A&E departments crammed to capacity,whats Leo going to do now?

F

flowerman

Guest
So whats Mr Varadkar going to do to sort this holy mess out now?

I think that he took on the wrong job and Id say that James O'Reilly is well happy and he finally got out of it when he did.
 
Why is the Minister always expected to sort out detailed administrative inefficiencies?
There is far more money in health than should be required. The solution is not to waste as much. It seems that some Lean principles are being applied in hospitals and the HSE generally but I have no idea how widespread or deep that goes. The solution is to do thousands of small things better. If you want to improve a process the first thing you do is ask the people who carry out the processes what the problems are.
If the heads of nursing, Admissions, patient discharge (assuming there is one), a few of the senior doctors and whatever other senior staff are required all sat in a room they could identify the choke points and probably identify the solutions.
If your were spending more than you earn in your own house the first thing you'd do is eliminate waste. Why does the same principal not apply when it's comes to the money the government takes out of your household in taxes?
 
Our Health Service has deliberately been run down for years. We have probably the best paid doctors in Europe. Our Medical Consultants are amongst the top paid people in the world. We have a public that insists on Freedom of Information where hospital staff spend an inordinate amount of time locating, copying, replying, advising etc and for people who received hospital treatment 30 years previously. A Medical Consultant with one secretary is a rarity. We have a change of non consultant hospital doctors every six months. Waiting Lists are getting longer (there's money for somebody in these delays). The waiting times in Accident & Emergency locations are dreadful and will lead to loss of lives (if it has not already done so). We have a Garda Force who have no other option but to deliver drugged and drunk people to Accident & Emergency every night. We have a public that believe they are entitled to walk into A&E 24/7 with a little cut in their finger (I'm using licence here!). A haggart of Government Ministers, CEO's etc have found the Health System to be their graveyard. Our nurses can make money working abroad and have much better conditions, access to courses etc. Many nurses returning to Ireland for Christmas were openenly headhunted in our airports this Christmas. Leo is waking up to this now and will do all he can to get out of Health.

The private hospitals are advertising daily for service (but only if you have the best of medical insurance, let's call a spade a spade). In a few years time these hospitals will be our Health System. Everybody (pensioners included) will need heavy medical insurance and not at a low cost. It is easy to predict that in a few short years the Health Insurance companies will be running our health system.
 
Leper said:
Our Health Service has deliberately been run down for years.
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That's a big statement. What do you mean?

Leper said:
Our Medical Consultants are amongst the top paid people in the world.
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The ones on the old contract are. The new ones are not.

Leper said:
Our nurses can make money working abroad and have much better conditions, access to courses etc. Many nurses returning to Ireland for Christmas were openenly headhunted in our airports this Christmas.
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We have more nurses per head of population than anywhere else in Europe (twice as many as France). The problem isn't a shortage of money, it's where and how it's being spent. The nurses I know that have qualified in the last few years couldn't get jobs here and are working in England and Canada. Are you sure that were being recruited at the airport?
 
I see the Minister is being criticised for being on holidays. I don't understand why it's a problem.
 
I wonder, is it time to consider out-sourcing A&E to the private sector where the HSE tenders out to competing hospitals, or simply just pay the 100 euro, or whatever the cost is?
 
Firefly said:
I wonder, is it time to consider out-sourcing A&E to the private sector where the HSE tenders out to competing hospitals, or simply just pay the 100 euro, or whatever the cost is?
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I'd like to see that done for the entire health service.
 
Purple said:
I'd like to see that done for the entire health service.
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This is being done on a piece by piece strategy. Let's look at the story so far:- Fifteen years ago approx things started to go badly wrong with our Health Service. Waiting Lists increased, A&E areas began to be overcrowded, etc. This got steadily worse (and according to HSE's CEO per yesterday's Morning Ireland Radio it will get worse again). Currently, it is difficult to be even "seen" in Accident and Emergency areas. Even if you have full health insurance you will suffer long delays for any kind of treatment in most of the hospital system. Nurses are leaving for better vacancies abroad. We could go on-and-on but for brevity let's say several government ministers and HSE CEO's have failed the public by their promises to improve things and as we have seen things have got worse and will get worse again.

The Medical Card System is being abused at a rate of knots. Then the HSE has deserving people thrown out of the system and put through every health indignity possible. The medical card abusers largely have gone untouched. Add in a plethora of hospital scandals and you do not have to be an artist to draw conclusions. Our hospital system is being prepared for privatisation and like a turkey looking forward to Christmas, we will get it sooner than we expect.

The Private Health Insurance companies are waiting in the wings to get their mitts on the hospital system. Listen to the radio and look at the tv ads nearly every private hospital is aggressively advertising for business (but only if you've got private cover). In the UK the hospital system is either Private or Public. There is no play between the two. In Ireland we have a Public hospital system infiltrated by the Private system, a recipe for monetary abuse for some. In the UK everybody can have hospital stay, GP visits, Prescriptions for £10.00 per year. They have a huge population and with our less population we should be able to supply the same service. Instead, ours is getting dearer and dearer for Public and Private. Have a look of what a couple will pay in 2015 for VHI etc. Also, look at what prescriptions outlay we have before we are subsidised. [I'm raging here, let's give Ireland back to the Brits; at least we then can afford to be sick].

We are being promised that a system like that in the Netherlands will be introduced in Ireland. The date for this keeps being put back and back. We won't see this in the lifetime of the present government.

[I hope the above answers Purple's main question. I do not know if we have more of the caring profession (including nurses) per capita in Ireland as I have not seen the figures].

[Purple's other Question:- When I collected my daughter (nurse) in the airport just before Christmas a well known hospital had a stand inviting returning nurses for almost immediate interview. My daughter had a brief chat, but she opted to return from whence she came].
 
Hi Leper,
We have one of the youngest populations in the developed world and yet we spend 25% above the EU average per capita on healthcare. The problem isn't money or any grand plan to ready the system for privatisation. The problem is incompetence, bad structures and a severe lack of labour mobility. The state is rubbish at running things and yet many people see the solution as getting them to run more things. I really don't understand why.
 
Leper , I would tend to agree with you.

The OECD report Health at a glance : Europe 2014 shows that on health spending per capita basis we are 9th overall & on a spending per GDP basis we are 16th & bottom of all the Western European Countries with the exception of Luxembourg.
 
Deiseblue said:
Leper , I would tend to agree with you.

The OECD report Health at a glance : Europe 2014 shows that on health spending per capita basis we are 9th overall & on a spending per GDP basis we are 16th & bottom of all the Western European Countries with the exception of Luxembourg.
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We all know that Irelands GDP is distorted and is a bad measure of economic activity so using it as a measure in this discussion is disingenuous, to say the least. The only country in Europe with a bigger disparity between GDP and GNP is Luxembourg...
 
it would be interesting to know how much it costs the HSE to treat patients in A&E. VHI Swiftcare charge 150e I think, make a profit, and see you within the hour. Given the waits in the HSE I would hope that it costs significantly less, but the skeptic in me is doubtful.
 
It would appear that it is becoming increasingly obvious that it proving extremely difficult to recruit front line staff , hopefully the Labour Court recommendations for improved terms & conditions for junior doctors will be followed by improved terms & conditions for all front line staff.

I must admit that I was most surprised to garner from the above mentioned OECD report that we are ranked 9th overall in terms of health spending per capita in Europe , comments elsewhere would have led me to believe that Ireland was way ahead of the pack in this regard - is there any basis for such an assertion ?
 
I misread the graph , we are ranked 12th overall in health spending per capita in Europe after you include the non EC countries - Norway , Switzerland & Iceland .
 
Deiseblue said:
It would appear that it is becoming increasingly obvious that it proving extremely difficult to recruit front line staff , hopefully the Labour Court recommendations for improved terms & conditions for junior doctors will be followed by improved terms & conditions for all front line staff.

I must admit that I was most surprised to garner from the above mentioned OECD report that we are ranked 9th overall in terms of health spending per capita in Europe , comments elsewhere would have led me to believe that Ireland was way ahead of the pack in this regard - is there any basis for such an assertion ?
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Have a look at this report; http://www.oecd.org/eco/growth/46508904.pdf .
It is also interesting that we spend such a comparatively high proportion of the total budget on wages.

Someone might like to quote this post as Deiseblue has me on his ignore list because I don't like unions.
 
A&E departments are always crammed at this exact time of year. It's used by certain groups to further their own agendas but the biggest reason is due to hospitals doing a partial shut down over Christmas.

I've been in hospital over Christmas and it was running at maybe 20% of capacity for one week and possibly longer. Clearly not maternity, emergency, etc.. but it does seem a large amount of hospital visits can wait a few weeks. We're not talking a 2 week hiccup either, to clear out the wards the hospital needs to be restricting admission earlier in December.

Getting a hospital back up to full capacity takes time, to get a bed people often have to come in via A&E so inevitably you've a problem.

I doubt if we can afford to design A&E to be large enough to deal with up to a months worth of patients in one week. I'd predict today that on January 5/6 of 2016 we'll be hearing the INMO telling us again we've several hundred people on trolleys.

I don't know if this can be fixed - certainly can't be fixed if no one admits it's a problem - perhaps if hospitals ran at closer to full capacity patients would opt to wait until January anyway?

I'd be interested to know what happens in other countries hospitals around Christmas?
 
Purple said:
I'd like to see that done for the entire health service.
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There was a time when I might have agreed.

However, over Christmas I spent 5 hours in A & E with a relative before he was eventually seen by a doctor.

The relative had an infected cyst which needed to be drained. We first went to the local pharmacy, which told him to go to his GP.

The GP would not touch it; neither would the doctor in the VHI Swiftcare clinic. So we had nowhere else to go except A & E, even though we tried everything to avoid it.

My relative was mortified, sitting among relatives and friends of people who had suffered strokes, heart attacks, really serious injuries, etc., and when eventually seen, apologized profusely to the doctor for presenting in A & E with such a comparatively trivial complaint. The doctor was excellent and very kind, a complete gentleman. The procedure took about 40 minutes.

In reply to our questions, the doctor said that this could have been handled by either the GP or the VHI Swiftcare clinic, but it depended on the competence and experience of the doctor. He also said that the length of the procedure might deter some GPs as they could see several patients during that period.

Also, the triage nurse, whom we saw first, seemed to be sick and tired of patients being foisted on A & E, in particular by VHI Swiftcare clinics, with complaints they should be able to handle themselves and in addition charging patients €75 for the privilege of doing nothing other than writing a letter of referral.
 
Sophrosyne,

The fact that GP's in Ireland do such a limited scope of work in comparison to their counterparts in other parts of Europe (while getting paid so much more) is a major part of the problem.
The fact that GP's don't do out of hours calls any more is also a major factor. If you call a doctor at night you could get a proctologist looking down your neck or an ENT doctor looking up your This post will be deleted if not edited to remove bad language. They don't have the confidence to do their job properly and so refer people to A&E who could and should be treated at home.
As for VHI Swiftcare clinics not being up to the mark etc.; who regulates them? If an A&E consultant sees a patient that has been referred by a GP or VHI Clinic but should have been treated by the GP or VHI Clinic then where is the mechanism to sanction the GP or Clinic? Who does the Consultant complain to? How does an audit of the GP or Clinic get triggered? Effectively a private business is foisting the cost of their incompetence onto the state. Why does that stand?
 
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