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  1. #1
    ger12 ger12 is offline
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    Healthcare Reform ... (sigh)

    There were/are high expectations of some reform in our helathcare system from our present government. Rome wasn't built in a day, reform measures can be slow.

    FG/Lab pledged to reduce the pay of both GPs and hospital consultants. Free GP care for all within the term of office of the new Government was promised, with insurance for universal hospital cover introduced by 2016. Both parties had promised universal health insurance in their manifestos.

    As promised by Fine Gael the HSE will cease to exist eventually as its functions are given to the Health Minister and the new universal insurance system.

    So, how are promised reforms panning out? The Sunday Business Post has a very informative piece on reform (or lack of it) within our healthcare system. Turns out that Roisin Shorthall promised 56,000 patients with long-term illness (like CF or MS) that they would receive medical cards from last March. Yep, the're still waiting. The IMO (which represents GP's) has had to date no discussions regarding this proposal. This may take some time.

    The SBP article believes that a failure of government to follow through on a promise to bolster HSE finances by 250 million in 2012 has contributed to the HSE overrun. Minister Reilly pledged to abolish the existing system of designated private-public beds in public hospitals. This would allow public hospitals to charge all private patients in their hospitals. This was expected to save about 145 million. Unfortunately, it's now looking like the government is going to u-turn on this policy.

    As for the promise to tackle hospital consultant pay, well, that was reneged on long and ever ago. The remuneration of GP's was also to be cut by this government. Again, talks with the IMO have yet to begin. Minister Reilly emotionally told the Dail last week that he believed too many older people were in long term care when they could be better supported in their home. Yet he has approved the HSE service plan which reduced the spend on home-help hours. The Special Delivery Unit has reduced trolley waits in A/E. This has had a knock on effect in other areas. Thousands more patients are waiting longer for hospital procedures. This is a serious development.

    And the HSE. Setting it up in 2004 was a bold move. I have seen great improvements in helathcare over the last number of years. Has this move contributed to these improvements? Far less waste, higher standards of care. The establishment of the HSE took power away from the health boards which were full of political appointments and perhaps cronyism. So, are we heading back in that direction?

    What has prevented this government from making progress on many promises? What' s the plan boys and girls? There is one, isn't there?
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  2. #2
    wombat wombat is offline
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    Quote Originally Posted by ger12 View Post

    What has prevented this government from making progress on many promises?
    Money, the lack thereof?
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  3. #3
    ger12 ger12 is offline
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    Quote Originally Posted by wombat View Post
    Money, the lack thereof?
    Lack of political courage in standing up to vested interests? Lack of a vision/plan? Taking popular decisions that were ill-conceived like dumping the HSE to move back a step?

    Are you suggesting this government was unaware of our financial woes when they took office?
    Last edited by ger12; 22nd July 2012 at 05:38 PM.
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  4. #4
    LOCALHERO LOCALHERO is offline

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    Quote Originally Posted by ger12 View Post
    There were/are high expectations of some reform in our helathcare system from our present government. Rome wasn't built in a day, reform measures can be slow.

    FG/Lab pledged to reduce the pay of both GPs and hospital consultants. Free GP care for all within the term of office of the new Government was promised, with insurance for universal hospital cover introduced by 2016. Both parties had promised universal health insurance in their manifestos.

    As promised by Fine Gael the HSE will cease to exist eventually as its functions are given to the Health Minister and the new universal insurance system.

    So, how are promised reforms panning out? The Sunday Business Post has a very informative piece on reform (or lack of it) within our healthcare system. Turns out that Roisin Shorthall promised 56,000 patients with long-term illness (like CF or MS) that they would receive medical cards from last March. Yep, the're still waiting. The IMO (which represents GP's) has had to date no discussions regarding this proposal. This may take some time.

    The SBP article believes that a failure of government to follow through on a promise to bolster HSE finances by 250 million in 2012 has contributed to the HSE overrun. Minister Reilly pledged to abolish the existing system of designated private-public beds in public hospitals. This would allow public hospitals to charge all private patients in their hospitals. This was expected to save about 145 million. Unfortunately, it's now looking like the government is going to u-turn on this policy.

    As for the promise to tackle hospital consultant pay, well, that was reneged on long and ever ago. The remuneration of GP's was also to be cut by this government. Again, talks with the IMO have yet to begin. Minister Reilly emotionally told the Dail last week that he believed too many older people were in long term care when they could be better supported in their home. Yet he has approved the HSE service plan which reduced the spend on home-help hours. The Special Delivery Unit has reduced trolley waits in A/E. This has had a knock on effect in other areas. Thousands more patients are waiting longer for hospital procedures. This is a serious development.

    And the HSE. Setting it up in 2004 was a bold move. I have seen great improvements in helathcare over the last number of years. Has this move contributed to these improvements? Far less waste, higher standards of care. The establishment of the HSE took power away from the health boards which were full of political appointments and perhaps cronyism. So, are we heading back in that direction?

    What has prevented this government from making progress on many promises? What' s the plan boys and girls? There is one, isn't there?
    Money first and foremost but allied to the fact that the HSE is and has always been a nonsense organisation that couldn't give a toss about patient care, only about self preservation.
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  5. #5
    damus damus is offline
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    That's an excuse. We jump from one financial crisis to crisis. Why are the the CEO's of hospitals who have maintained huge overruns year upon year still in place? Where's the oversight from above in that the HSE is only hemming in the reigns on hospital expenditure in the last quarter of the financial year? Why has nobody in the HSE been held to account for their lack of financial oversight in terms of how money is getting expended?

    Why is there no white paper of the health reform programme? Has there been any cost analysis of the likely costs of the health reform programme? How much will it cost the taxpayer to rebrand the HSE? Why aren't we demanding why there won't be any redundancies in the Integrated Care Agency if senior management posts are being abolished? Why aren't we asking how this reform programme will be any different from every other reform programme that has been undertaken? Why is there no root and branch reform starting with tackling the different sectoral interests in our health service? Why was there a 360 degree u-turn on consultants pay, given this was one of the pinacles on which FG was elected? Now we know that this government is looking towards changes in work practices. So, what changes in work practices have actually taken place?

    Now turning to the people who should be at the centre of this service....the patients! First, was the promise to abolish the GMS prescription levy kept....no. Has GMS eligibility been extended to people under the LTI - no. Has the colon screening programme been introduced - no. Despite the spin being put on it, do we still have a problem with overcrowding in the majority of our major ED's - I suspect so. Do we still have a problem with delayed discharge patients because there is nowhere to put them - most definately. Does Govt. policy truly support the care of the older person - well, on that one actions speak volumes! Lets see, there's been a 25% fall in the number of applications that have been approved under Fairdeal, and in case you think that there's been a re-direction to support older people to live in their own homes, this also coincides with a reduction in the availability of homecare packages and home-help hours. Oh, I also nearly forgot about the fact that we've got 350,000 and 160,000 who are currently on OPD and in-patient treatment lists. I actually dread to think what the updated stats are for July.

    But don't worry, because we've still got enough money for ministers to break the pay ceilings for advisors of this, that and whatever!
    Last edited by damus; 23rd July 2012 at 02:58 PM.
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  6. #6
    ger12 ger12 is offline
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    Quote Originally Posted by LOCALHERO View Post
    Money first and foremost but allied to the fact that the HSE is and has always been a nonsense organisation that couldn't give a toss about patient care, only about self preservation.
    Money is preventing this government from tackling GP and hospital consultant pay? Money is preventing allowing public hospitals from charging all private patients?

    The HSE was only set up in 2005. There have been big impovements in many areas since then. It has not been smooth sailing. But heck, do you remember the scam that was the health boards? Are we really going back to politicians running different areas in health? Back to who you know .....
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  7. #7
    nakatomi nakatomi is offline

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    They could also save money by reversing the cuts in nurses hours that resulted from the nursing strike a few years ago.
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  8. #8
    uriah uriah is offline

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    They said it would take seven years.
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  9. #9
    turdsl turdsl is offline

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    We have a failed minister who told us the other night that he as much entered politics to do us all a favour,with his expertise, unfortunately, it was all in his own shallow dreams.
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  10. #10
    Will Yam Will Yam is offline

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    Quote Originally Posted by wombat View Post
    Money, the lack thereof?
    No, not excluisvely.

    Its the vested interests who wont permit change. Consultants, nurses, ambulcance drivers HSE managers etc etc etc
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