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Thread: Time to end the NTPF

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    Politics.ie Member spidermom's Avatar
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    Default Time to end the NTPF

    With harneys pronouncement today that the health service will face huge cutbacks next year it is now time to cut the NTPF.
    Its budget for 2010 is 90 million. This is equal to the deficits being faced by 3/4 of the largest hospitals in the state, all of which have now closed beds to deal with the budgetary cutbacks introduced last year.
    But here is why the NTPF should be cut.

    NTPF treats fewer than 8,000....
    The National Treatment Purchase Fund (NTPF) has arranged treatment for just 7,894 inpatients and first-time consultations for 3,000 out-patients in the five months to the end of May.
    The Fund has claimed it will “facilitate approximately 31,000 patients in 2010” from its allocated budget. “The Fund is on schedule to meet this target,” an NTPF spokesperson said. It is understood the inpatient figure for 2010 includes radiology investigations.......

    For comparison purposes Tallaght Hospital deals with 34,000 inpatients,78,000 A+E attendances and 228,000 outpatients for twice that budget...

    There is also the thorny issue fo the "costs" charged for surgery under the NTPF..Wide variation in hip implant costs

    I wish someone would explain this to me...because this is my clinical area and I DON'T understand it!!!
    When a man sits with a pretty girl for an hour, it seems like a minute. But let him sit on a hot stove for a minute and it's longer than any hour. That's relativity.

    ALBERT EINSTEIN

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    The thing about the NTPF is that the staff employed are not permanent and so there is no pension costs to be considered. Yes there may be increased short term costs but someone really needs to do a cost benefit analysis.

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    Politics.ie Member rockofcashel's Avatar
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    Cause privitisation is good spidermom.. it's efficient.. get with the programme Commie
    1,197 people agree with me.. how many agree with you ?

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    Quote Originally Posted by nakatomi View Post
    The thing about the NTPF is that the staff employed are not permanent and so there is no pension costs to be considered. Yes there may be increased short term costs but someone really needs to do a cost benefit analysis.
    The core frontline health service is now pretty much staffed by employees who are not permanent, let alone the NTPF. I am of an age where I know a hell of alot of nurses who are 2-3 years qualified. Every single one of them who remains in employment in Ireland, rather than London, is on a short term contract which is renewed again and again and again to avoid paying them a pension.

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    Politics.ie Member LeDroit's Avatar
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    Quote Originally Posted by rockofcashel View Post
    Cause privitisation is good spidermom.. it's efficient.. get with the programme Commie
    +1

    Finally!
    "A govt big enough to give you everything you want, is strong enough to take everything you have" Thomas Jefferson

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    Quote Originally Posted by rockofcashel View Post
    Cause privitisation is good spidermom.. it's efficient.. get with the programme Commie
    The health system had years and all the money it wanted to sort out the waiting lists, it never could.
    The bottom line is the NTPF works, the "system" didn't, not in that regard anyway.

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    Quote Originally Posted by Dolores Ibárruri View Post
    And I thought you were left-wing, tonic. I'm gutted.
    Results over ideology, every time.

    To a large extent the waiting lists are no more, be happy.

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    Politics.ie Member spidermom's Avatar
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    Quote Originally Posted by Dolores Ibárruri View Post
    It had very little to do with the NTPF (NTPF is less than 2% of public procedures) - the increase in the number of consultants in public hospitals was the main factor (thank you FF/PD for that at least) for the decline in inpatient waiting times - new technology and treatments which don't involve surgery also helped. But outpatient waiting lists haven't improved (if you get MS, you'll know all about it). The NTPF is expensive and will cost the exchequer a lot more in the long run. It also encourages over-investigation and over-treatment, which are the main causes of the costs getting so out of control in fee-per-item healthcare regions.

    You really are unbelievable at spin, tonic. Is that, like, your job?
    Another issus that remains hidden from the NTPF data is the numbers of patients who suffer post op complications and end up in Public hospitals. In particular infections...have had at least 2 patients weekly....forever!!
    The hospital that performs the surgery should be the one to treat the patients...or there should be a mechanism for the public hospital to recoup the cost.Infection rate for my hospital do not take into account infections acquired elsewhere!!
    When a man sits with a pretty girl for an hour, it seems like a minute. But let him sit on a hot stove for a minute and it's longer than any hour. That's relativity.

    ALBERT EINSTEIN

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    Quote Originally Posted by Dolores Ibárruri View Post
    It had very little to do with the NTPF (NTPF is less than 2% of public procedures) - the increase in the number of consultants in public hospitals was the main factor (thank you FF/PD for that at least) for the decline in inpatient waiting times - new technology and treatments which don't involve surgery also helped. But outpatient waiting lists haven't improved (if you get MS, you'll know all about it). The NTPF is expensive and will cost the exchequer a lot more in the long run. It also encourages over-investigation and over-treatment, which are the main causes of the costs getting so out of control in fee-per-item healthcare regions.
    As I remember it, the reduction in waiting lists, for which we have been paying forever, but began only in recent years (much like the NTPF) and preceded the increase in hospital consultants by some time.

    Quote Originally Posted by Dolores Ibárruri View Post
    You really are unbelievable at spin, tonic. Is that, like, your job?
    No, it's not, like, my job, but you're not bad yourself the old spin. Respect.

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    Quote Originally Posted by Dolores Ibárruri View Post
    Things having been improving in the health service for some time (Euro Health Consumer Index agrees) - but there's a public relations problem because of the big three issues: inequality, high costs and ongoing issues with access for some services. The point isn't that the government hasn't made worthwhile efforts, it's that the PD wing is still committed to the market-based ideology that has paradoxically driven up costs - and is contrary to the extensive international literature on the subject. (e.g. Market-Based Failure — A Second Opinion on U.S. Health Care Costs. Robert Kuttner. N Engl J Med 2008; 358:549-551February 7, 2008).

    I find it really frustrating when the government ignores good scientific evidence when formulating health and social policy.

    You might like this piece by Jeffrey Sachs The Social Welfare State, beyond Ideology: Scientific American
    "The Nordic states have also worked to keep social expenditures compatible with an open, competitive, market-based economic system. Tax rates on capital are relatively low. Labor market policies pay low-skilled and otherwise difficult-to-employ individuals to work in the service sector, in key quality-of-life areas such as child care, health, and support for the elderly and disabled."

    I don't like the sound of that, whatever does he mean by "pay low-skilled and otherwise difficult-to-employ individuals to work in the service sector, in key quality-of-life areas"



    Anyway, back to business.

    In the French health system, much beloved by those who think everything in this country is the worst in the world, 25% of treatments are completed in private hospitals, the government pay only the first 80% of costs with the patient paying the balance either through private insurance or out of pocket. All this while the French pay much higher social/medical taxes than we do and their health system is still over 50 billion in debt.

    I think you've got to have some private element in health care, otherwise you have no yardstick for efficiency, the P/S unions are just too strong and if not reined in will destroy what services we have through soaking up all increase health spend in wages.

    Say what you will, but without the NTPF we would still have the same waiting lists with the same blame/counter blame and excuses that we had for years, which at the end of the day is damn all use to those who need the service and need it now.

    The NTPF got the job done and I don't think there is an argument strong enough to counter that fact.

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