least as efficient as their EU equivalents.
 
Do we? According to the OECD, Ireland has the third highest number of practicing nurses per 1,000 of population in the OECD and this number has increased by 1% since 2000 http://www.oecd-ilibrary.org/sites/9789264183896-en/03/03/g3-03-01.html?itemId=/content/chapter/9789264183896-30-en&_csp_=e92c9913836e5fffbbecfc400984a40b

We've more nurses than the Nordics, except for Denmark. We've almost double the number of nurses than the EU average. Clearly Irish nurses aren't as productive as foreign nurses, so why have we special pay deals and recruitment campaigns for nurses? Especially since, according to the OECD,
nurses in Ireland have relatively high salaries; higher than in e.g. the UK or Norway.
http://www.oecd-ilibrary.org/docserver/download/4211011ec032.pdf?expires=1438882268&id=id&accname=guest&checksum=543DA9F59D1566788C762A3E5653B02C

Perhaps rather than focusing on throwing money at a problem – always the Irish response – we should look at importing foreign work practices into our health service, to bring it up to EU standards. It's not unreasonable in the current economic situation to expect nurses to be at least as efficient as their EU equivalents.

OK PMU let's stop recruiting nurses. You said we have double the EU average of nurses (add in doctors, attendants and health care assistants in other countries and see what figures you come up with). Like you said Irish nurses are not as productive as nurses in other countries, what an inspired statement of rubbish.

You also say we should import foreign work practices. I wonder why so many foreign nurses are trained here for them to return and work in their own countries with Irish practices.

You know PMU, you have opened my eyes. Thank God we exported nearly all our recently qualified nurses to the UK. Somebody said earlier that the UK will accept every nurse we produce and more.

So PMU have a look at my posts and even Purple's both of us have pretty intimate knowledge of the hospital system here. I'm sure the nursing population will be delighted with you. Did you ever think of going into politics? No minister for health even came near solving the problems of the hospital system. You could be the inspiration dear old Ireland needs.
 
Its nice to see a thread like this that gets better as it goes on. After starting as a silly piece on Liam Doran it has become an interesting discussion.

Leper, if PMU says that we have almost twice as many nurses as the OECD average, you will have to better than the above. Is it true and if so why do we need more nurses.

Can I suggest that people working in a poorly managed organisation often work harder and longer with less effect than people working in a well run organisation. Poor productivity is usually a management issue rather than a worker issue.

Improved work practices might allow Irish healthcare staff to deliver a better service.

That we have a very poorly run health service was demonstrated clearly by the attempt to computerise the health service payroll system, which was abandoned after spending €200 million.

You believe that agency staff are more expensive than full time staff. Well I don't know much about health staff costs, but I do know a little about pensions. If a public sector worked retires on a pension of €40,000 pa based on their final salary, that costs the taxpayer about €1.2 million (discounted at 3.33%)so it is very possible that agency staff at a much higher hourly rate work out cheaper than full-time staff.
 
Its nice to see a thread like this that gets better as it goes on. After starting as a silly piece on Liam Doran it has become an interesting discussion.

Leper, if PMU says that we have almost twice as many nurses as the OECD average, you will have to better than the above. Is it true and if so why do we need more nurses.

Can I suggest that people working in a poorly managed organisation often work harder and longer with less effect than people working in a well run organisation. Poor productivity is usually a management issue rather than a worker issue.

Improved work practices might allow Irish healthcare staff to deliver a better service.

That we have a very poorly run health service was demonstrated clearly by the attempt to computerise the health service payroll system, which was abandoned after spending €200 million.

You believe that agency staff are more expensive than full time staff. Well I don't know much about health staff costs, but I do know a little about pensions. If a public sector worked retires on a pension of €40,000 pa based on their final salary, that costs the taxpayer about €1.2 million (discounted at 3.33%)so it is very possible that agency staff at a much higher hourly rate work out cheaper than full-time staff.

The OECD says this and that. Largely what it says in relation to nurses and healthcare staff in general is purely a mismanagement of figures. There are more caring staff in our health service than nurses. There are attendants, health care assistants, doctors, consultants (sorry for stating the obvious). But, when all are compiled you will see that we have less healthcare staff per capita on most (if not all) of the above stated workers.

I'm with you on the poor management issue. I'm with you on the costs of healthcare too. It wasn't the public service that fell down on the job on the computerised payroll issue. "Reputable" consultants were brought in from the private sector and let's be honest cocked up everything that could be cocked up despite early warnings from veteran campaigners. And what I am saying is an understatement.

Now let's look at the pension issue which you raised. If you can show me a nurse, attendant, healthcare assistant, clerical officer, porter, etc retiring on a pension of €40,000 I'll say that you are a magician. A nurse retiring after 40 years service would have a pension much less than that. While I am at it, I (again) wish to point out that public service employees pay into their own pension. Not only that the government (on advice from the private sector accountants) stole (no other word for it) almost the entire pension fund to use as they pleased. The government could not pay it back and implimented a pension levy on public service employees to restock the pension fund. I, for example, am paying a Pension Levy which is greater than my pension entitlement. €40,000 pension for the likes of me, you're dreaming. I won't get even half that.

Let's revisit Agency Staff. They are a necessity in the current environment. They cost more than fulltime staff to service. They must be paid for their holidays, their time, their qualifications. The agency must be paid also. You need back-up staff to process these payments. Let's talk more on Agency Nurses. Let's say a hospital is free of MRSA. An Agency Nurse (attendant, healthcare assistant etc) comes from an infected hospital. How long do you think it will be before the non infected hospital becomes infected?

We can look at other countries and their systems. I like the UK equivalent. Like I pointed out Mick-the-Brit has GP fees, Hospital Care, Prescriptions for £10 per year. We could have that, but political decisions will have to be made and we will have to separate the public from the private healthcare system. But, the Consultants will fight tooth-and-nail to prevent this. Also, they have the political clout. The bottom line in three little words:- Consultants run hospitals.

Our system is subject to many checks (HIQA etc) and a hospital, care-home etc can be closed within hours if standards are not met. We have a public that use Accident & Emergency like a free service. Our Gardaí deliver drug abusers, drunks to hospitals every night putting a strain on resources. I don't blame the Gardaí as they are under scrutiny if anything goes wrong. We have a litigeous state and our healthcare is being sued hourly and in many cases undeservedly. Anybody can turn up at Accident & Emergency, get treatment for almost anything and later walk out and do not have to pay anything. Accident & Emergency have to be protected too. I can say, that as a patient in A&E I experienced some dreadful fear as a result of other patients just dumped into the hospital.

I think I was a little bit rough on PMU above and I apologise for that.

I hope somebody looking in on this forum in ten years time and after privatisation of our hospital system will see a huge improvement in the interim. But, it won't happen and I don't believe things will improve.
 
OK PMU let's stop recruiting nurses. You said we have double the EU average of nurses (add in doctors, attendants and health care assistants in other countries and see what figures you come up with). ..

I never said we have twice as many nurses as the OECD average. The OECD's authoritative publication 'Government at a Glance' said it.

The OECD says this and that. Largely what it says in relation to nurses and healthcare staff in general is purely a mismanagement of figures.
If you say this is 'mismanagement of figures' the fault lies with the Department of Health. OECD member states provide the figures to the OECD for this publication. The OECD is itself disinterested but provides the statistics for informational purposes and to aid policy making in participating states.
 
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