Public hospitals very low productivity in operations compared to private hospitals?

[patslatt]

A junior surgeon emailed Newstalk's Eamon Keane's Monday 12 noon show to say that private hospitals are about twice as efficient in terms of the numbers of operations performed as public hospitals.He blames public hospital nurses' frequent breaks,porters' obstructionism,absenteeism of hospital staff and failure to start work before 8am as key factors. He says there would be no need for the National Treatment Purchase Fund if public hospitals were performing to their potential. It is surprising that humble porters can throw their weight around as much as they do,a relic of 1970s era militant unionism.

A nurse responded by texting that surgeons in private hospitals put patients at risk by taking on too much work to make money. This sounded suspiciously envious to my ears. Besides, insurance costs which are astronomical in surgery should ensure safe surgical practices.

The only valid reason I can think of that would justify some of the difference in the numbers is that public hospitals perform more complex surgery than private hospitals which tend to specialise in profitable,standardised surgery.

[cyberianpan]

I'd point out that your sources are anecdotal rather than evidential

So not sure how much I'd read into them

Furthermore I wonder who this "junior surgeon" is ... most private hospitals don't have junior doctors...

cYp

[Odyessus]

A junior surgeon emailed Newstalk's Eamon Keane's Monday 12 noon show to say that private hospitals are about twice as efficient in terms of the numbers of operations performed as public hospitals.He blames public hospital nurses' frequent breaks,porters' obstructionism,absenteeism of hospital staff and failure to start work before 8am as key factors. He says there would be no need for the National Treatment Purchase Fund if public hospitals were performing to their potential. It is surprising that humble porters can throw their weight around as much as they do,a relic of 1970s era militant unionism.

A nurse responded by texting that surgeons in private hospitals put patients at risk by taking on too much work to make money. This sounded suspiciously envious to my ears. Besides, insurance costs which are astronomical in surgery should ensure safe surgical practices.

The only valid reason I can think of that would justify some of the difference in the numbers is that public hospitals perform more complex surgery than private hospitals which tend to specialise in profitable,standardised surgery.

It does not surprise me at all. The more patients a private hospital attracts the better they like it. More customers, more money.

Public hospitals wish the patients would go elsewhere.

[drzhivago]

I'd point out that your sources are anecdotal rather than evidential

So not sure how much I'd read into them

Furthermore I wonder who this "junior surgeon" is ... most private hospitals don't have junior doctors...

cYp

Closer to the bone than you would think

Reluctant to use the word all but ALL the big private hospitals

• Mater private]St Vincents Private
• Blackrock Clinic
• Beacon Clinic
• Hermitage
• Bons Secours
• Galway Clinic
• Aut even

all have junior doctors on staff

Bons Secours in Cork which is the biggest private hospital in Europe has a significant number of junior doctors including Interns, the only private hospital which has interns

[drzhivago]

A junior surgeon emailed Newstalk's Eamon Keane's Monday 12 noon show to say that private hospitals are about twice as efficient in terms of the numbers of operations performed as public hospitals.He blames public hospital nurses' frequent breaks,porters' obstructionism,absenteeism of hospital staff and failure to start work before 8am as key factors. He says there would be no need for the National Treatment Purchase Fund if public hospitals were performing to their potential. It is surprising that humble porters can throw their weight around as much as they do,a relic of 1970s era militant unionism.

A nurse responded by texting that surgeons in private hospitals put patients at risk by taking on too much work to make money. This sounded suspiciously envious to my ears. Besides, insurance costs which are astronomical in surgery should ensure safe surgical practices.

The only valid reason I can think of that would justify some of the difference in the numbers is that public hospitals perform more complex surgery than private hospitals which tend to specialise in profitable,standardised surgery.

There is no doubt they are more efficient when you look at things like processing a patient from ward bed to operating theatre because there are less people in the chain

Public hospital-consultant nearly finishes a case, theatre supervisor says so to shift leader, says to head porter, delegates porter to go to ward, porter talks to CNM on ward,finds patient (who may be wandering away as not given a time for operation) brings patient down lift to theatre reception, patient checks in, serious of checks peformed, interviewed by theatre nurse, interviewed by anaesthetist, discussion with surgeon, WAIT while theatre is cleaned then patient brought into theatre

Private hospital--a lot less steps in chain and occasionally more initiative, staff knowing that when the list is finished for the day they are off hence in interest to be very efficient and preempt what is happening next, not so in public system

You are partially correct about the degree of complex surgery, I would say that none happens in Private, Blackrock clinic does cardiac surgery, one of them does neurosurgery but these are generally elective cases, well planned in advance

he main difference is public deals with emergency cases, over a long period volume is somewhat predictable but type of cases arent ths time can be spent on the morning panning what surgery is going to take place and agreeing same, remember these patients have come in the previous night or early am, havent been booked in advance and may need quite a bit of buffing up before they are ready for the anaesthesia (which carries a risk) and surgery (which also carries a risk in the emergency setting)


Apologies for lengthy post

[patslatt]

Proper explanation required a description at length.

Taking into account the differences between the public and private hospitals that you mention,how much of an improvement in productivity do you think could be achieved by public hospitals through improved planning and workplace discipline?

[JCSkinner]

People might want to factor in the difference between performing open-heart surgery and removing moles into the equation.
I'm also curious about this 'junior doctor' in a private hospital. That sounds frankly bogus.

[Odyessus]

There is no doubt they are more efficient when you look at things like processing a patient from ward bed to operating theatre because there are less people in the chain

Public hospital-consultant nearly finishes a case, theatre supervisor says so to shift leader, says to head porter, delegates porter to go to ward, porter talks to CNM on ward,finds patient (who may be wandering away as not given a time for operation) brings patient down lift to theatre reception, patient checks in, serious of checks peformed, interviewed by theatre nurse, interviewed by anaesthetist, discussion with surgeon, WAIT while theatre is cleaned then patient brought into theatre

Private hospital--a lot less steps in chain and occasionally more initiative, staff knowing that when the list is finished for the day they are off hence in interest to be very efficient and preempt what is happening next, not so in public system

You are partially correct about the degree of complex surgery, I would say that none happens in Private, Blackrock clinic does cardiac surgery, one of them does neurosurgery but these are generally elective cases, well planned in advance

he main difference is public deals with emergency cases, over a long period volume is somewhat predictable but type of cases arent ths time can be spent on the morning panning what surgery is going to take place and agreeing same, remember these patients have come in the previous night or early am, havent been booked in advance and may need quite a bit of buffing up before they are ready for the anaesthesia (which carries a risk) and surgery (which also carries a risk in the emergency setting)


Apologies for lengthy post

No need for apologies. "An explanation should be as short as possible, but no shorter." - Albert Einstein.

[DCon]

drzhivago, would it be possible for private Hospitals to take emergency cases and write the cost of these off their taxes?

Has this ever been considered?

[patslatt]

drzhivago, would it be possible for private Hospitals to take emergency cases and write the cost of these off their taxes?

Has this ever been considered?

Such a writeoff is still an outlay in terms of foregone tax revenues that could have been spent elsewhere,including on the HSE supported hospitals.