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Thread: HSE bashing

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    Politics.ie Member ger12's Avatar
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    Default HSE bashing

    The HSE gets the blame for almost everything round here. Unfairly IMO. I'm a long long time working on the frontline in Irish hospitals. There have been great improvements in recent years in standards of services and care provided due to the HSE I believe, evidence based best practice being the mantra.

    According to the 2009 and 2012 Euro Health Consumer Index, the country's health service is currently ranked 13th out of 33 European health services, ahead of Germany.

    This marks a significant improvement since the survey in 2006, when Ireland was listed in 28th place out of 29 nations included.

    The Executive was established by the Health Act, 2004 and came into official operation on 1 January 2005. It replaced the ten regional Health Boards, the Eastern Regional Health Authority and a number of other different agencies and organisations. Remember them? You know, when it was who you knew from whichever political party that could bump you up a waiting list.

    So Michael Martin, as Minister for Health from 2000-2004, introduced a ban on tobacco smoking, disbanded the health boards and established the HSE, and in particular oversaw serious steps to improve cancer and cardiac services, with e.g. delivery of the first National Cancer Strategy.

    As CEO, Professor Drumm (at the time Head of the Department of Paediatrics at University College Dublin and Consultant Paediatric Gastroenterologist at Our Lady's Children¿s Hospital in Dublin) led the largest public service Transformation Programme ever undertaken in Ireland.

    Now it hasn't been easy and certainly has it's flaws. I'm not suggesting that the HSE is perfect but I am suggesting as a model, it can work in this country when there is a separation of power between the Government of the day and the body that is responsible for the delivery of health services. Had politicians continued to drive the health service before the establishment of the HSE, we'd continue to have a hospital in every town, with inefficient and fractured services. Not e.g. Centres of Excellence for Cancer Care where an abnormal CXR or breast lump can get you an appointment in a rapid access clinic within two to four weeks.

    The failure to ensure a sod has been turned on a NCH is a political failure and a great injustice for this States children.

    Moving on to Minister Reilly. The independent HSE board asked to step down, his own chaps replacing them from the HSE and DOH. Then there's the the Health Service Executive Governance Bill. It will enable the Department of Health to have control of the entire health budget from January 2014 onwards. Where to start? I've posted a link to a blog by journalist, broadcaster & policy analyst Sara Burke which makes for serious food for thought regard this Bill.

    In financial perilous times such as these, maintaining services are challenging. And the last twelve months have been most difficult as many services have been stretched to breaking point. Perhaps now we should, as a Nation, be discussing exactly what form of health service do we see in the future. Private? Mix of public/private? An NHS style? Everyone equal? You get what you pay for? No sign of the promised White paper on Universal Health Care while we appear to be heading towards a U.S. style system.

    Lastly, I'm not a member of any PP, would be known on this site to promote Green policies.


    Just more jobs for the boys | SaraBurke.com
    Euro health consumer index - Wikipedia, the free encyclopedia
    Aviva - Irish healthcare system shows major improvement
    HSE.ie - Health Service Executive Website -
    The devil without the details | SaraBurke.com
    Health Service Executive (Governance) Bill 2012
    http://www.oireachtas.ie/viewdoc.asp.../document1.htm

    HSE terminates funding for patient group - Health News | Irish Medical News | The Irish Times - Sat, Apr 27, 2013
    Childcare cases taken by HSE increased by 20 per cent last year, data shows - Crime & Law News from Ireland & Abroad | The Irish Times - Mon, Apr 15, 2013
    HSE left
    Report shows HSE failures in child protection - RTÉ News
    HSE to review Midleton ambulance response - RTÉ News
    Another HSE scandal - Will this madness ever end? | Irish Examiner
    Last edited by ger12; 11th May 2013 at 01:15 PM.
    At 12 weeks the “clump of cells” toes curl, her mouth makes sucking movements, she has a human face and if you prod the tummy she will move in response

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    The HSE spends the most per capita for any health board on the planet. That's the fundamental flaw.
    “The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.” - Friedrich A. Hayek

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    Politics.ie Member ger12's Avatar
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    Quote Originally Posted by Cassandra Syndrome View Post
    The HSE spends the most per capita for any health board on the planet. That's the fundamental flaw.
    Have you a link?
    At 12 weeks the “clump of cells” toes curl, her mouth makes sucking movements, she has a human face and if you prod the tummy she will move in response

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    Politics.ie Member Prester Jim's Avatar
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    I don't think the bashing is ever about the frontline staff as a whole or even sections of it, every sane person deeply appreciates the service given.
    The bashing is about the HSE leadership, health ministers and management in general.
    For me it is about the total lack of vision; are they looking after everyone universally or are they private?
    This fast and slow track service is abominable and immoral in my view.
    We need to decide on the one method and have it for all and have it put into actions as soon as possible.

  5. #5
    Politics.ie Member ger12's Avatar
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    Quote Originally Posted by Prester Jim View Post
    I don't think the bashing is ever about the frontline staff as a whole or even sections of it, every sane person deeply appreciates the service given.
    The bashing is about the HSE leadership, health ministers and management in general.
    For me it is about the total lack of vision; are they looking after everyone universally or are they private?
    This fast and slow track service is abominable and immoral in my view.
    We need to decide on the one method and have it for all and have it put into actions as soon as possible.
    A Strategy for Cancer Control in Ireland published in 2006 has lead to HSE National Cancer Control Programme.

    A Strategy for Cancer Control in Ireland
    Cancer services
    National Cancer Control Programme · TheJournal.ie

    Frontline staff like myself depend on organisations like the HSE to come up with plans such as these, based on best practice, to implement best practice.

    The vision shown by Michael Martin in undertaking to reform our healthcare system was and is commendable. The lack of vision in recent years is of serious concern. The two tier health system is becoming a three tier one.
    At 12 weeks the “clump of cells” toes curl, her mouth makes sucking movements, she has a human face and if you prod the tummy she will move in response

  6. #6

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    Quote Originally Posted by ger12 View Post
    Have you a link?
    Page 57 of the report.

    http://www.dohc.ie/publications/pdf/...1.pdf?direct=1

    These figures are 2009, but use GNP as well as GDP. The US spends $3,000 on public health care per capita, the rest is private. Since 2009, this economy has shrunk the most of those countries listed, driving up our percentages of health care per GNI per capita.
    “The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.” - Friedrich A. Hayek

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    Politics.ie Member ger12's Avatar
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    Quote Originally Posted by Cassandra Syndrome View Post
    The HSE spends the most per capita for any health board on the planet. That's the fundamental flaw.
    List of countries by total health expenditure (PPP) per capita - Wikipedia, the free encyclopedia

    You sure?
    At 12 weeks the “clump of cells” toes curl, her mouth makes sucking movements, she has a human face and if you prod the tummy she will move in response

  8. #8

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    Quote Originally Posted by Prester Jim View Post
    I don't think the bashing is ever about the frontline staff as a whole or even sections of it, every sane person deeply appreciates the service given.
    The bashing is about the HSE leadership, health ministers and management in general.
    For me it is about the total lack of vision; are they looking after everyone universally or are they private?
    This fast and slow track service is abominable and immoral in my view.
    We need to decide on the one method and have it for all and have it put into actions as soon as possible.
    Bingo. That's the problem. Too many chiefs, not enough indians. Everyone knows and appreciates the commitment and work effort of doctor and nurses and the health carers, it's the fat cats at the top doing nowt and badly managing the system that rattles peoples cages.
    “The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.” - Friedrich A. Hayek

  9. #9
    Politics.ie Member Prester Jim's Avatar
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    Quote Originally Posted by ger12 View Post
    A Strategy for Cancer Control in Ireland published in 2006 has lead to HSE National Cancer Control Programme.

    A Strategy for Cancer Control in Ireland
    Cancer services
    National Cancer Control Programme · TheJournal.ie

    Frontline staff like myself depend on organisations like the HSE to come up with plans such as these, based on best practice, to implement best practice.
    I don't deny they have some good ideas, I just doubt their ability to run the HSE as a cogent whole because I doubt they have a proper vision as to how it should be run. Hopefully I am wrong.
    I know it seems like laziness to look other places for solutions but, there are systems in other states that do work well or at least better than the HSE does.
    We are looking at Finland, NI and other places for models to improve the DoE, why not do the same for the HSE.
    There was a lot of talk about the Dutch model or the Canadian model being adopted here.
    All efforts quickly seem (from my outside perspective) to become swamped in fights with vested interests or watered down politically because some minister or lobby group sticks their oar in and makes a play to distort the proposed model in their favour.
    This is usually private companies, hospitals or health insurance groups it seems.
    We all feel ownership of the HSE and feel frustrated that our voice is lost in the din from lobbyists.

    As a health insider you must have an opinion about how the future HSE should look and what model we should be aiming at?

  10. #10
    Politics.ie Member ger12's Avatar
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    Quote Originally Posted by Cassandra Syndrome View Post
    Bingo. That's the problem. Too many chiefs, not enough indians. Everyone knows and appreciates the commitment and work effort of doctor and nurses and the health carers, it's the fat cats at the top doing nowt and badly managing the system that rattles peoples cages.
    What do you suggest as a way forward? No HSE?
    At 12 weeks the “clump of cells” toes curl, her mouth makes sucking movements, she has a human face and if you prod the tummy she will move in response

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