Originally Posted by ger12

Great to hear Ms Shortall on the radio saying that the Minister is heading towards a U.S. style health service. Cat is out of the bag at last.

I heard this claim. Having worked in the US I'm not sure where she gets this. Reminds me of the Tea Party claiming Obama is a firebrand revolutionary socialist bent on transforming the US into Cuba. There was a good article in the examiner today laying bare the inherent contradictions in health policy in the program for government. Sorry no link but it was quite good. Ya'll have to go out and buy it boy!. It pointed out having free primary care with universal health care is a non-runner.

Originally Posted by Merovingian

I heard this claim. Having worked in the US I'm not sure where she gets this. Reminds me of the Tea Party claiming Obama is a firebrand revolutionary socialist bent on transforming the US into Cuba. There was a good article in the examiner today laying bare the inherent contradictions in health policy in the program for government. Sorry no link but it was quite good. Ya'll have to go out and buy it boy!. It pointed out having free primary care with universal health care is a non-runner.

it's true though. Very slimmed down public service, shut or amalgamated hospitals, reduced salaries and conditions attract the primary health care providers (doctors) to the private sector. Anyone can see how it will end up. When push comes to shove, the only places with a government-provided health service will be areas with sigificant voter presence for whatever incumbent party is in power (what Reilly did, essentially).

Originally Posted by Merovingian

I heard this claim. Having worked in the US I'm not sure where she gets this. Reminds me of the Tea Party claiming Obama is a firebrand revolutionary socialist bent on transforming the US into Cuba. There was a good article in the examiner today laying bare the inherent contradictions in health policy in the program for government. Sorry no link but it was quite good. Ya'll have to go out and buy it boy!. It pointed out having free primary care with universal health care is a non-runner.

Yep, either/or. Seeing as Minister Reilly has not make moves in either direction, my moneys on a U.S. style "model".

Originally Posted by damus

I wonder how much Shorthall knew of this latest fiasco - and what the Minister's own opinion of the last minute introduction of a new system where in order to receive payment from the PCRS for the administration of the winter flu vaccine, GP's are now being asked to hand over personal data of all GMS patients who receive the vaccine which not only breaches patient confidentiality but is contrary to data protection laws!

The IMN are reporting how without warning and just as the winter flu vaccination programme was set to commence the PCRS introduced a new system that now requires GP's to collect the PPS numbers of all GMS patients that receive the flu vaccination before they will receive payment.

Not surprisingly there seems to be some discord between what the HSE is saying on the one hand and what the DoHC is saying on the otherhand. Dr. Raymond Walley who is a GP told the IMN that they already had meetings with the DoHC who told them that the PCRS is not allowed to look for patients PPS numbers from GP's. Apparently, the PCRS attempted to introduce the same system in January of this year - but this plan fell by the wayside following the uproar by GP's. The primary concern of GP's is that;



Mr. Eric Young who is Asst. Director of IR at the IMO claimed that the move by the PCRS is nothing more than "service rationing". It's a view that I would tend to agree with because in order to claim a payment for the administration of the vaccination from the PCRS, whoever administers the vaccine has to note the patients GMS number on the paperwork. It also begs the question whether the GMS section of the PCRS actually talks to the PCRS section that actually issues payments to GP's? Of course the other point is that GMS and GP visit cards already contain the patients PPS number in that that information is already provided to the PCRS as part of the application process!

New vaccination system chaos

Apart from all the well discussed issues on here regarding Reilly, I get the sense he has created chaos within our health system. I understand when you are changing systems it is a fluid situation, and can seem chaotic. But when dealing with the health and welfare of patients you cannot have chaos. There should be no need if preparations are planned thoroughly.

This, however, is where I think the main problem is. Reilly has done little given the amount of time he has been there. Now there is focus on him and his performance, he's rushing through changes when the relevant areas are not yet ready. I've heard him mention something else regarding the last quarter.... I think it may have been to do with the first "installment" of the free GP care ? He's slamming things in now regardless of effect....

Originally Posted by damus

Reilly just been announced that the HSE will be rolling out in a phased basis the national colorectal screening programme in the last quarter and it will be confined to people aged 60-69 years. This is despite the Irish Cancer Society highlighting the need for the screening programme to incorporate people aged 55-74 years.

This could've and should've been done in the first six months of the Government. Everyone knows the benefit of early detection of this and any type of cancer. I lost my father to this cancer. He had waited 11 months for a colonoscopy even with two letters after the referral from the GP.

Originally Posted by Ardillaun

There's an air of unreality about these discussions. An utterly broke country like Ireland - as you all know, we're talking not just banks and homeowners but the massive current spending hole and a looming pension crisis - should no longer be competing with the UK or Germany on compensation, let alone Canada or Australia. I believe many medical grads will stay home for lower pay if they were given the chance because they want to live in their own country. If not, the world has lots of doctors. One way or another, the country is headed for a markedly lower standard of living that should affect the better off more severely.

Thats true. Many will stay as they are near the end oftheir career or they have a mortgage that pins them down. However, the calibre of the new entrants intot he PS will fall, possibly precipitously. Thats life. You get better medical specialists on average in Boston than you do in South Dakota. The bigger issue from a purely economic viewpoint is how much we pay everyone else. At the moment all the focus is on Consultant pay. However, they form <3% of the workforce and their pay over 100K is subject to a marginal rate of taxation / levy in the order of 65%. Savings are there but not as good as first appears. I was recently made aware of a review of spending in a private hospital. The salaries of the non-medics are generally pegged to PS levels. A european consortium reviewing labour costs felt that they were way way out of line with European norms. I'm talking what is considered 'low paid' - nurses aids, porters, admin and they relatively well paid - physios etc. So folks the Consultants will fall first and then everyone else will succumb soon after....

Originally Posted by Merovingian

They need it. I spoken with Consultants involved in negotiation with the HSE / DoH. Apparently it's head wreaking 'cos they arrive at the negotiations unprepared and not knowing what they want. Then they spin 'intransigence' from the Consultants!.

Don't they take instruction from the Minister?

Originally Posted by ger12

Yep, either/or. Seeing as Minister Reilly has not make moves in either direction, my moneys on a U.S. style "model".

Maybe. However, I think the more likely explanation is than moving to UHI is a mammoth underaking. It should realistically be planned out over a 10-15year period with multi-annual planning, budgeting, education of the population and adjustment in employment mechanisms for medics etc. Far easier to say: I'm going to introduce this in 3 years and all will be fine and dandy. Does anyone really think Dr Reilly is the guy for this?

Does anyone know what the HSE's Succession Management Programme is? Apparently 30 people have completed this pilot course in the HSE.

Reilly also wants all hospitals to use text messages to remind patients of their upcoming OPD appointments, with no-shows and people who don't respond to the text being charged the next time they attempt to show up for an appointment. I have to say that I can see the merit in charging no-shows. In 2009, there were 550,000 missed appointments at a cost of €33m - I don't have updated stats.

Reilly: Charge no-show patients for appointments | Irish Examiner

Outpatient no-shows cost HSE

Patients not turning up for clinics - irishhealth.com

Originally Posted by Merovingian

Maybe. However, I think the more likely explanation is than moving to UHI is a mammoth underaking. It should realistically be planned out over a 10-15year period with multi-annual planning, budgeting, education of the population and adjustment in employment mechanisms for medics etc. Far easier to say: I'm going to introduce this in 3 years and all will be fine and dandy. Does anyone really think Dr Reilly is the guy for this?

The Minister has yet to come up with a plan/blueprint for UHI. I would have thought it would have been a priority for him to get cracking on it. At this stage I reckon it was another one of his tall tales. Sadly, Mr Reilly is no Noel Browne.

Originally Posted by damus

Does anyone know what the HSE's Succession Management Programme is? Apparently 30 people have completed this pilot course in the HSE.

Reilly also wants all hospitals to use text messages to remind patients of their upcoming OPD appointments, with no-shows and people who don't respond to the text being charged the next time they attempt to show up for an appointment. I have to say that I can see the merit in charging no-shows. In 2009, there were 550,000 missed appointments at a cost of €33m - I don't have updated stats.

Reilly: Charge no-show patients for appointments | Irish Examiner

Outpatient no-shows cost HSE

Patients not turning up for clinics - irishhealth.com

4 people did not turn up to clinic today. Thank God. It was overbooked by 5. Single handed clinic, complex case load, 4 hours 16 patients seen. We thought about texting. However, most attedees are elderly I'd guess that 50% of people I saw today elderly / rural / poor do not have mobile phones themselves. Many Consultants tend to overbook on the basis that there is a no show rate of 10-15%. Sorta like the US airlines used to do. This sorta soundbite thing sounds good but in practice most Docs have dealt with it in one way or another. To be honest it suggests those at the top are out of touch with the punter on the ground.