# Ratio of administrators to consultants in the HSE is 6.2 to 1



## Brendan Burgess (21 Jan 2017)

A very interesting article by Dr Ruairi Hanley on Hibernia Forum challenging the need to spend more money on the health services and challenging the demonisation of private medicine.

*Public vs Private – The Great Health Service Hypocrisy*

"To put this in context, in 2013 the Irish Hospital Consultants Association pointed out that the ratio of managers and administrators to Consultants in Britain’s NHS is 3.1, a level regarded as excessive.

Here in Ireland the equivalent ratio stood at 6.2 and no-one batted an eyelid."

I wonder if that could be true?  Is it a classification issue?


"Meanwhile, back on planet HSE, our public hospitals continue to employ hundreds of “Porters” across Ireland. These are a group of largely male, heavily unionised workers whose main skill seems to be an ability to push trolleys from one part of a building to another at a pace to be determined by SIPTU agreements. No-one dares question why so many of these people exist or why other staff members could not carry out this work."


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## bleary (21 Jan 2017)

Hmm I don't know if it is true or where the figures come from but I don't think that taking clinical staff off duties to bring patients to x rays Mris etc is a great use of staff.if not clinical staff then who does he suggest.
Odd suggestion.


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## Purple (23 Jan 2017)

I'd love to see one of the large hospitals adopt a Lean program, unencumbered by demarcation or other restrictive work practices which are the lifeblood of Unions. They would need a JCB to get rid of all the unnecessary staff.


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## Brendan Burgess (23 Jan 2017)

Purple said:


> They would need a JCB to get rid of all the unnecessary staff.



But who would drive it?


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## Purple (23 Jan 2017)

Brendan Burgess said:


> But who would drive it?


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## mathepac (23 Jan 2017)

I'm not sure what point Dr Ruairi Hanley was trying to make, it's not like hospital consultants are the only people delivering health-care in the HSEs.

Just looking at raw numbers across the HSEs, not hospitals specifically, the employee census of 15/12/2016 reports 2,862 Whole Time Equivalent, WTE, consultants. Because of job-sharing, part-time-working, public/private work,  1WTE could mean that, for example, 2 employees share  a 40-hour/week job working 20 hours per week each. In reality they probably work 3 days one week, 2 days the next, turn and turn about.

The HSEs report that a head-count (number of live employees on the payroll) of 3,203 consultant-grade employees delivered 2,862 consultant WTEs at 15/12/2016.

On the same date, a head-count of 17,398 administrative employees delivered 16,164 admin WTEs.

Based on these numbers, the head-count ratio is 5.43 admins / consultant and the WTE ratio is 5.64, still higher than the ratio he quotes for the NHS, but smaller than his 6.2 number.

None of the admin numbers above include the porters (headcount 1,641, WTEs 1,511) that Dr Ruairi Hanley seems to have such a problem with, nor do they include maintenance, technical services staff, ambulance control personnel, ambulance trainers, ambulance officers or various other non-clinical grades who are needed to keep the HSEs' wheels turning.

Does anybody want more numbers? Growth in employee numbers over the last 4 years? Absenteeism by job category? The number of Section 38 employees who don't work for the HSEs directly, but are classed as public servants? The differences between Section 38 vs Section 39 employees?


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## Brendan Burgess (23 Jan 2017)

The point he is making is that there are more relatively speaking, twice as many administrators in Ireland as there are in the UK. 
That the HSE is inefficient in its use of money.  Throwing more money at an inefficient system won't improve outcomes. 

In general, we would prefer to see more medical staff instead of administrators.  I would have thought that the appropriate comparisons would have been Total administrators to total medical staff or Senior Management to Medical Consultants. 

I suppose one would have to go back to the original IHCA report to see if their comparison was fair. 

Brendan


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## jjm (23 Jan 2017)

but who would drive it?
I just hope the don'n get any of the people who go out election after election voting to keep the same crowd in power.  People who blame Unions are the problem.We don't elect Unions but we do elect people to run the country.Blaming Unions allow the people we elected get a free run its keeps the spotlight off them. A  JCB driver with the wool pulled down over there eyes is someone hopefully i never have to depend on one for my life.


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## Gerry Canning (23 Jan 2017)

Brendan .
You posted twice as many admin in Ire as in Uk ?, I don,t see that on the postings ?
It seems unlikely ? but if so = whew!


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## mathepac (23 Jan 2017)

Total Medical/Dental headcount 10,516, a ratio of 1.71 admins/medic or Medical/Dental WTEs 9,336, a ratio of 1.73 admins/medic.

The HSEs including section 38 sub-contractors has a headcount of 121,710 or 107,085 WTEs.


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## Delboy (23 Jan 2017)

jjm2016 said:


> but who would drive it?
> I just hope the don'n get any of the people who go out election after election voting to keep the same crowd in power.  People who blame Unions are the problem.We don't elect Unions but we do elect people to run the country.Blaming Unions allow the people we elected get a free run its keeps the spotlight off them. A  JCB driver with the wool pulled down over there eyes is someone hopefully i never have to depend on one for my life.


So if Simon Harris says enough is enough and finally tries to implement radical change and the Unions call a strike (which they will) which impacts health care delivery, cancelled operations etc, then the people will understand and not hammer FG in the next election or see Harris fail to get elected himself? I think not


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## Purple (23 Jan 2017)

jjm2016 said:


> but who would drive it?
> I just hope the don'n get any of the people who go out election after election voting to keep the same crowd in power.  People who blame Unions are the problem.We don't elect Unions but we do elect people to run the country.Blaming Unions allow the people we elected get a free run its keeps the spotlight off them.


That's right, the people who actually run the system on a daily basis, who allocate resources, who set up, implement and run the health service are not responsible for the shortcomings in the health service and the Unions whose only function is to get as much money for as little work for their members and set standards as low as possible, tasks they are brilliant at, are also not to blame.  
I'd love to have you on the jury if I was in court!


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## Purple (23 Jan 2017)

Delboy said:


> So if Simon Harris says enough is enough and finally tries to implement radical change and the Unions call a strike (which they will) which impacts health care delivery, cancelled operations etc, then the people will understand and not hammer FG in the next election or see Harris fail to get elected himself? I think not


The function on Health Service Unions is to ensure that the interests of their members is the driving force in how the public health service is organised and run. The function of the government it to ensure that the public  health service is run for the benefit of the public. In that war the Unions are Germany and the government is Poland.


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## mathepac (23 Jan 2017)

What makes for horrifying reading are the absenteeism numbers Jan-Oct 2016 (the latest I can find) and the preceding years. All the numbers seem "stuck" with the heavily unionised areas  consistently missing the targets of 3.5% absenteeism and 100%  certification. This screams abuse of sick days to me, with Liam Doran's gang close to the front a lot of the time.

How can Harris or anyone else keep throwing people and money in here knowing that a lot of it just vanishes into absenteeism? The problem with nursing as a staff category is that they will be back-filled by agency nurses at astronomical costs.

The numbers mean that on average 2,013 nursing staff were on sick leave at any one time and that 12.5% of absences, 1 in 8, was uncertified. Truly staggering.

Why is it that medical staff appear to be less prone to absences from work? Based on 2016 figures in the table (from the HSE BTW) non-medical staff impose 3 to 5 times the absenteeism rate on the organisation compared to medics. Why?

[broken link removed]


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## jjm (23 Jan 2017)

Before the came to power FG promised the people the would sort out the Health service .I don't know where you were in 2008 I was in Ireland the Germans stood up for there People and made sure they got there Pension funds back the  government had no choice make no mistake about it the people in germany would march and there government fear them .


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## mathepac (23 Jan 2017)

Up to his appointment as DG HSEs, Tony O'Brien was the "Trolley Man" tasked with getting patients off trollies and reducing the queues in clogged up A&Es. He failed totally at that job so he was the obvious choice for DG. Is that what Harris is hinting at with the root and branch examination of managerial performance in the HSEs?

The organisations and the overpaid help supposedly managing them are now a huge embarrassment to Inda & Co.  Although he was their man whose appointment "behind closed doors" led to a lot of FF bluster about the lack of openness and transparency, a fair old bit of guff from the Soldiers of Destiny, is it curtains for "Trolley Tony"? Next please.

http://www.irishexaminer.com/ireland/hse-appoints-insider-tony-obrien-as-new-director-202237.html


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## Kine (24 Jan 2017)

Unfortunately we'll still be having this discussion in 10 years


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## mathepac (24 Jan 2017)

I don't believe so. If things continue there will be no more HSE. Mary Harney set it up as a catch-fence between the politicians and the health system, but stuff is now leaking through the fence to the politicos. That cannot continue. Privatisation is next and is already happening. Trumpism (extreme Thatcherism) is alive and well in Ireland.


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## Steven Barrett (24 Jan 2017)

mathepac said:


> What makes for horrifying reading are the absenteeism numbers Jan-Oct 2016 (the latest I can find) and the preceding years. All the numbers seem "stuck" with the heavily unionised areas  consistently missing the targets of 3.5% absenteeism and 100%  certification. This screams abuse of sick days to me, with Liam Doran's gang close to the front a lot of the time.
> 
> *How can Harris or anyone else keep throwing people and money in here knowing that a lot of it just vanishes into absenteeism?* The problem with nursing as a staff category is that they will be back-filled by agency nurses at astronomical costs.
> 
> ...



It's not their money so they don't care. Running over on budget makes absolutely no difference to anyone's salary or future prospects.

They hate their jobs. The levels of bureaucracy in the HSE is only staggered, with lots of unqualified, incompetent managers in place. Many of whom care more about box ticking and appearing to run a tight ship when all they do is stop staff from doing their jobs. Primetime can run a weekly show on the incompetence of the HSE. 


Steven
www.bluewaterfp.ie


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## mathepac (24 Jan 2017)

Any numbers, internal reports, C&AG reports you can point to @SBarrett?


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## Purple (24 Jan 2017)

What's the working year for a nurse? Is it bank holidays plus 28 days or do they get more holidays than that?
If it is then the average nurse takes 11 sick days a year.
Doctors spend as much time around sick people. How come they have a fifth of the sick days?
We have 2.7 doctors per 1000 people. The OECD average is 3.3 per 1000. With our young population and being a developed country that seems reasonable.
We have 12.4 nurses per 1000 people. The OECD average is 9.1 per 1000. How come we have a shortage of nurses? Could it be that we have enough nurses but we aren't using them properly?

Why is the fact that we have the second highest spend per head in the OECD but the poorest outcomes not the only discussion being had about the healthcare sector? Why does the media concentrate on hard luck  human interest stories and not this fact or those in Brendan's link?

The public debate should be;
We have enough nurses.
We probably have enough doctors.
We spend more than enough on health.
Do whatever is necessary to sort it out and run the public health service for the benefit of the public. Anyone who stands in the way of reform, be the doctors or nurses or union reps or local politicians should be treated like criminals.


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## mathepac (24 Jan 2017)

Purple said:


> We have 2.7 doctors per 1000 people.


OECD 2015 says *3.2* per 1,000


Purple said:


> We have 12.4 nurses per 1000 people.


OECD 2014 says *11.9* per 1,000


Purple said:


> Why is the fact that we have the second highest spend per head in the OECD


8th highest per capita spend (US$ value) in the OECD 2014


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## odyssey06 (24 Jan 2017)

Not sure who is right between Mathepac and Purple, but my takeaway from the figures is that you can't pin the issues in the health service on the lack of money going into it...


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## mathepac (24 Jan 2017)

To try and establish how nurses are deployed, I accessed the "Grade List for use in Health Service Personnel Census (HSPC) by Category: 2017" from HSE Corporate, one of the 5  (or is it now 6 HSEs?) we have had foisted on us.

This is what I found:

There are 17 Grade Groups within "Nursing" as follows:

Advanced Nurse/ Midwife Practitioner   
Clinical Nurse/ Midwife Manager   
Clinical Nurse/ Midwife Specialist   
Director Nursing/Midwifery, Assistant   
Director of Nursing/Midwifery   
Nursing Bank   
Nursing Education/Clinical   
Nursing/Midwifery Other (Corporate)   
Other Nursing/ Midwifery   
Post-registration Nurse Students   
Pre-registration Nurse Students   
Pre-registration Nursing/ Midwifery   
Public Health Nursing   
Staff Midwives   
Staff Nurse [Intellectual Disability]   
Staff Nurse [Psychiatric]   
Staff Nurses [General/ Children's]
I have no idea what the differences are in detail but I could probably make an educated guess at most of them. The bad news is that within one single Grade Group, 2 above, the are 14 different Grades of CN/MM as follows:-

2. Clinical Nurse / Midwife Manager

Clinical Midwife Manger 1
Clinical Midwife Manger 2
Clinical Midwife Manger 3
Clinical Nurse Manager 1
Clinical Nurse Manager 1 (Mental Health)
Clinical Nurse Manager 1 - Theatre
Clinical Nurse Manager 2
Clinical Nurse Manager 2 (Mental Health)
Clinical Nurse Manager 2 - Night
Clinical Nurse Manager 2 - Theatre
Clinical Nurse Manager 3
Clinical Nurse Manager 3 (Mental Health)
Clinical Nurse Manager 3 - Night
Clinical Nurse Manager 3 - Theatre
There are about 120 different grades in Nursing so if I have a nurse in one of those grades out sick or on holiday do I need to get someone to "act up" with an allowance or do I have to hire in an agency "Clinical Nurse Manager 3 (Mental Health)" that I can only employ on days or what? No wonder there are so many admins. My head hurts just thinking about it.


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## jjm (24 Jan 2017)

Purple at last you said politicians well done. If the pressure is put on Politicians they know there Fortunes will wax and wane if they do not sort it .Then it will be  Squeaky Bum Time.They need to fear The purples of this country more than the fear the Liam
The Politicians of this Country would not sleep at night if they though the Centre was going to turn on them. (Centre Stands For Inertia.) Like the Mortgage Issue You would be Suprised at the people who would want to represent the new centre

Ps post no 12 Purple said
Id love to have you on the Jury if I was in Court
And I would make sure you were put away for your own protection.


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## mathepac (24 Jan 2017)

odyssey06 said:


> Not sure who is right


I am. Go to OECD and see the latest numbers *https://data.oecd.org/healthres/health-spending.htm#indicator-chart* You can sort and customise by clicking on column headings etc. Really smart user interface excellent site.


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## losttheplot (24 Jan 2017)

Wasn't the complexity of the grades and payscales part of the problem with the PPARS system that cost millions.


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## mathepac (25 Jan 2017)

That was a symptom of a much more fundamental problem; a weak management that allowed the grading system to be implemented and run by the unions for their members' benefit rather than patients or clients.


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## Leper (25 Jan 2017)

mathepac said:


> I don't believe so. If things continue there will be no more HSE. Mary Harney set it up as a catch-fence between the politicians and the health system, but stuff is now leaking through the fence to the politicos. That cannot continue. Privatisation is next and is already happening. Trumpism (extreme Thatcherism) is alive and well in Ireland.



Mathepac is right and in a relatively short time there will be no HSE hospitals in Ireland.  Ask anybody working in the hospital system.  The service has been run down for years and shorter than any of us believe, it is only a matter of  time before the hospital service is privatised.  The private health insurance people will be running our hospitals along with investors. Will the new system work? I don't have a crystal ball but I fear for what is ahead. Even if you have private health insurance hospitalisation might not be available instantly.  If you haven't got private health insurance, God help you and you'll be wasting your time screaming for hospital admittance. They won't want to know you, you know!

One thing is certain when privatisation occurs there won't be gardaí turning up at Accident and Emergency with drunken people looking for nothing other than fight.  There won't be people showing up in A & E with minor ailments either. The ambulance service will not be collecting people other than those who are really ill (rent a grandmother will cease).  Hospital Patients will be discharged much faster than at present. In view of what the NHS in the UK has to offer we won't be keeping good quality nurses in private Irish hospitals either. Many forget that Liam Doran is representing nurses in private hospitals too.

Great! says you, we'll have a hospital system that works.  (grinning to himself he continues to write . . . ) the private hospital system in Ireland also has difficulty in keeping nurses . . . despite their expensive newspaper features advising to the contrary . . . ever ask yourself how many consultants working in private hospitals also have fulltime contracts with the HSE hospital system?

. . . be careful what you wish for . . . you'll get it shortly . . .


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## Purple (25 Jan 2017)

odyssey06 said:


> Not sure who is right between Mathepac and Purple, but my takeaway from the figures is that you can't pin the issues in the health service on the lack of money going into it...


Mathepac is correct. I was looking at old data.


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## Purple (25 Jan 2017)

Leper said:


> . . . be careful what you wish for . . . you'll get it shortly . . .


I want a well run and efficient publicly funded healthcare system which puts the interests of the public ahead of the interests of the people employed to deliver it. You needn't worry, the two faced, lying and duplicitous Unions, the incompetent (and unionised) Management and the parish-pump politicians who want a hospital in every town in Ireland will ensure the current shambles lumbers on and people keep tying on trolleys.  
I see Liam is getting the Nurses out on strike again. They should be ashamed of themselves.


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## odyssey06 (25 Jan 2017)

I wonder if Liam Doran has ever come up with a cost neutral improvement to the health service?


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## Purple (25 Jan 2017)

odyssey06 said:


> I wonder if Liam Doran has ever come up with a cost neutral improvement to the health service?


It has no interest in improving the health service. He is interested in getting as much money as possible for as little work as possible for his members. If he is seeking to improve the health service he's not doing his job. If he is doing his job he is more likely than not damaging the health service and the country as a whole. The same can be said for all Unions and Union leaders.


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## Firefly (25 Jan 2017)

Purple said:


> We have 12.4 nurses per 1000 people. The OECD average is 9.1 per 1000. How come we have a shortage of nurses? Could it be that we have enough nurses but we aren't using them properly?



Yeah, but look who have less nurses per per capita than us. I mean, would we really want to compare ourselves to this shambolic lot?


Netherlands
Austria
Sweden
New Zealand
Canada
France

Joking aside, France is often touted as having an exceptional healthcare system. On a per capita basis we have 30% more nurses!!!

End of Page 2 .... https://www.oecd.org/ireland/Health-at-a-Glance-2015-Key-Findings-IRELAND.pdf

Liam Doran should be ashamed of himself. Cutting sick leave alone would make a massive difference.


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## odyssey06 (25 Jan 2017)

Purple said:


> It has no interest in improving the health service. He is interested in getting as much money as possible for as little work as possible for his members. If he is seeking to improve the health service he's not doing his job. If he is doing his job he is more likely than not damaging the health service and the country as a whole. The same can be said for all Unions and Union leaders.



I agree that he has no interest... but disagree that it's part of his job. He's constantly bleating about not just the pay but the conditions and stress etc etc of his members working in these hospitals. I am sure his members would want him to help tackle those issues too. Yet he never seems to come up with a positive cost-neutral suggestion to improve their day to day working conditions and remove stress and friction ... every problem comes to him with the same solution, a bigger pork barrel.


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## Purple (25 Jan 2017)

odyssey06 said:


> I agree that he has no interest... but disagree that it's part of his job. He's constantly bleating about not just the pay but the conditions and stress etc etc of his members working in these hospitals. I am sure his members would want him to help tackle those issues too. Yet he never seems to come up with a positive cost-neutral suggestion to improve their day to day working conditions and remove stress and friction ... every problem comes to him with the same solution, a bigger pork barrel.


An efficient health system would mean the same or fewer nurses and a better organised and run service would mean less stress and so more people would be willing to work there. That would mean less pressure for pay increases. Liam is running a business. His business is called the INMO. It makes money by getting members to pay a membership. It runs directly against his interests to have a efficient and well run healthcare system which is patient focused.
The same is true for all Unions which feed off the public teat.


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## jjm (25 Jan 2017)

If you give politicians one Euro they want to spend two euro.All politics is local.We have a minister in power at present who nearly brought down the Government  he got his way  in the end if we had more money to throw around he would have got more.Who are we going to blame  Liam.  Politicians set bad example what do you expect.


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## mathepac (25 Jan 2017)

Firefly said:


> Liam Doran should be ashamed of himself. Cutting sick leave alone would make a massive difference.


The numbers I posted relate to absenteeism, as only 87% is certified sick-leave. This may seem a minor point but the HSEs have a target of 100% certified sick leave. just making progress towards this goal alone  could save millions as they get paid for not working plus the potential cost of an agency replacement.


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## Purple (25 Jan 2017)

mathepac said:


> The numbers I posted relate to absenteeism, as only 87% is certified sick-leave. This may seem a minor point but the HSEs have a target of 100% certified sick leave. just making progress towards this goal alone  could save millions as they get paid for not working plus the potential cost of an agency replacement.


Just as paper doesn't refuse ink doctors don't refuse money so if a nurse goes to their GP and looks for a sick cert they are going to get one, whether they need it or not. The real question is why nurses take so much sick leave. It doesn't matter whether it's certified or not. The notion that all certified sick leave is legitimate is nonsense. Doctors don't want to lose customers and even if they are completely ethical about giving out certs they still base their diagnosis on what the patient tells then. It isn't Star Trek, they don't have a Tricorder.

Even if there was no messing the in-built inefficiency and duplication within the system would still mean there would be gross inefficiency and waste.


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## odyssey06 (25 Jan 2017)

True that not all certified sick leave is legit, but, the process of forcing someone to pay for and attend a GP surgery does act as a deterrent to some though.


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## Leper (25 Jan 2017)

Purple said:


> Just as paper doesn't refuse ink doctors don't refuse money so if a nurse goes to their GP and looks for a sick cert they are going to get one, whether they need it or not. The real question is why nurses take so much sick leave. It doesn't matter whether it's certified or not. The notion that all certified sick leave is legitimate is nonsense. Doctors don't want to lose customers and even if they are completely ethical about giving out certs they still base their diagnosis on what the patient tells then. It isn't Star Trek, they don't have a Tricorder.
> 
> Even if there was no messing the in-built inefficiency and duplication within the system would still mean there would be gross inefficiency and waste.



Good Man! Purple.  I didn't know you had such an insight to how general practitioners behave.  And doctors being intimidated by nurses seeking sick certs - Is this a new type of bullying?  I'd love to see any hospital management refusing a sick note signed by a GP for any member of staff. It's all about the litigation, you know! By the way, what's your source? I'm sure hospital management will be interested.


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## mathepac (25 Jan 2017)

When I worked there, we had access to free flu, pneumonia (asthma sufferer) and hep B vaccines. If any HSE employees goes sick with any the these illnesses, they should be fired, unless there is some compelling reason why they cannot avail of the vaccine.


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## Firefly (25 Jan 2017)

odyssey06 said:


> True that not all certified sick leave is legit, but, the process of forcing someone to pay for and attend a GP surgery does act as a deterrent to some though.



Perhaps a certified sick note should be presented on the 2nd day rather than the 3rd day?


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## jjm (25 Jan 2017)

It is a vicious circle the HSE is driving people into private Health insurance some of these policies cover up to 12 Doctor visits a year.So no charge.If people are paying for a doctors cert they  may take enough days to cover the cost make it worth there time and money. If people go to a doctor just to get a day off they may over do there fake Illness to make sure the get a cert and the doctor giving them the week off Instead of a day.Where I work we done away with the Doctors sick cert a long time ago. We have no problem with absenteeism. Company would be looking for underline reasons if people were taking time off and fixing the problem. Good Management. There is nothing stopping people sending in certs if they want .We can look for a return to work cert if need be.


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## jjm (25 Jan 2017)

In the past purple may have known how .Then again he may not


I expect the above will make it to the grammatical  forum


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## Leper (25 Jan 2017)

Not great replies Purple. Source not great either. The GP who lost a job for refusing to give out sick certs without seeing the patient has a water-tight and just case against her former employer. Doctors are as dishonest as everybody else - Really? If you can't trust a medical doctor, then who can you trust? Certs being a waste of time - I think not.


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## Leper (26 Jan 2017)

mathepac said:


> When I worked there, we had access to free flu, pneumonia (asthma sufferer) and hep B vaccines. If any HSE employees goes sick with any the these illnesses, they should be fired, unless there is some compelling reason why they cannot avail of the vaccine.



Come on Mathepac! You can do better than this and you know it. Let's take the flu injections over the past three years.  The medics got the strain of the virus wrong based on their predicting (or guessing) for flu in the northern hemisphere.  Consequently, the flu prevention injections received in Ireland were as unhelpful and useless as Purple anti trades unions posts.


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## Purple (26 Jan 2017)

Leper said:


> Not great replies Purple. Source not great either. The GP who lost a job for refusing to give out sick certs without seeing the patient has a water-tight and just case against her former employer. Doctors are as dishonest as everybody else - Really? If you can't trust a medical doctor, then who can you trust? Certs being a waste of time - I think not.


A doctor suing a doctor will find it very hard to get work again. Do you really think doctors are better than the rest of us? Why, because they got more points in the leaving cert? Don't be do naive; they are just people, no more or less honest then the next person. We used to think about Priests like that. Have we learned nothing?
I didn't say Cert's were a waste of time but if you think there are doctors not giving out bogus certs to make extra money, keep their customers on-side or because their customer told them porkies and they don't want to call them a liar then I have a bridge in Brooklyn to sell you.


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## Purple (26 Jan 2017)

Leper said:


> Come on Mathepac! You can do better than this and you know it. Let's take the flu injections over the past three years.  The medics got the strain of the virus wrong based on their predicting (or guessing) for flu in the northern hemisphere.  Consequently, the flu prevention injections received in Ireland were as unhelpful and useless as Purple anti trades unions posts.


That was a well documented case. Where the vaccine works Mathepac's point holds true.

And yes, I am anti Trade Union and any other vested interest groups which damage this country and people. In the case of Health Sector Unions their actions have stymied reforms which could have saved thousands of lives and reduced the suffering of tens of thousands. In my opinion their leaders have blood on their hands.


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## Steven Barrett (26 Jan 2017)

mathepac said:


> Any numbers, internal reports, C&AG reports you can point to @SBarrett?



Talking to people who work in hospitals


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## thedaddyman (26 Jan 2017)

Purple said:


> I'd love to see one of the large hospitals adopt a Lean program, unencumbered by demarcation or other restrictive work practices which are the lifeblood of Unions. They would need a JCB to get rid of all the unnecessary staff.



I was in CUH 3 years ago in intensive care with a family member and they were kicking off such a programme. Lots of people around with clipboards measuring and timing things. Having seen Lean being badly implemented in a couple of large organisations I'm skeptical about it to be honest but as you rightly say, until the ability to make real change is there it doesn't matter what they do or how they structure a change process, vested interests will get in the way. Unfortunately, some of that change will require investment, digitizing records is one example of what could and should be done.


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## Purple (26 Jan 2017)

thedaddyman said:


> I was in CUH 3 years ago in intensive care with a family member and they were kicking off such a programme. Lots of people around with clipboards measuring and timing things. Having seen Lean being badly implemented in a couple of large organisations I'm skeptical about it to be honest but as you rightly say, until the ability to make real change is there it doesn't matter what they do or how they structure a change process, vested interests will get in the way. Unfortunately, some of that change will require investment, digitizing records is one example of what could and should be done.


Yes, it only works if you can reallocate some people and get rid of others but keep staff employed is more important than keeping patients alive. At a macro level when funds are being allocated that is the outcome of squandering precious public money.


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## Firefly (26 Jan 2017)

Leper said:


> Not great replies Purple. Source not great either.



It was his wife dude!


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## Purple (26 Jan 2017)

Firefly said:


> It was his wife dude!


Maybe he's met her


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## Firefly (26 Jan 2017)

Purple said:


> Maybe he's met her


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## Deiseblue (26 Jan 2017)

Meanwhile back in the real world the INMO/HSE talks in the WRC have broken down with notice of industrial action likely shortly.
It also appears likely that consultant pay will rise after the HSE dropped their High Court appeal against compensation awards to two consultants over failure to pay them agreed levels of salary 8 years ago - basically a breach of contract , obviously the Irish Hospital Consultants Association welcomed this as if this compensation is rolled out for all it's members the payroll  cost will be at least €350 million or a worst case scenario of €700 million.
A court case is also in the pipeline with the IMO challenging the abolition of the €3000 living out allowance for junior doctors.


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## Purple (26 Jan 2017)

Deiseblue said:


> Meanwhile back in the real world the INMO/HSE talks in the WRC have broken down with notice of industrial action shortly.
> It also appears likely that consultant pay will rise after the HSE dropped their High Court appeal against compensation awards to two consultants over failure to pay them agreed levels of salary 8 years ago - basically a breach of contract , obviously the Irish Hospital Consultants Association welcomed this as if this compensation is rolled out for all it's members the payroll  cost will be at least €350 million or a worst case scenario of €700 million.
> A court case is also in the pipeline with the IMO challenging the abolition of the €3000 living out allowance for junior doctors.


Hundreds of millions less to spend on sick people. Isn't it great to see the so called Healthcare "Professionals" have their priorities straight. I presume they are now going to stop going on radio and TV and pretending that they are interested in patient care.


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## Delboy (26 Jan 2017)

Mo money, mo money...and zero reform.
The Irish health service as it is and as it always will be.


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## Delboy (26 Jan 2017)

Purple said:


> Hundreds of millions less to spend on sick people. Isn't it great to see the so called Healthcare "Professionals" have their priorities straight. I presume they are now going to stop going on radio and TV and pretending that they are interested in patient care.


Au contraire Purple, au contraire.
The Head of the Consultants Assoc was on Morning Ireland earlier saying that by paying Consultants what they are owed would mean savings for the HSE! Apparently so many Consultants were upset at the breach of contract that they upped and left and the HSE has had to employ temp Consultants at a cost of 100m per annum.
Plus the pay is so bad that its causing hundreds of vacancies so this back pay will help solve that to a small degree.

I thought we had the best paid Consultants in the world?


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## Purple (26 Jan 2017)

Delboy said:


> Au contraire Purple, au contraire.
> The Head of the Consultants Assoc was on Morning Ireland earlier saying that by paying Consultants what they are owed would mean savings for the HSE! Apparently so many Consultants were upset at the breach of contract that they upped and left and the HSE has had to employ temp Consultants at a cost of 100m per annum.
> Plus the pay is so bad that its causing hundreds of vacancies so this back pay will help solve that to a small degree.
> 
> I thought we had the best paid Consultants in the world?


I take it all back; their motivation for suing the government for hundreds of millions of Euro in pay rises was completely selfless. In answer to "Will someone please think about the children?!" the answer is "Yes, they are". Doesn't it make you feel all warm and fuzzy inside...


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## Deiseblue (26 Jan 2017)

In fairness , Delboy no group of workers would tolerate such an egregious breach of contract as that foisted on consultants , so egregious in fact that the Attorney General advised the Government not to appeal the award to the two consultants as basically the Government didn't have a leg to stand on.
This decision is why we have industrial legislation which protects workers , eventually in the case of the consultants - after all nobody wants to see employers blithely ignore agreed contracts do they ?
Betcha the Government is dreading the result of the living out allowance case ?


----------



## Leper (27 Jan 2017)

For the record:- I never met Purple's wife and I was trying to keep the posts on a non-personal basis, nice dude that I am .  I don't doubt that there are take-a-few-bob-from-anybody doctors around, but I reckon most of them are honest.  Like Purple pointed out, I have never seen one doctor sue another.  One thing doctors have a fear of is the legal litigation system where many of them suffer.  Ask any gynaecologist.

There is no workable alternative to a doctor who issues medical certificates for patients.  Look at some of the posts on this thread.  We have one guy who would sack an employee who failed to show because of 'flu although a useless flu injection had been received.  Is it no wonder, we need trades unions?

As for Purple (I love the guy) I am glad he gets about enough not to need trades union representation.  Imagine Purple in an ordinary job, posting constantly (7.3K posts todate) most during working hours, consequently, getting sacked as his employer thinks he should be using his working time more purposely. Please note, I am not objecting to Purple posting whenever he wishes but let's say he gets sacked by somebody like Mathepac. I bet Purple would like the likes of Liam Doran to be representing him. 

Oh! yes . . . the innocence of Delboy:-


Delboy said:


> The Irish health service as it is and as it always will be.



After privatisation (not too many years away) of the hospital system we won't have a health service.  We'll have the private health insurers dictating what we can or cannot do and will have an Excess laden system which will frighten us into staying at home. Is the private hospital system the answer to all our ills? Ask any of the nurses who are leaving the private hospitals? (Some of the private hospitals have difficulty in retaining doctors too). I know nurses are leaving the HSE hospitals too.  But, lots of us tend to ignore those leaving private hospitals.


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## Delboy (27 Jan 2017)

Rambling post with not a lot to it except a few digs at other posters.

I don't see any oncoming privatisation of the hospital system. Thats just hyperbole.
We still have the highest number of registered nurses as pointed out previously so if they are leaving public/private hospitals, it's not impacting the overall % v's other countries.
The facts clearly show ever increasing budgets for the health service while the same problems arise every year...trolley crisis, long waiting lists, cancelled procedures etc. So I see no change in the health service even if another few billion were thrown it. Wages would be the main beneficiary.


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## Deiseblue (27 Jan 2017)

I cannot see where it was pointed out previously that we have the highest number of registered nurses ( per capita presumably ) .
Perhaps you could point me in that direction ?


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## Purple (27 Jan 2017)

Deiseblue said:


> I cannot see where it was pointed out previously that we have the highest number of registered nurses ( per capita presumably ) .
> Perhaps you could point me in that direction ?


There's good info here. We are well above the OECD average 12.4 per 1000 of population against OECD average of 9.1 per 1000. That's 50% more than the UK.

Can somebody quote the above info as I'm on Deise's ignore list (I upset him a while ago) and he won't see my post.


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## Purple (27 Jan 2017)

Leper said:


> For the record:- I never met Purple's wife


 I wish I could say the same 



Leper said:


> There is no workable alternative to a doctor who issues medical certificates for patients.


 Agreed, I was just suggesting that they are no guarantee that there's no messing going on. 



Leper said:


> As for Purple (I love the guy) I am glad he gets about enough not to need trades union representation.


 Love you too . I'm delighted I have never really had to deal with a Union. From speaking to hard working friends in the Public Sector they seem to be a nightmare to deal with. 



Leper said:


> Imagine Purple in an ordinary job, posting constantly (7.3K posts todate) most during working hours, consequently, getting sacked as his employer thinks he should be using his working time more purposely. Please note, I am not objecting to Purple posting whenever he wishes but let's say he gets sacked by somebody like Mathepac. I bet Purple would like the likes of Liam Doran to be representing him.


I'd love an ordinary job where I could work ordinary hours but I don;t have one so I'll have to keep working irregular hours. Bloody customers in different time zones...
Anyway, we measure people on value added and output, not hours worked. Some of our best paid guys on the shop floor work the shortest hours. If you get your work done and make money for the business and want to only work short hours (35 or 38 hours a week, that sort of thing) that's fine. The rest of us work 45 to 55 hours a week.


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## Leo (27 Jan 2017)

Purple said:


> There's good info here. We are well above the OECD average 12.4 per 1000 of population against OECD average of 9.1 per 1000. That's 50% more than the UK.


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## Deiseblue (27 Jan 2017)

Deiseblue said:


> I cannot see where it was pointed out previously that we have the highest number of registered nurses ( per capita presumably ) .
> Perhaps you could point me in that direction ?



I still see nothing to suggest to support your assertion regarding the highest number of registered nurses per capita .
If you are referring to Firefly's post #34 helpfully ranking OECD countries then we are seventh not first !
The figure of 12.4 nurses per 1000 population is a 2013 figure which is presumably derived from the Nursing & Midwifery board , in 2014 he board removed 1803 nurses from the register & in 2015 the board removed 3592 nurses from the register.
To my astonishment there are approx  14000 nurses who are fully registered but classed as inactive who were to receive a letter from the board asking them to come back to work ! - per the Indo of 8/9/2016.
To say the least it should be interesting to see up to date OECD rankings , is it any wonder that Simon Harris hopes to see 1000 nurses being recruited next year & hopefully doctors as there is a dearth of same.
In the interests of clarity there are approx 35,000 Public Sector nurses & given the population of 4,757,976 that is 7.356 nurses per 1000 head of population.


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## Purple (27 Jan 2017)

Deiseblue said:


> In the interests of clarity there are approx 35,000 Public Sector nurses & given the population of 4,757,976 that is 7.356 nurses per 1000 head of population.


How many private sector nurses are there?
Were the nurses which were removed from the register working or retired/ no longer in the sector?


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## mathepac (27 Jan 2017)

@Deiseblue, I think it's safe to assume that the OECD gathers information in a standard form across all geographies therefore they are comparing like with like.

Using the *"Health Services Employment: Section 6 Grade level detail - Overview by Grade Group: December 15 to Dec 2016"* the HSEs state there is a total of 35,353 WTE nurses employed in the HSEs and Section 38 contractors. Strangely when I add their own numbers I get 35,430 WTEs.  

Using their WTE number of 35,353 that equates to a headcount of 41,077 as of the same date. Using your population number, 4,757,976 and the HSEs' headcount number, that gives 8.63 nurses / 1,000 population. These nurses must be paid, admin'd, pensioned, managed and backfilled when they "go on the sick".

The HSEs numbers mean that expressed as WTEs, nurse occupy 33% of HSE/S38  posts or as head count 34%.

I still can't find numbers for private facilities who are not S38/39 contractors.


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## Mrs Vimes (27 Jan 2017)

I don't know where the number of nurses figure comes from, but if it's total registration with An Bord Altranais (sp?) it includes quite a few people I know who don't usually work, but keep their registration active and pick up the odd shift to keep their sanity or to cover whatever their kids are looking for this week.


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## Sophrosyne (27 Jan 2017)

What really matters to any organization is the number of personnel *present *each day.

In this day and age, I don’t know why the Health Minister or any other minister for that matter does not have or asked for a computer program to let him/her know at the very least:

·  Grade

·  Job title

·  Location

·  Who is present

·  Who is absent

·  Nature of absence

Other essential could be added.

The unique identifier should be the PPSN.


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## Marion (27 Jan 2017)

Or as my classes (Further Ed) regularly ask:

"What right do you have to get this information"

Marion


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## Sophrosyne (27 Jan 2017)

Marion said:


> Or as my classes (Further Ed) regularly ask:
> 
> "What right do you have to get this information"
> 
> Marion



What would be the possible objections?


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## Marion (27 Jan 2017)

Not sure.

Snowflakes sense of entitlement perhaps? All about Me.

Also,  It might impact on grants for some people, but not all.


Marion


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## Sophrosyne (27 Jan 2017)

Perhaps.

However, often front line managers have to schedule around annual leave, flexi leave, sick leave, training leave, mismatched work-sharing patterns and various types of other leave and career breaks.

Often they find themselves explaining this to senior managers who have no idea what they are talking about.

In order to manage large organizations, attendance patterns - including the bottom line, who is present, who are they and where are they - need to be visible to all levels of management, including the minister.


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## Marion (27 Jan 2017)

I'm in total agreement.

They might ask what my rights are - but I am well able to explain my role. 

I was just making a point that people can be difficult about information.

Marion


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## Delboy (27 Jan 2017)

Sophrosyne said:


> In this day and age, I don’t know why the Health Minister or any other minister for that matter does not have or asked for a *computer program* to let him/her know at the very least:


They tried that...it was called PPars. There were so many grades, categories within grades, allowances, expenses, local agreements...all going back to the dawn of time that the thing couldn't get off the ground, despite tens of millions being spent on it


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## Sophrosyne (27 Jan 2017)

Wasn't PPARS primarily a payroll program?


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## Sophrosyne (27 Jan 2017)

Marion said:


> I'm in total agreement.
> 
> They might ask what my rights are - but I am well able to explain my role.
> 
> ...



I agree.

However, what I am proposing is a program to monitor attendance.

Sometimes managers even one or two steps above the front line do not appreciate or fully appreciate the amount of possible absences and the effect that has in managing the front line.

Also, organizations from time to time need to take a step back and understand why they exist.


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## Sophrosyne (27 Jan 2017)

Delboy said:


> They tried that...it was called PPars. There were so many grades, categories within grades, allowances, expenses, local agreements...all going back to the dawn of time that the thing couldn't get off the ground, despite tens of millions being spent on it



There must be a paper system in operation, which calculates the pay taking account of everything you say.

Given that a computer program can be designed for anything for which rules can be written, what went wrong?


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## Delboy (27 Jan 2017)

I presume there are dozens of local systems all around the country. Whether they feed into anything central?
This is all presumption on my part by the way


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## Sophrosyne (27 Jan 2017)

Delboy said:


> I presume there are dozens of local systems all around the country. Whether they feed into anything central?
> This is all presumption on my part by the way



What does that mean?


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## Delboy (27 Jan 2017)

It means I have no idea of what systems the HSE has. I'm just guessing in response to your question about them having a central system to record all the info.
I'm saying that there are so much complications within the grades and so many grades and so many layers of agreements both locally and nationally that they may not have a central system at all. Just lots of local ones


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## Marion (27 Jan 2017)

Often the front line realise that everything works fabulously well when the management take off on junkets/conferences.

Why do management conferences/junkets take place during normal working weeks?

I'm always fascinated that work places thrive when management are absent.

Absenteeism is not always about front line staff.

Marion


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## mathepac (28 Jan 2017)

Sophrosyne said:


> Often they find themselves explaining this to senior managers who have no idea what they are talking about.


As they and the people they manage are usually members of of the same union maybe Liam Doran could explain or someone from the Dept of Health & Children, they created this monster no-one understands.


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## Sophrosyne (28 Jan 2017)

Marion said:


> Often the front line realise that everything works fabulously well when the management take off on junkets/conferences.
> 
> Why do management conferences/junkets take place during normal working weeks?
> 
> ...



Ineffective management is a different but connected issue.

For services to function they need adequate and appropriate personnel to be present to deliver the service.

Currently, the number and nature of personnel present is not apparent.

Surely, the need for this is self-evident.


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## mathepac (28 Jan 2017)

Marion said:


> Absenteeism is not always about front line staff.


I don't know when the military term "front-line staff" started being used presumably when the "wars" on hunger, crime, drugs etc broke out. It's a meaningless emotive term that hides more than it clarifies.

If you want to know who goes absent and when from the HSEs, please refer back to my post #14, it couldn't be clearer


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## Leper (28 Jan 2017)

This thread has gone in so many directions that I am finding it difficult to keep up. Hospital management, the government, the unions, the administration staff, Sick Leave, etc have been fingered for blame. 

The fact is our hospital system is short of nurses because the rewards of even working in the UK ailing hospital system are infinitely more inviting than here. Our younger nursing people are better educated than nurses who came up through the hospital system.  They are not fools.  They can make more money working abroad.  They can have nursing courses free of charge that cost an arm and a leg here. They have better working conditions. Even the UK government gives them generous allowances towards their accommodation. A nurse seeking far bigger money than in these parts of europe can leg it to the Middle East for a few years and on return can pay cash for a house instead of begging for a mortgage. Sometimes I wonder why any young nurse would continue to work here.

Even one poster suggested that Liam Doran is the cause of all that is not good in our system.  Newsflash! Liam Doran is paid to represent nurses and midwives through his trade union, he is not the conscience of the HSE.  Liam Doran after a precarious start in the INMO (or whatever it was previously called) has become a figure that many other trade unionists would want representing them now.  I wonder how long more the INMO will be able to keep him.  I wish he was representing me. I know Purple will have something to say on this.  Incidentally, Purple with his anti trades union views has probably become the greatest recruiting agent for any trades union.

Sick Leave and hospitals:- Nurses, Doctors, Care Assistants, Attendants, Porters, Ward Clerks etc are more open to infection than most of us posting here.  I hope nobody contributing here believes that that dispensers at the doors of hospitals play a huge part in the prevention of infections.  The dispensers look good, but that is about all. Nurses in their hourly lives would be open to more infections than most. If you have problems taking this in then have a look at the MRSA test alone conducted on all patients on admission. And that is only the start.  Add in shortage of staff, night duty, surgery, wound cleaning, etc and there is a just reason for more sick leave.  How many medical staff are physically threatened every weekend in Accident & Emergency? Don't forget hospital enforced sick leave either; if it is considered that a nurse with some infectuous illnesses would be a threat to patient care then sick leave is imposed on the nurse.

Somebody mentioned PPARS.  I think we discussed this to death in several previous threads.

Nearly Forgot:- I think it was Delboy who informed us that privatisation of our hospital system is not on the cards. I brought this to the attention of several hospital staff grades yesterday and I won't bore you other than to say it was treated with guffaws (no disrespect to Delboy).


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## Purple (30 Jan 2017)

You are right Leper, just give them all more money. That'll sort things out.


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## odyssey06 (30 Jan 2017)

I don't see any moral difference between the CEO of a 'privatised' hospital, whose only concern is profit\shareholders and not health of patients (or his own staff). And Liam Doran, whose only concern appears to be the remuneration of his members and not health of patients (or his own members).


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## Delboy (30 Jan 2017)

Leper said:


> Nearly Forgot:- I think it was Delboy who informed us that privatisation of our hospital system is not on the cards. I brought this to the attention of several hospital staff grades yesterday and I won't bore you other than to say it was treated with guffaws (no disrespect to Delboy).


So in say, 20 years time, most Irish hospitals now public (James, Mater, Blanch, Sligo, CUH etc etc) will be privatised?


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## Leo (30 Jan 2017)

Delboy said:


> I presume there are dozens of local systems all around the country. Whether they feed into anything central?
> This is all presumption on my part by the way



One problem they had in implementing that systems is that there were dozens of systems in operation within individual hospitals, much of it not on paper. Different departments had evolved different practices going back over the years, in newer hospitals that had merged a number of older hospitals some departments even had multiple systems in place encompassing the practices in the source hospitals. There was a lack of engagement with PPARS due to fears some of these legacy practices would have to change.

Some departments still manage staffing rotas, holidays and time in lieu using a central book, or big chart on a wall, with staff submitting the details to the payroll system after the fact!


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## jjm (30 Jan 2017)

There can only be one person driving change .That person has to be the Minister .We need to start asking how the Billions in taxes and the billions borrowed in our name are spent. Government Tax/ borrow they are the ones responsible  for any waste .


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## Leo (30 Jan 2017)

jjm2016 said:


> There can only be one person driving change .That person has to be the Minister .We need to start asking how the Billions in taxes and the billions borrowed in our name are spent. Government Tax/ borrow they are the ones responsible  for any waste .



Change driven by one person is rarely, if ever successful. Also, the minister does not have the authority to drive change where it's needed here.

Without the unions' backing, local administration are unable to change local practices, and the unions aren't in the business of agreeing to increased efficiency if there isn't a significant upside for them.


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## Leper (30 Jan 2017)

Delboy said:


> So in say, 20 years time, most Irish hospitals now public (James, Mater, Blanch, Sligo, CUH etc etc) will be privatised?


20 Years? You won't have to wait that long.  Privatisation will take place well before.


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## Sophrosyne (30 Jan 2017)

Leo said:


> There was a lack of engagement with PPARS due to fears some of these legacy practices would have to change.
> 
> Some departments still manage staffing rotas, holidays and time in lieu using a central book, or big chart on a wall, with staff submitting the details to the payroll system after the fact!



Unbelievable!


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## jjm (30 Jan 2017)

Leo
PPARS waa pulled because the minister and the government of the Day did not put the effort in to streamlining and reforms For it to Work.There were lots of local arrangements that needed to be changed
Example  like an allowances given to people to close gates in days gone bye passed on to  staff  Who had no gates to close. Things like this should have being sorted out and PPARS should have gone ahead .Unions are not the problem Government Will is the problem.Union members pay taxes also  lots have Retired Early rather than put up with the miss management  they see every day.


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## mathepac (30 Jan 2017)

The Minister(s) has no responsibility for running the health service on a day-to-day basis. The minister and Dept of Health are responsible for policy and Tony O'Brien and the various heads of the other HSEs are responsible for running them in line with policy. Mary Harney established the HSE, just one at the time, to absolve the politicians from any responsibility  for executing policy.


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## becky (30 Jan 2017)

I operate the PPARs everyday, it wasn't totally pulled, it was  in areas that hadn't gone live. 

Off the top of my head, the former mid west, North west, midlands, st James hospital are all fully live. The western health board were next but it was pulled after months of work done preparing for go live. 

The main issue at the time was the cost as the complexities were not fully appreciated at the time. 

It's a good system and from what we were working with it was life changing.

I can now go back 12 years and get all my sick days in a matter of minutes.


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## Delboy (30 Jan 2017)

Leper said:


> 20 Years? You won't have to wait that long.  Privatisation will take place well before.


I simply don't see that happening here. I may be wrong but privatisation of the hospitals for example in say the enxt 10 years...with 2 years more of this ineffectual Govt, then FF getting back in for a few more years. Simply won't happen.


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## Delboy (30 Jan 2017)

jjm2016 said:


> Leo
> PPARS waa pulled because the minister and the government of the Day did not put the effort in to streamlining and reforms For it to Work.There were lots of local arrangements that needed to be changed
> Example  like an allowances given to people to close gates in days gone bye passed on to  staff  Who had no gates to close. Things like this should have being sorted out and PPARS should have gone ahead .Unions are not the problem Government Will is the problem.Union members pay taxes also  lots have Retired Early rather than put up with the miss management  they see every day.


How can you say Unions are not the problem!!! Why do you think the 'gates' allowance is still in place? What do you think would happen if Mgmt tried to take it away?


----------



## mathepac (30 Jan 2017)

becky said:


> I can now go back 12 years and get all my sick days in a matter of minutes.


Great. Remember this is anonymous. What was your performance vs. corporate targets, 3.5% absences and 100% certification for all sickness. How does your performance compare with the averages in your staff group?


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## jjm (30 Jan 2017)

We were promised by the main party in Government Before the 2011 general election Once elected they Would Take control back under the Minister for Health.It was Promised bye the Newly appointed Minister in 2011 .The same party is still the main government Party in power .The have held the Minister for health position All of this time.


----------



## Leper (30 Jan 2017)

Delboy said:


> I simply don't see that happening here. I may be wrong but privatisation of the hospitals for example in say the enxt 10 years...with 2 years more of this ineffectual Govt, then FF getting back in for a few more years. Simply won't happen.



I wish you were right Delboy but ask any seasoned campaigner working in the HSE hospital system at the moment and you'll soon know that our government has no interest whatsoever in improving the service and they are pining for the day when they can sell it off.


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## Leper (30 Jan 2017)

With respect guys, we are running down a blind alley regarding PPARS.  We discussed it at length in previous threads.  Forget about Gate Allowances etc which had nothing whatsoever to do with the failure of PPARS.  The simple fact is that the project was screwed up and the government had ploughed 240M into it for nil result. They had to pull the plug. I'm not going to get into the blame game because we all have our thoughts and during the whole PPARS project lots of people went to ground within and without the HSE.

PPARS under different titles was installed in several government departments and semi state companies which worked despite allowances, amount grades etc. These are only a smokescreen for what I believe happened.


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## jjm (31 Jan 2017)

We are not going down a blind alley regrading PPARS.People through there Government Need to get value for there money and see how it is spent.
becky said
I can now go back 12 Years and get all of my sick days in a matter of minutes.She also said there are parts of the Hse who to this day do not use the watered down verson .Why.It was a tool which allowed the Government To see how sections of the health service are ran.The 2 nd cath lab for Waterford would be a good example . Management need to be showing how good there Performance and absences levels along with showing the are getting the best use out of the cath lab they already have since it was installed.


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## Sophrosyne (31 Jan 2017)

Leper,

I don’t I think anyone is trying to run down people who are doing a good job and I am not particularly advocating privatization.

As you say, many government departments and semi-state companies have embraced technology and modernized and streamlined their operations because they realized they had to in order to continue to exist.

If, for whatever reason, certain people in the HSE are clinging to an obsolete and wasteful modus operandi and obstinately resisting any moves to bring about 21st century efficiencies, including technology, then they should not be surprised if there is a decision to privatize.

They will have no one to blame but themselves.


----------



## Leper (31 Jan 2017)

jjm2016 said:


> We are not going down a blind alley regrading PPARS.People through there Government Need to get value for there money and see how it is spent.
> becky said
> I can now go back 12 Years and get all of my sick days in a matter of minutes.She also said there are parts of the Hse who to this day do not use the watered down verson .Why.It was a tool which allowed the Government To see how sections of the health service are ran.The 2 nd cath lab for Waterford would be a good example . Management need to be showing how good there Performance and absences levels along with showing the are getting the best use out of the cath lab they already have since it was installed.



I mean this thread is going down a blind alley.  In a previous extensive thread the PPARS debacle was debated extensively mainly by people who knew nothing of the cause of its failure and blatently defended those who were culpable. The whole project resulted in €240M being flushed down the toilet. €240M would build and kit out a huge new hospital from scratch.

No member of staff or management needs to go back 12 years for anybody's sick leave record.  Four years is more relevant.

Question:- Was anybody sacked or taken to account for the debacle? And I include the private advisors too.


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## Leo (31 Jan 2017)

jjm2016 said:


> ...the minister and the government of the Day did not put the effort in to streamlining and reforms For it to Work.There were lots of local arrangements that needed to be changed



Under what legislation or authority do you think a minister can interfere with working practices in such a manner?


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## jjm (31 Jan 2017)

For a start By highlighting them and requiring there removal before taxpayers money is used or wasted  .There are lots of companies and I don't think the HSE is any different where work practices needed to  changed and were changed. The people on the ground doing the work seen the need long before Management .They see it will change there life for the better .Becky post no 100 says it all .Looks like the were pushing an open door.The people on the ground are doing a good job the system is letting them down.


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## Leo (31 Jan 2017)

jjm2016 said:


> For a start By highlighting them and requiring there removal before taxpayers money is used or wasted  .There are lots of companies and I don't think the HSE is any different where work practices needed to  changed and were changed. The people on the ground doing the work seen the need long before Management .They see it will change there life for the better .Becky post no 100 says it all .Looks like the were pushing an open door.



Highlighting them? How does that change anything? Most of the waste is clear to anyone working in the health service, many attempts to date have been shot down by those within the system with vested interests in maintaining the status quo. 

The suggestion that the minister could just cut funding to force improvement in efficiency is laughable. It's been tried multiple times, failing every time and when the hospitals start running out of money and deferring procedures or curtailing services, Joe Duffy's phone lines light up and the goverment are forced to write another cheque.


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## jjm (31 Jan 2017)

I think most people see through Joe Duffy.


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## becky (31 Jan 2017)

I was highlighting 12 years as that's since we went live.

I agree 4 years is sufficient for the sick leave entitlement but going back further can be useful. I went back 5 years last year to see who got between Christmas and new year off as staff members felt they worked Christmas every year, PPAR's said otherwise.

Going back further is especially useful for superannuation who now can see what salary paid, point of scale, any allowances even the gate one (whatever that is).

I don't see where I referred to a watered down version. The west had to continue to use the old systems as the project was pulled. They had no choice.


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## jjm (31 Jan 2017)

Hi becky
You did not say watered down Version I said that)(.If it worked for most of the country why was the west not included.I would expect as it got rolled out and debugged It should have being easier to Implement in the West.
Trying to hang on to Political power by pulling strings and Parish pump Politics was the reason it was pulled not cost or Unions.There was no other reason to drop the ball .


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## Purple (1 Feb 2017)

So, let's summarise;
It's all the Ministers fault. It's those politicians, they are the problem.
Nurses and Doctors are all great. None of them are wasteful or greedy or dishonest. They are selfless people who would do it for nothing except that if they weren't well paid they couldn't attract and retain the right people. This is in no way contradictory.

The Management of hospitals are all useless, disinterested and wasteful. Unlike "Front Line Staff" they have no interest in patient care. If it wasn't for the Unions keeping an eye on things they would probably shoot babies and old people in order to save money.

The Unions are completely blameless in all of this. If only the government would do what Liam Doran says everything would be fine.

The reason the health service is such a mess is really a Machiavellian plot by the government to sell off the health service in its entirety. This is completely compatible with the concurrent accusation that the government is populist and stuffed with Parish Pump politicians, even though there is no public appetite for this to happen.

None of the people who work in the health service can suggest one thing to improve things except giving themselves a pay increase, reducing their hours and/or employing more of them. This should not surprise or perplex anyone after all, how could the people who work somewhere be able to see better ways of doing things?


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## Leper (2 Feb 2017)

. . . . just another union membership recruiting post from Purple . . . . Which of the Bearded Brotherhood are you? . . . .  Hmmmmmmmmmmmmm!


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## Purple (2 Feb 2017)

Leper said:


> . . . . just another union membership recruiting post from Purple . . . . Which of the Bearded Brotherhood are you? . . . .  Hmmmmmmmmmmmmm!


What bit did I get wrong Leper?

... and it's Brethren, get it right!


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## Leper (2 Feb 2017)

. . . apologies Purple . . . . or is it Liam?


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## jjm (2 Feb 2017)

Liam is going through a purple patch.The other is going through a purple haze.


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