Considering the dysfunction observed in the HSE, privatization may not necessarily be a bad thing.
Health policy Digital innovation in the HSE
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Health policy
Sophrosyne
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My observation is the same as @Protocol’s.
If Mr Curley found his task was made impossible then it is reasonable to ask whomever made it impossible to explain themselves, regardless of union representation.
Who appoints hospital administrators? Are there different grades of administrator. To whom do they report?
If Mr Curley found his task was made impossible then it is reasonable to ask whomever made it impossible to explain themselves, regardless of union representation.
Who appoints hospital administrators? Are there different grades of administrator. To whom do they report?
You're both very welcome.
My mate was a HSE consultant radiologist before he emigrated to a country with a better health system. He told me once that he could access x-rays and scans from every public hospital in Ireland online - with the exception of the CUH group of hospitals. Seemingly CUH refused to share these - and the HSE, displaying the courage of a jellyfish, immediately backed down.
The questions that you need to ask are: how can they be bought to heel and what sanctions would they face if found not to be delivering.
Supplementary question: if they were threatened with dismissal and sought a High Court injunction how long would the full dismissal process take?
(If you want some help with the timings, then you only need to think of a case involving a certain educator which is currently crawling its way through the High Court! Meanwhile he remains on full salary).
Sophrosyne
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The instance you mentioned is extreme. That is not the case with most employees.
Administrators who are impeding or resisting must report to someone.
In particular, I am thinking of the continued maintenance of paper records when those records have already been digitized.
That is a complete waste of public money which would be difficult for any administrator, union or indeed anyone to justify.
Unions might call on the the usual training issues, but that is a short-term defence.
These matters seldom involve disciplinary issues or dismissals. It just needs to be made clear that, regardless of their other qualities, a demonstration of cooperation with digital progress is an important issue in their annual or periodic reviews/assessments.
Those paper records may well have helped to save the day in some areas after many of the HSE's systems were hacked only a couple of years ago!
Bear in mind that virtually nothing is ever as black and white as people make it out to be!
I'm in the HSE and in the last few years we've had PPARs, the X Ray system, iPMS, a new annual leave counter, ( I really don't know what else it does), a record management system introduced. Theses are the ones that I can remember off the top of my head but I'm sure there are more, I just can't remember them.
Using the term administrator is very old school. We now call them hospital managers, business managers, COOs, CFOs, General Manager etc.
This guy gave no notice so obviously there was a big row. He's doing the usual it's all the administrators fault but all the nurses and doctors are marvellous.
I'd like more specifics.
Using the term administrator is very old school. We now call them hospital managers, business managers, COOs, CFOs, General Manager etc.
This guy gave no notice so obviously there was a big row. He's doing the usual it's all the administrators fault but all the nurses and doctors are marvellous.
I'd like more specifics.
Sophrosyne
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Perhaps they were back in the day.
Nowadays, technologies related to fraud and back-up systems matter if departments take the security of records seriously. Some departments do.
Paper systems cannot compete with the instant, visibility, interrogative and research value of electronic records for clinicians, researchers, patients, policy makers etc., countrywide.
It is a matter of people understanding the importance and value of information and innovation technology to health progress in the 21st century.
Nowadays, technologies related to fraud and back-up systems matter if departments take the security of records seriously. Some departments do.
Paper systems cannot compete with the instant, visibility, interrogative and research value of electronic records for clinicians, researchers, patients, policy makers etc., countrywide.
It is a matter of people understanding the importance and value of information and innovation technology to health progress in the 21st century.
Sophrosyne
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I agree.
That is the problem. We never get to specifics.
Obviously, Mr Curley was frustrated about what he felt was obstruction by "administrators" but does not elucidate beyond that.
But he is not the first to cite the same problem.
Therefore, it is difficult for the public to understand precisely why so many eminent people tasked with value for money and innovation fall foul of what they feel is a lack of cooperation or downright obstruction.
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They still are. And they're quite handy whenever there's a long power outage too.
So are stand-by batteries and generators
This is exactly the conclusion that right-wing governments want their citizens to arrive at; just look at what's happening to the NHS at the moment. Look at the track record of those who own private healthcare in Ireland at the moment, and tell me there is not a powerful lobby interested in running the HSE (competition) into the ground, in order to then declare it not fit for purpose. This is exactly the method that was used to destroy competition in the construction sector (in the form of local authority house building), resulting in a homelessness crisis in what is allegedly one of the wealthiest countries in the world.
If the current government was in fact serious about implementing Sláintecare -- which clearly they are not, as evidenced by numerous recent high-profile resignations -- then there would be consequences for those who allowed things like the 2021 HSE cyberattack to happen; who got fired over that? What about the three-fold increase in the cost of building what will now be the most expensive hospital on the planet, for which nobody is apparently accountable? The list goes on.
It's actually quite difficult to spend twenty thousand million Euro every year, and still end up with citizens dying because basic healthcare was not available to them when they needed it.
T McGibney
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A 77% increase in funding in the past decade is a peculiar way of running something into the ground.
No, firstly the old racket of councils building what were literally ghettos, and getting political crony contractors (some of whom were councillors themselves or close family members of councillors) to build them and then letting them fall into decrepitude within as little as 15 years was the antithesis of competition.
And when we had genuine competition in construction during the Celtic tiger years, the left clamoured for the builders and developers to be put out of business, permanently. Unfortunately they got their way and there has barely been a house built anywhere since. Now they feign shock and horror when there's a totally predicable housing shortage.
All of which is indicative of a lack of competition rather than a surfeit of it.
It's actually 23 thousand million Euro every year, and going to escalate as our population ages.
Maybe, just maybe, the HSE with its oodles of money, ludicrous inefficiencies, bizarre work practices, and even teenagers dying on trolleys, just isn't fit for purpose?
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Sophrosyne
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Agreed.
Sometimes the obvious, rather than the conspiracy theory is closer to the bone.
I'm more interested in the track record of the Public healtcare sector at the moment & their accountability in terms of value returned or lack therof. I & probably most of us on AAM are paying for it every month through our tax contributions. The words I'd use to describe the efficacy of the Irish healtcare system would get my post deleted & perhaps get me banned.
I genuinely don't understand the parallel, or what was allegedly done to destroy compteition in construction sector, could you spell it out for me? (sincere)
Agreed. Doesn't this illustrate that there is room to consider privatisation? Between the Health Board 7 the HSE model I have no memory of the health service in Ireland ever really being good. Let's start with good. Excellent, world class & all that jazz can come later - let's start with good.
Why in a State of 5 million people do we need a HSE?
Surely the Dept of Health should be running the public health system?
As for the system as it is - we took something like 3,000 beds out of the Public Hospitals in 1987.
Less than half of them have, I hear, been restored.
Population in 1987 c3.5m
Population in 2023 c5m.
You can't fit a Quart into a Pint bottle (or for younger readers) 2 litres into a litre bottle
Surely the Dept of Health should be running the public health system?
As for the system as it is - we took something like 3,000 beds out of the Public Hospitals in 1987.
Less than half of them have, I hear, been restored.
Population in 1987 c3.5m
Population in 2023 c5m.
You can't fit a Quart into a Pint bottle (or for younger readers) 2 litres into a litre bottle
The Department of Health is responsible for policy. The HSE is responsible for implementation.
Much the same model can be seen in other Departments, e.g. Justice and Defence - which set out policy objectives for AGS and the Defence Forces respectively.
The Department of Finance sets out economic policy, but taxes are collected by the Revenue Commissioners!
