# Nurses



## Purple (23 Jul 2015)

I heard a discussion this morning on RTE radio about the HSE's drive to recruit Irish nurses from the UK and further afield. Liam Doran was not in the discussion. Is he ill?


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## Firefly (23 Jul 2015)

Met him once at Fota - he was in the group ahead of ours. Heard they put on prawn sandwiches in the clubhouse especially for him...


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## Firefly (23 Jul 2015)

Purple said:


> I heard a discussion this morning on RTE radio about the HSE's drive to recruit Irish nurses from the UK and further afield. Liam Doran was not in the discussion. Is he ill?



More wurkers = less pay increases for existing wurkers = Liam's absence


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## Purple (23 Jul 2015)

Firefly said:


> Met him once at Fota - he was in the group ahead of ours. Heard they put on prawn sandwiches in the clubhouse especially for him...


I think until we find out what's happened to him you should refrain from such derogatory comments. Are you not worried about him as well??


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## Firefly (23 Jul 2015)

Purple said:


> I think until we find out what's happened to him you should refrain from such derogatory comments. Are you not worried about him as well??



Deeply worried. Difficult to know though as he gives out so much I'd wonder if he is permanently unwell? Perhaps he had one too many prawn sandwiches. Or even worse, a dodgy bottle of champagne?


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## Leper (24 Jul 2015)

If anybody has been watching my posts they will see that I warned of what would happen by the government's deliberate failure to replace retiring nurses.  Unfortunately, it has come to happen.  We need 500 nurses immediately.  Only a few years ago I remember my daughter qualifying as a nurse and out of 151 nurses who qualified there were 148 employed in the UK by the following week.  The HSE was forced to employ agency nurses (at higher costs) rather than give fulltime jobs to graduates.  Ludicrous! Yes! barefaced ludicrous at that.

In the UK Irish nurses were offered generous relocation allowances, fulltime contracts, free access to courses (that they would have had to pay for here), a better quality of work environment etc.   And the government thinks that these nurses will return to Ireland?  Return to what? Increase in working hours from 37 to 39, a lesser hourly rate, lesser holidays, cut-rate overtime, work another half hour daily at nil pay, less access to courses that the nurses will have to pay for.

Lads, have your laugh, Doran from slow beginnings as a trades union representative has mushroomed into a fierce truth-teller.  And even we cannot argue with the truth.  Do you think authorities in the UK are stupid enough to let go of Irish Nurses?  This is a no-brainer.


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## Vanessa (2 Aug 2015)

I met a UK recruiter at a jobs fair in Dublin. She said that they would take every newly qualified midwife in Ireland that they could get and would still be short


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## Leper (2 Aug 2015)

Vanessa said:


> I met a UK recruiter at a jobs fair in Dublin. She said that they would take every newly qualified midwife in Ireland that they could get and would still be short



Vanessa, you are right.  The tragedy here is that we are training nurses/midwives for the export market.  The cost on the taxpayer is horrendous.  But, we are getting what we put up with.

At Christmas several hospitals set up recruitment stands at our airports to try and entice nurses return to Ireland.  That recruitment process was a failure.  I notice this time the HSE is looking for full time nursing staff and not 2 year contracts. Furthermore, nurses who work here tend to accept positions in the private sector where the pay and condditions are better. There has been a drain of nursing staff to private hospitals.

The whole set up has been well below par for cost.  Agency nurses cost much more than a hospital staff nurse.  Furthermore, agency nurses while good at their profession are paid hourly and give an hourly return.  Fulltime staff nurses give much more. What I am pointing out are no-brainer situations. Have we got anybody with brains running the country?


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## Purple (4 Aug 2015)

Leper said:


> Furthermore, nurses who work here tend to accept positions in the private sector where the pay and conditions are better. There has been a drain of nursing staff to private hospitals.


 If pay and conditions are better in the private sector and they can still compete with the public sector then we should be looking at the structural inefficiencies in the Public Sector which make them uncompetitive. When those are addressed the resources will be there to give pay increases.




Leper said:


> The whole set up has been well below par for cost.  Agency nurses cost much more than a hospital staff nurse.  Furthermore, agency nurses while good at their profession are paid hourly and give an hourly return.  Fulltime staff nurses give much more. What I am pointing out are no-brainer situations. Have we got anybody with brains running the country?


Contract staff to not get the same T’s & C’s and full time permanent nurses and, crucially, they do not have a job for life and do not accrue pension entitlements. Taking that pension cost and the lack of labour mobility into account I find it hard to believe that the real total cost of contract staff is higher.  

If we are training more nurses than we can employ then we should reduce the number we train.


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## Leper (4 Aug 2015)

Purple said:


> If pay and conditions are better in the private sector and they can still compete with the public sector then we should be looking at the structural inefficiencies in the Public Sector which make them uncompetitive. When those are addressed the resources will be there to give pay increases.
> 
> 
> Contract staff to not get the same T’s & C’s and full time permanent nurses and, crucially, they do not have a job for life and do not accrue pension entitlements. Taking that pension cost and the lack of labour mobility into account I find it hard to believe that the real total cost of contract staff is higher.
> ...



1. Nurses are moving to the Private Sector because (a) They get better pay (b) They have to work less unsocial hours.  Nurses are not stupid, you know.  "Uncompetitive" situations have nothing relevant to my points.  Listen to the radio ads re some private hospitals, great if you get sick 8am - 5.00pm Monday to Friday etc you're sound.  The Public Sector picks up the slack here and saves the Private Sector considerable money by seeing and accepting patients 24/7.  Let's call a spade a spade here.

2. Contract Staff must be paid for holidays, bank holidays, night duty, unsocial hours, weekend work etc too.  Whatever way you look at it the price of Contract Staff by far exceeds the cost of Staff Nurses. Incidentally, a Contract person can abandon ship at the end of the day while Staff Nurses bring their experience with them from hour to hour i.e they can't wash their hands of ongoing patient situations.

3. When my daughter completed her nursing degree only a few years ago, she and nearly 100% of newly qualified nurses headed for the UK almost immediately where they were treated well, paid relocation allowances, given free access to Nursing courses that would have cost them here, better working conditions etc etc.  If we reduce what we train we'll have nobody to tend to our ageing population.  As you can see we almost have that terrible situation already. Even our health people admit there is now a serious shortage of nurses.

But, the Private Sector will save us! Gawd, I can't wait.  Wait until the private insurance companies take over all our hospitals as is planned and Purple Auld Stock you'll have what you wished for.  And . . . then God help us all . . . I am very frightened . . . Whatever you do, don't get sick . . . the accountants will save us - (Insert a Swear word here).


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## Purple (5 Aug 2015)

I don't accept that contract staff are more expensive in the long run as they do not accrue pension entitlements.

The Belgian healthcare system is regarded as amongst the best in the world. There are some public hospitals but most are private. They all compete with each other. The public get an excellent service.
If the state could deliver an excellent healthcare service I'd be all in favour of them doing it but they have demonstrated again and again that they are not competent to do so.
If there were no private hospitals then they state would have to provide more. Every euro spent there is a euro that the state doesn't have to spend. Private healthcare is a massive subsidy of the public system.


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## Leper (5 Aug 2015)

Purple said:


> I don't accept that contract staff are more expensive in the long run as they do not accrue pension entitlements.
> 
> The Belgian healthcare system is regarded as amongst the best in the world. There are some public hospitals but most are private. They all compete with each other. The public get an excellent service.
> If the state could deliver an excellent healthcare service I'd be all in favour of them doing it but they have demonstrated again and again that they are not competent to do so.
> If there were no private hospitals then they state would have to provide more. Every euro spent there is a euro that the state doesn't have to spend. Private healthcare is a massive subsidy of the public system.



(a) If you don't accept that contract staff are more expensive in the long run I have the figures.  I don't accept that the weather this summer is so bad, but it is.  The truth is always the truth and you get that from me. Contract nurses must also be credited with their service for future employment.  The clerical support for contract nurses by far exceeds the support for Staff Nurses.

(b) The Belgian healthcare system, the Dutch healthcare system, the British healthcare system are all better than ours.  So is most others.  Although the Brits complain about their healthcare system they have GP visits, hospital care, prescriptions etc for 10.00 per year.  I hear people say the Brits have the population to support this. I am not convinced that with a bit of thought, our government could go down this direction.

(c) Other healthcare systems have (i) private hospitals (ii) public hospitals.  They are separate.  We have private use by consultants in public hospitals (bloody criminal!).

(d) I look forward to the day that the Gardaí will be bringing drunks, drug abusers etc to private hospitals for help.  I can't wait to see chained 
prisoners of serious crime brought to private hospitals for care.

(e) Perhaps sometime we can have private hospitals that have an accident and emergency service 24/7?

(f) We have health insurers boasting that you can now be treated in your own home instead of a hospital and a visiting nurse/doctor will be supplied.  Great if you have a known illness - too bad if you are being treated for the wrong illness.  Is this method 100% safe? Today I asked five nurses and none could give me any guarantee of safety of this method.

(g) I read on the newspapers today that the amount of patients now waiting on trollies is greater than ever.  There's something wrong somewhere and you do not have to be an artist to draw conclusions.

Our population will get what it wished for soon enough by handing over the healthcare to the finance people of health insurers.  I wonder do they know for what they are wishing?


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## Purple (6 Aug 2015)

Leper,

We both agree that the healthcare system is a shambles.
We both agree (I think) is that the core problem is not funding.

You are strongly opposed to private hospitals in general and private A&E departments in particular.
Can I ask you why this is? Do you think we would have a better system if there were no public hospitals?
I don't understand how you think a person visiting a private A&E department, thereby not visiting a public A&E and not consuming that public service does not constitute a saving to the state. The same goes for a person opting for a procedure in a private hospital. We can argue that a two-tier system is unfair but that's a different point.

I don't care what system is in place, public, private or a mix of both, as long as it works. I have no faith in the people who run our public system. I include the medical establishment, both doctors and Nurses; they are as part of the problem as the managers and administrators. I do not mean individual nurses or doctors but their representatives, the medical establishment, who have opposed change and improvement for generations. 

What we have doesn't work. Throwing money at it hasn't worked. Why not try something different, why not look at the best systems among our neighbours and duplicate what works? 
If the Unions are really interested in delivering a world class system for the public and not just feathering their own nests then they would cooperate fully without looking for their pound of flesh.


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## Leper (6 Aug 2015)

Purple said:


> Leper,
> 
> We both agree that the healthcare system is a shambles.
> We both agree (I think) is that the core problem is not funding.
> ...



1. I never said our healthcare system is a shambles.  Yes, it could do with improvement and in many instances has shot itself in the foot and will have to come to terms with its shortcomings.  But, generally it is a good service.  Ask anybody who had serious heart surgery, cancer surgery, etc.

2. I am not opposed to private hospitals.  Private hospitals are like private schools, there is a demand for them for one reason or other.But, our private hospitals should be forced to give a 24/7 service and be available for the Gardaí dropping off drug abusers, alcohol abusers too.  People get sick outside 9 to 5 you know!

3. The management, medical people, nurses, general staff of public hospitals are easy targets for ridicule.  Strangely, it is the people who ridicule them most are the people usurping authority for their own means.  How often have you heard a politician say "The back room staff are the cause of the healthcare's problems"? (Medical and Nursing staff are generally referred to as Frontline Staff). Yet, it is the same politicians who are looking for immediate answers to his/her Parliamentary Questions, constituents enquiries etc.  Staff working in hospitals would be better used if they had no politicians queries to process. Private hospitals are not answerable to politicians queries.

4. "As long as it works" - You think a private healthcare system works in Ireland? How many people had "tummy tucks," "sagging asses" etc treated in private hospitals under private health insurance?  Who pays for this through private health insurance? Answer:- Us and through continuously rising membership fees. You get your GP to write a report that your sagging ass is causing you medical problems and you've got what cannot be otherwise described other than an Extensive Beauty Treatment and paid for by the membership.

I know we have deviated from the title here so let's deviate some more:-
If IKEA is a heaven for flat-pack Ireland.  Ireland as a country is a Scamster Heaven.  Ask yourself the following questions:- How many people have Medical Cards who should not have them?  How many people are working and simultaneously illegally drawing unemployment benefit? How many people are in receipt of Deserted Spouse Allowance and are no more deserted than Times Square? While we're at it . . . how many people obtained 3rd Level Grants who are not entitled to them?

We have two Irelands, those who scam and the PEFT Brigade.  [PEFT = Pay Every effing thing].  Our Dept of Social Welfare went after some scammers last year to have their inspectors branded as Nazis and "SS" by the leading opposition party.  3rd Level Grants are seen as fair game by those who can get their accountants to "doctor" the books. I won't even mention the Medical Card Scheme.

We are unlikely to see any abuser of the 3rd Level Grants, crooked Medical Card holders, Social Welfare defrauders brought to justice, outside of very few exceptions.  But, the illicit practices recur and its fingers up to anybody who tries to take them to task. But, we as a public pay up, shut up, and do nothing.

So Private Hospitals are going to save us? -  I admire your innocence. [Trades Unions are there to represent their members and for nothing else].


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## Purple (7 Aug 2015)

Leper,
I'm not suggesting that Private Hospitals will solve our problems, not within the current structure anyway. I'm saying that public hospitals won't either.


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## PMU (8 Aug 2015)

Leper said:


> If anybody has been watching my posts they will see that I warned of what would happen by the government's deliberate failure to replace retiring nurses.  Unfortunately, it has come to happen.  We need 500 nurses immediately. .



Do we? According to the OECD, Ireland has the third highest number of practicing nurses per 1,000 of population in the OECD and this number has increased by 1% since 2000 http://www.oecd-ilibrary.org/sites/9789264183896-en/03/03/g3-03-01.html?itemId=/content/chapter/9789264183896-30-en&_csp_=e92c9913836e5fffbbecfc400984a40b

We've more nurses than the Nordics, except for Denmark. We've almost double the number of nurses than the EU average. Clearly Irish nurses aren't as productive as foreign nurses, so why have we special pay deals and recruitment campaigns for nurses? Especially since, according to the OECD,
nurses in Ireland have relatively high salaries; higher than in e.g. the UK or Norway.  
http://www.oecd-ilibrary.org/docserver/download/4211011ec032.pdf?expires=1438882268&id=id&accname=guest&checksum=543DA9F59D1566788C762A3E5653B02C

Perhaps rather than focusing on throwing money at a problem – always the Irish response – we should look at importing foreign work practices into our health service, to bring it up to EU standards. It's not unreasonable in the current economic situation to expect nurses to be at least as efficient as their EU equivalents.


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## Leper (9 Aug 2015)

PMU said:


> Do we? According to the OECD, Ireland has the third highest number of practicing nurses per 1,000 of population in the OECD and this number has increased by 1% since 2000 http://www.oecd-ilibrary.org/sites/9789264183896-en/03/03/g3-03-01.html?itemId=/content/chapter/9789264183896-30-en&_csp_=e92c9913836e5fffbbecfc400984a40b
> 
> We've more nurses than the Nordics, except for Denmark. We've almost double the number of nurses than the EU average. Clearly Irish nurses aren't as productive as foreign nurses, so why have we special pay deals and recruitment campaigns for nurses? Especially since, according to the OECD,
> nurses in Ireland have relatively high salaries; higher than in e.g. the UK or Norway.
> ...



OK PMU let's stop recruiting nurses. You said we have double the EU average of nurses (add in doctors, attendants and health care assistants in other countries and see what figures you come up with).  Like you said Irish nurses are not as productive as nurses in other countries, what an inspired statement of rubbish.

You also say we should import foreign work practices.  I wonder why so many foreign nurses are trained here for them to return and work in their own countries with Irish practices.

You know PMU, you have opened my eyes.  Thank God we exported nearly all our recently qualified nurses to the UK.  Somebody said earlier that the UK will accept every nurse we produce and more. 

So PMU have a look at my posts and even Purple's both of us have pretty intimate knowledge of the hospital system here. I'm sure the nursing population will be delighted with you.  Did you ever think of going into politics? No minister for health even came near solving the problems of the hospital system.  You could be the inspiration dear old Ireland needs.


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## cremeegg (11 Aug 2015)

Its nice to see a thread like this that gets better as it goes on. After starting as a silly piece on Liam Doran it has become an interesting discussion.

Leper, if PMU says that we have almost twice as many nurses as the OECD average, you will have to better than the above.  Is it true and if so why do we need more nurses.

Can I suggest that people working in a poorly managed organisation often work harder and longer with less effect than people working in a well run organisation. Poor productivity is usually a management issue rather than a worker issue.

Improved work practices might allow Irish healthcare staff to deliver a better service.

That we have a very poorly run health service was demonstrated clearly by the attempt to computerise the health service payroll system, which was abandoned after spending €200 million.

You believe that agency staff are more expensive than full time staff. Well I don't know much about health staff costs, but I do know a little about pensions. If a public sector worked retires on a pension of €40,000 pa based on their final salary, that costs the taxpayer about €1.2 million (discounted at 3.33%)so it is very possible that agency staff at a much higher hourly rate work out cheaper than full-time staff.


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## Leper (12 Aug 2015)

cremeegg said:


> Its nice to see a thread like this that gets better as it goes on. After starting as a silly piece on Liam Doran it has become an interesting discussion.
> 
> Leper, if PMU says that we have almost twice as many nurses as the OECD average, you will have to better than the above.  Is it true and if so why do we need more nurses.
> 
> ...



The OECD says this and that.  Largely what it says in relation to nurses and healthcare staff in general is purely a mismanagement of figures.  There are more caring staff in our health service than nurses.  There are attendants, health care assistants, doctors, consultants (sorry for stating the obvious).  But, when all are compiled you will see that we have less healthcare staff per capita on most (if not all) of the above stated workers.

I'm with you on the poor management issue.  I'm with you on the costs of healthcare too.  It wasn't the public service that fell down on the job on the computerised payroll issue.  "Reputable" consultants were brought in from the private sector and let's be honest cocked up everything that could be cocked up despite early warnings from veteran campaigners.  And what I am saying is an understatement.

Now let's look at the pension issue which you raised.  If you can show me a nurse, attendant, healthcare assistant, clerical officer, porter, etc retiring on a pension of €40,000 I'll say that you are a magician.  A nurse retiring after 40 years service would have a pension much less than that.  While I am at it, I (again) wish to point out that public service employees pay into their own pension.  Not only that the government (on advice from the private sector accountants) stole (no other word for it) almost the entire pension fund to use as they pleased.  The government could not pay it back and implimented a pension levy on public service employees to restock the pension fund.  I, for example, am paying a Pension Levy which is greater than my pension entitlement.  €40,000 pension for the likes of me, you're dreaming. I won't get even half that.

Let's revisit Agency Staff.  They are a necessity in the current environment.  They cost more than fulltime staff to service.  They must be paid for their holidays, their time, their qualifications.  The agency must be paid also.  You need back-up staff to process these payments. Let's talk more on Agency Nurses.  Let's say a hospital is free of MRSA.  An Agency Nurse (attendant, healthcare assistant etc) comes from an infected hospital.  How long do you think it will be before the non infected hospital becomes infected?

We can look at other countries and their systems.  I like the UK equivalent.  Like I pointed out Mick-the-Brit has GP fees, Hospital Care, Prescriptions for £10 per year.  We could have that, but political decisions will have to be made and we will have to separate the public from the private healthcare system.  But, the Consultants will fight tooth-and-nail to prevent this.  Also, they have the political clout.  The bottom line in three little words:- Consultants run hospitals.

Our system is subject to many checks (HIQA etc) and a hospital, care-home etc can be closed within hours if standards are not met.  We have a public that use Accident & Emergency like a free service.  Our Gardaí deliver drug abusers, drunks to hospitals every night putting a strain on resources.  I don't blame the Gardaí as they are under scrutiny if anything goes wrong.  We have a litigeous state and our healthcare is being sued hourly and in many cases undeservedly.  Anybody can turn up at Accident & Emergency, get treatment for almost anything and later walk out and do not have to pay anything.  Accident & Emergency have to be protected too.  I can say, that as a patient in A&E I experienced some dreadful fear as a result of other patients just dumped into the hospital.

I think I was a little bit rough on PMU above and I apologise for that.

I hope somebody looking in on this forum in ten years time and after privatisation of our hospital system will see a huge improvement in the interim.  But, it won't happen and I don't believe things will improve.


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## PMU (13 Aug 2015)

Leper said:


> OK PMU let's stop recruiting nurses.  You said we have double the EU average of nurses (add in doctors, attendants and health care assistants in other countries and see what figures you come up with). ..



I never said we have twice as many nurses as the OECD average. The OECD's authoritative publication 'Government at a Glance' said it.



Leper said:


> The OECD says this and that.  Largely what it says in relation to nurses and healthcare staff in general is purely a mismanagement of figures.


If you say this is 'mismanagement of figures' the fault lies with the Department of Health.  OECD member states provide the figures to the OECD for this publication.  The OECD is itself disinterested but provides the statistics for informational purposes and to aid policy making in participating states.


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## Leper (13 Aug 2015)

We're getting involved with nurses in nordic countries etc. No doubt somebody else will come up with figures from North Korea or some other "Health Haven."  While all this is going on the campaign for what cannot be described as anything else other than the Health Insurance companies taking over the health service drives on.  And, of course, this is going to be the answer to all Ireland's health problems.  I think not and I see a population looking forward to this like turkeys look forward to Christmas.  Then what happens when (almost) inevitably we will have a worse health system than at present?

Like I said earlier, the PEFT people will pay up as usual.  Those who do not pay will still not pay.  It is like everything else in Ireland those who can cheat the system will.  Debt collectors will be more important than medical staff.  Accountants will be ensuring the future of hospitals on money issues only. Then, I reckon we can all look forward to self diagnosis and to treating our illnesses at home.  But, aren't the health insurance companies advertising this already?


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## Vanessa (14 Aug 2015)

Purple said:


> If pay and conditions are better in the private sector and they can still compete with the public sector then we should be looking at the structural inefficiencies in the Public Sector which make them uncompetitive. When those are addressed the resources will be there to give pay increases.
> 
> 
> Contract staff to not get the same T’s & C’s and full time permanent nurses and, crucially, they do not have tion to a job for life and do not accrue pension entitlements. Taking that pension cost and the lack of labour mobility into account I find it hard to believe that the real total cost of contract staff is higher.
> ...


Lets face reality. We are training people so that they can get decent employment overseas. When we are in a position to increase nurse numbers and teacher numbers we can do so. In the meantime what do we do? At least this way our children can follow the career they want albeit in another country. Better than having thrm emigrate skill less


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## cremeegg (25 Aug 2015)

Leper said:


> I'm with you on the poor management issue. I'm with you on the costs of healthcare too. It wasn't the public service that fell down on the job on the computerised payroll issue. "Reputable" consultants were brought in from the private sector and let's be honest cocked up everything that could be cocked up despite early warnings from veteran campaigners. And what I am saying is an understatement.



The failure of the computerisation of the health service payroll was one of the largest single financial disasters in this country before the bailout. It was comparable in size to PMPA and AIBs UK Insurance bailout (which eventually was recouped).

The reason the project failed was because the pay regulations for some staff are not coherent, there is no clear algorithm. Wage entitlements have been built up over many years and many agreements, there are overlapping allowances and no resolution when agreements contradict each other.

This incoherent pay structure is not confined to the health service. In the construction industry, the agreements covering a banksmans pay are mutually contradictory. In practice employers just guess what they should be paid.

The reasons behind this are a combinations of strong trade unions, weak management and interfering politicians.  And lets be honest a public that is too unconcerned to care.

Certainly the consultants were happy to collect a good rate per hour to work on a project that was inherently impossible. They must have realised this, if not from the beginning then at an early stage. If I was a partner in the firm concerned I don't think I would have an easy conscience. However the consultants didn't cause the problem, however much they may have milked it.

On a positive note, the Revenue faced a similar challenge in setting up ROS. Millions of different taxpayers using thousands of different accounting systems needed to be brought into one tax filing system. Instead of spending millions on developing a system to deal with all the complexity, Revenue simply published their requirements and gave taxpayers and their accountants time to develop ways to work with that.

Now could Revenue run the health service ?


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## Leper (26 Aug 2015)

cremeegg said:


> The failure of the computerisation of the health service payroll was one of the largest single financial disasters in this country before the bailout. It was comparable in size to PMPA and AIBs UK Insurance bailout (which eventually was recouped).
> 
> The reason the project failed was because the pay regulations for some staff are not coherent, there is no clear algorithm. Wage entitlements have been built up over many years and many agreements, there are overlapping allowances and no resolution when agreements contradict each other.
> 
> ...



1.You're right on one of the issues above i.e. the private sector well known consultants were happy to drain the last penny out of the Health Service with their bad advice. I understand some within the Health Service shouted stop and were ignored by the "private sector" consultants and even those making money within. The lot cost €240,000,000.00 - probably the expense of building two new large hospitals.

2. The system being installed was one which worked in several public bodies who had just as much complexities as grades in the HSE.  I understand what happened was the equivalent of building a house and putting up the roof first without supporting walls or even a foundation.  The whole process was a monumental cock-up from start to finish.  I shouldn't have used the word "finish" as the whole plan was jettisoned within a week of being launched.  I suppose you could compare it to the launch of the Titanic!

3. The Trades Unions had nothing whatsoever to do with the situation.  Trades Unions do not install computer systems. I don't know how you (a poster of some valued posts) could say this.  I think Purple is having an unfavourable influence on you!


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## Purple (26 Aug 2015)

Leper said:


> 3. The Trades Unions had nothing whatsoever to do with the situation. Trades Unions do not install computer systems. I don't know how you (a poster of some valued posts) could say this. I think Purple is having an unfavourable influence on you!


That's a bit harsh!... though cremeegg is on the money!  
What do you think would have happened if the HSE tried to standardise nursing contracts across all the old Health Board areas?
Do you think the Unions would have acted in the common interest or, as they usually do, tried to grab as much cash for their members as possible and damn the rest of us?


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## Sunny (26 Aug 2015)

Sorry but the idea that private consultants were solely to blame for that fiasco is fanciful. Read the Auditor General Report on the matter. That project is now held up as an example of what not to do when it comes to project management. The Health Services at the time didn't even know about roughly 80% of the different pay arrangements and allowances of staff until they had already started the project so the initial scoping was rubbish. The project wasn't clearly defined. It wasn't just a payroll system. It was to facilitate change management in the health service but this was never clearly defined. Because the project wasn't clearly defined, they decided to go on time and material cost basis with outside consultants instead of fixed cost contracts where the risk is shared between the consultants and the client and there is more pressure on both parties to perform.
Even if private contractors were milking the system (which they were and are doing now in banking), the Health Service and the Department of Health were the client. It was up to them to manage it. Once they could see the project over-runs, they should have paused and conducted a proper review. But they didn't. They just threw more money at it. That wasn't the consultants fault. It was the fault of an incompetent organisation who have proved themselves time and time again to be incapable of running the health service.


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## Leper (26 Aug 2015)

Ah ! Sunny,   If, if, if, . . . I agree with you, the fiasco was managed by a shower of inspired nincompoops both in the private and public sectors.  But, the advisors would listen to nobody and drove the train off the tracks and continued driving until all had been milked and of course the Irish Taxpayer took up the tab, as usual. Then the train crashed.

The same computer system was installed in several Departments and large Semi-State companies where it worked.  These had grades every bit as complex as the Health Service. Be under no illusion the private sector advisors would listen to nobody and the fiasco occurred.

Purple, Good to see ya around these parts again.  I missed you; nobody to disagree with me.  I don't know the point you are making about standardising nursing contracts across all the old health board areas.  Nursing contracts are fairly standardised for years. 

Cremegg is not on the money either, but entitled to his opinion.

The Trades Unions had nothing whatsoever to do with the failure of the PPARS project.  It was the private sector consultants, they talked big achieved little and made a fortune in the process.  There were people within the HSE who made money too.  Unfortunately, I wasn't one of them.


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## Purple (29 Aug 2015)

Leper said:


> It was the private sector consultants, they talked big achieved little and made a fortune in the process.  There were people within the HSE who made money too.  Unfortunately, I wasn't one of them.


So let me get this straight; the people who set the parameters, initiated the project, hired the consultants and assembled their own internal teams, were in charge of the HSE and delivering the services and whose decision it was to yea or nay every stage of the project and sign off on the final results are not to blame for the waste of €240,000,000 of Irish tax payers money. No, the fault lies with the consultants who they hired to advise them! That's just nuts.

It's like me asking someone to design and build a house for me with while having no idea of what I want but designing it on the hop, during the construction phase, and then blaming the architect when the crazy scope of work I give him cannot be built on the foundation I have already laid and the whole mess cost a fortune.


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## Leper (29 Aug 2015)

Purple said:


> So let me get this straight; the people who set the parameters, initiated the project, hired the consultants and assembled their own internal teams, were in charge of the HSE and delivering the services and whose decision it was to yea or nay every stage of the project and sign off on the final results are not to blame for the waste of €240,000,000 of Irish tax payers money. No, the fault lies with the consultants who they hired to advise them! That's just nuts.
> 
> It's like me asking someone to design and build a house for me with while having no idea of what I want but designing it on the hop, during the construction phase, and then blaming the architect when the crazy scope of work I give him cannot be built on the foundation I have already laid and the whole mess cost a fortune.


You're right Purple, it was just nuts hiring an outside company to mastermind the whole computerised proceedings. And nobody shouted stop.  The private consultants had carte blanche to do as they wished and they botched it probably having been advised all they way that things were not going well and they still botched it. Complete nuts. Everybody knew what was wanted i.e a payroll and personnel  computerised system and still they got it wrong. Nuts and more nuts . . .


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## Leo (31 Aug 2015)

Leper said:


> You're right Purple, it was just nuts hiring an outside company to mastermind the whole computerised proceedings. And nobody shouted stop.  The private consultants had carte blanche to do as they wished and they botched it probably having been advised all they way that things were not going well and they still botched it. Complete nuts. Everybody knew what was wanted i.e a payroll and personnel  computerised system and still they got it wrong. Nuts and more nuts . . .



Having been on both sides of it, consultants are generally good at doing what you ask them to. It's when you have no idea what you want, and hire them in thinking they're going to solve a myriad of problems you don't understand yourself, then you're in trouble. You can't blame the consultants here, buck stops with whoever continued to sign-off on this. A project of that size would have had multiple sign-offs at various stages, the only people with the authority to shout stop here were the same people who continued to sign on the line saying keep on paying them!


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## so-crates (2 Sep 2015)

Generally speaking, people working on a large IT project are actually personally invested in it and viewing such consultants as simply leeching is unfair. They want it to succeed. They are often emotionally attached to it, especially if they are investing long hours on it. On long projects they generally embed with and strongly identify with the internal people on the project. A failed project is good for no-one. There is no positive in a failed project and there can be personal consequences such as loss of reputation and more. It is also emotionally taxing especially if formerly healthy working relationships sour in the dissolution and become marked by negativity, blame and acrimony. Having had to go through one or two debacles on IT projects they all have a few things in common. Weak management with a poor or non-existing understanding of the scope. poor buy in from the senior management (especially if they feel the project has been forced on them). Poor scope and poorer scope control. Ill-defined, vague and partial requirements. It is rare that I could actually point a finger at a consultant and say they are the one to blame for the failure. Sometimes they may have contributed or exacerbated a situation but generally the framework and the direction given are the structural flaws that form the basis of the failure.


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## Leper (3 Sep 2015)

Leo said:


> Having been on both sides of it, consultants are generally good at doing what you ask them to. It's when you have no idea what you want, and hire them in thinking they're going to solve a myriad of problems you don't understand yourself, then you're in trouble. You can't blame the consultants here, buck stops with whoever continued to sign-off on this. A project of that size would have had multiple sign-offs at various stages, the only people with the authority to shout stop here were the same people who continued to sign on the line saying keep on paying them!



Normally, I enjoy Leo's post, but this post is off the wall. "It's when you have no idea what you want" - the Health Service knew well what it wanted and hired dumbell advisors to execute orders i.e. provide a working personnel and wages computer system.  This system worked for several government departments and there was no reason it would not work for our Health Service.  The blame of the debacle lies 100% with the Consultants.  

Let's say for a moment that the Consultants are blameless; then why hire them in the first place?  And to make matters worse the Consultants nearly launched the iceberg stricken ship to cause more mayhem. 

Socrates is right " a failed project is good for no-one." But, there were no personal consequences after such a loss.  The consultancy just changed its name and moved on leaving a disaster behind.  Think of what the waste of money could have done in building full and fully kitted out new hospitals.

Sorry Guys, the consultants cocked up and bigtime! The taxpayer took up the tab of course.


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## Purple (3 Sep 2015)

Leper said:


> Sorry Guys, the consultants cocked up and bigtime! The taxpayer took up the tab of course.


So there was no oversight, no gated stages, no progress reports, nothing?
They were given a brief and went off to execute it and were told not to come back or bother anyone until it was finished?

Either the people in the HSE gave them the wrong brief and so should be sacked or they gave them the right brief but didn't engage properly and so should be sacked.
They wasted €250,000,000 of the states money. There is no way they get to just blame "the consultants". If they were not competent to oversee the project they should have said so. They didn't and so the buck stops with them.


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## Leo (3 Sep 2015)

That's not how hiring consultants works, those doing the hiring are responsible for setting the terms of the contract, and specifying the requirements for the solution they want in clear terms. If those doing the hiring have a good grasp of the issue they are trying to resolve, then they will usually produce good clear and precise requirements with little of no ambiguity. 

I've seen it so many times where those bringing the consultants in are not fully informed or knowledgeable of the issue they were trying to solve, but obviously there's no way they can admit that and keep their senior position/ credibility. As they don't fully understand the issue, they have no idea how to go about resolving it, so reaching out and hiring consultants is seen as a prudent way of transferring the problem and saving face for weak management. When things go wrong then they can blame the consultants, 'sure we tried our best but those dastardly consultants just came in and took all our money'. In many cases, 

I've seen the hiring side of 'dumbbell consultants', but in my experience, competent hiring managers spotted the problem very quickly and they were sent on their way, contract terminated and very little money wasted. Why is it those in our health service aren't so competent when it comes to spending our money? 

I've also seen instances of consultancy hired in to large organisations where no one in management there had any real clue how their own systems worked. The result, vague specifications where accurate cost estimates couldn't be produced due to the number of open questions. Rather than answer all the questions and clarify requirements or admit they simply don't know, weak hiring management just agree to go the cost plus route and work it all out along the way. Then as the work proceeds and they realise the original spec wasn't adequate, and they need to add more requirements, the costs keep escalating and escalating. In all too many of these cases, shrewd managers who realise they're out of their depth move to other roles within the organisation so as to distance themselves from the impending disaster.

To attempt to blame the consultants here while absolving those who hired them, and continued to sign-off on their payments while delivering nothing is out of touch with the reality of business, the buck stops with those writing the cheques.


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## Leper (3 Sep 2015)

Leo, Purple, we're talking about a computer system to pay wages and record service here; not a space project rivalry with NASA to put a man on Mars.  The goal was clear, the route was clear, the non-delivery was disastrous.  Why hire consultants in the first place if they hadn't a clue? Why did the consultants accept payment(s) if the job failed? Why did the Health Service people pay them? Were Health Service people sacked as a result ? (I think I can answer 'No' to this last question).

I don't have the answers but from Leo's post above "That's not how hiring consultants work . . ." does not fuel any favourable opinion I have on the performance of consultants. Frankly, I believe those consultants were out of their depth in delivery, professionalism and action.  If not, then what were they actually doing?


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## Leo (3 Sep 2015)

I think we're all aware of that Leper. But you do realise a system like that is in all likelihood a lot more complex than the systems that powered the Apollo missions, or indeed put a man on Mars? Just speaking from the experiences of those in my own family who work in the health service across a number of hospitals and roles, the variations of terms that are involved in a single hospital, let alone the entire system is mind boggling. How these systems were allowed to develop over the years is beyond me, but you can be sure it's the local management and unions who are responsible, not some consultant. From speaking to them when this was hitting the news, the variations and amount of local agreements would be nigh on impossible to implement programmatically, and it was clear senior management within the service didn't understand this. 

Just say the consultants were out of their depth as you suggest, then it should have been obvious to even the least intelligent of health service management that that was the case. If that was the case, and it wasn't clear, then the health service management overseeing this fiasco were incompetent. Someone in the health service was regularly reviewing progress and signing-off on the work carried out by the consultants for them to continue getting paid.

If you hire someone to build me a house, and week after week they continue to carry out lots of building-like work without getting anywhere nearer to building a house, would you keep paying them for years on end? Trouble is, what happened here is someone hired a builder to build some stuff, without really being able to tell them what the stuff was, and not knowing the stuff they were building wasn't really the stuff anyone wanted, but continued to pay them all along.


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## Leper (3 Sep 2015)

Well, Leo both of probably think in the same square, but move in different circles.  Both of us probably have loyalties not shared too.  You have your opinion and long may you have it, and I have mine too.  I hope for the sake of Ireland Ltd, that such cock-ups like that of PPARS will never happen again and that Consultants and Health Service management will listen without recrimination to honest and intelligent people who can tell the truth and listen less to those who shout the loudest.

Regards
Lep


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## Leo (4 Sep 2015)

I hear you Leper. Unfortunately I think too many people in positions of authority here across public, private and political sectors are more interested in protecting the status quo and seeing what's in it for themselves rather than putting in the very difficult work of resolving the real root of the issues at play here.


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## Gerry Canning (7 Sep 2015)

Leo,

I think you have it in one.

I see little leadership/vision/accountability on any issues.

As a fresh example .
On the Migrant Crisis.
I see our politicians have woken up that their voters have decided, its largely a Refugee Crisis, not a migrant one.
On all our {leaders} I am taken with the Quote about politicians, but applies to all persons in supposed authority..
{there goes the Mob ,I am their leader , I must follow}


I am not being cynical ,just getting tired !


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## Purple (7 Sep 2015)

Gerry Canning said:


> Leo,
> 
> I think you have it in one.
> 
> ...


In fairness to Brian Hayes he's been saying it is a refugee crisis and that we should take a considerable amount for weeks.
I know he's an MEP but he didn't wait to see how the wind was blowing.


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