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.