# A&E departments crammed to capacity,whats Leo going to do now?



## flowerman (5 Jan 2015)

So whats Mr Varadkar going to do to sort this holy mess out now?

I think that he took on the wrong job and Id say that James O'Reilly is well happy and he finally got out of it when he did.


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## Purple (6 Jan 2015)

Why is the Minister always expected to sort out detailed administrative inefficiencies?
There is far more money in health than should be required. The solution is not to waste as much. It seems that some Lean principles are being applied in hospitals and the HSE generally but I have no idea how widespread or deep that goes. The solution is to do thousands of small things better. If you want to improve a process the first thing you do is ask the people who carry out the processes what the problems are.
If the heads of nursing,  Admissions, patient discharge (assuming there is one), a few of the senior doctors and whatever other senior staff are required all sat in a room they could identify the choke points and probably identify the solutions.
If your were spending more than you earn in your own house the first thing you'd do is eliminate waste. Why does the same principal not apply when it's comes to the money the government takes out of your household in taxes?


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## Leper (7 Jan 2015)

Our Health Service has deliberately been run down for years.  We have probably the best paid doctors in Europe.  Our Medical Consultants are amongst the top paid people in the world.  We have a public that insists on Freedom of Information where hospital staff spend an inordinate amount of time locating, copying, replying, advising etc and for people who received hospital treatment 30 years previously.  A Medical Consultant with one secretary is a rarity. We have a change of non consultant hospital doctors every six months.  Waiting Lists are getting longer (there's money for somebody in these delays).  The waiting times in Accident & Emergency locations are dreadful and will lead to loss of lives (if it has not already done so).  We have a Garda Force who have no other option but to deliver drugged and drunk people to Accident & Emergency every night.  We have a public that believe they are entitled to walk into A&E 24/7 with a little cut in their finger (I'm using licence here!). A haggart of Government Ministers, CEO's etc have found the Health System to be their graveyard. Our nurses can make money working abroad and have much better conditions, access to courses etc.  Many nurses returning to Ireland for Christmas were openenly headhunted in our airports this Christmas. Leo is waking up to this now and will do all he can to get out of Health.

The private hospitals are advertising daily for service (but only if you have the best of medical insurance, let's call a spade a spade).  In a few years time these hospitals will be our Health System.  Everybody (pensioners included) will need heavy medical insurance and not at a low cost.  It is easy to predict that in a few short years the Health Insurance companies will be running our health system.


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## Purple (7 Jan 2015)

Leper said:


> Our Health Service has deliberately been run down for years.


 That's a big statement. What do you mean?



Leper said:


> Our Medical Consultants are amongst the top paid people in the world.


 The ones on the old contract are. The new ones are not.



Leper said:


> Our nurses can make money working abroad and have much better conditions, access to courses etc. Many nurses returning to Ireland for Christmas were openenly headhunted in our airports this Christmas.


 We have more nurses per head of population than anywhere else in Europe (twice as many as France). The problem isn't a shortage of money, it's where and how it's being spent. The nurses I know that have qualified in the last few years couldn't get jobs here and are working in England and Canada. Are you sure that were being recruited at the airport?


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## Purple (7 Jan 2015)

I see the Minister is being criticised for being on holidays. I don't understand why it's a problem.


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## Firefly (7 Jan 2015)

I wonder, is it time to consider out-sourcing A&E to the private sector where the HSE tenders out to competing hospitals, or simply just pay the 100 euro, or whatever the cost is?


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## Purple (7 Jan 2015)

Firefly said:


> I wonder, is it time to consider out-sourcing A&E to the private sector where the HSE tenders out to competing hospitals, or simply just pay the 100 euro, or whatever the cost is?


I'd like to see that done for the entire health service.


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## Leper (8 Jan 2015)

Purple said:


> I'd like to see that done for the entire health service.



This is being done on a piece by piece strategy.  Let's look at the story so far:- Fifteen years ago approx things started to go badly wrong with our Health Service. Waiting Lists increased, A&E areas began to be overcrowded, etc.  This got steadily worse (and according to HSE's CEO per yesterday's Morning Ireland Radio it will get worse again).  Currently, it is difficult to be even "seen" in Accident and Emergency areas.  Even if you have full health insurance you will suffer long delays for any kind of treatment in most of the hospital system.  Nurses are leaving for better vacancies abroad.  We could go on-and-on but for brevity let's say several government ministers and HSE CEO's have failed the public by their promises to improve things and as we have seen things have got worse and will get worse again.

The Medical Card System is being abused at a rate of knots.  Then the HSE has deserving people thrown out of the system and put through every health indignity possible.  The medical card abusers largely have gone untouched.  Add in a plethora of hospital scandals and you do not have to be an artist to draw conclusions.  Our hospital system is being prepared for privatisation and like a turkey looking forward to Christmas, we will get it sooner than we expect.

The Private Health Insurance companies are waiting in the wings to get their mitts on the hospital system.  Listen to the radio and look at the tv ads nearly every private hospital is aggressively advertising for business (but only if you've got private cover).  In the UK the hospital system is either Private or Public.  There is no play between the two.  In Ireland we have a Public hospital system infiltrated by the Private system, a recipe for monetary abuse for some.  In the UK everybody can have hospital stay, GP visits, Prescriptions for £10.00 per year.  They have a huge population and with our less population we should be able to supply the same service. Instead, ours is getting dearer and dearer for Public and Private.  Have a look of what a couple will pay in 2015 for VHI etc. Also, look at what prescriptions outlay we have before we are subsidised.  [I'm raging here, let's give Ireland back to the Brits; at least we then can afford to be sick].

We are being promised that a system like that in the Netherlands will be introduced in Ireland.  The date for this keeps being put back and back. We won't see this in the lifetime of the present government.

[I hope the above answers Purple's main question.  I do not know if we have more of the caring profession (including nurses) per capita in Ireland as I have not seen the figures].  

[Purple's other Question:- When I collected my daughter (nurse) in the airport just before Christmas a well known hospital had a stand inviting returning nurses for almost immediate interview.  My daughter had a brief chat, but she opted to return from whence she came].


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## Purple (8 Jan 2015)

Hi Leper,
We have one of the youngest populations in the developed world and yet we spend 25% above the EU average per capita on healthcare. The problem isn't money or any grand plan to ready the system for privatisation. The problem is incompetence, bad structures and a severe lack of labour mobility. The state is rubbish at running things and yet many people see the solution as getting  them to run more things.  I really don't understand why.


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## Deiseblue (8 Jan 2015)

Leper , I would tend to agree with you.

The OECD report Health at a glance : Europe 2014 shows that on health spending per capita basis we are 9th overall & on a spending per GDP basis we are 16th & bottom of all the Western European Countries with the exception of Luxembourg.


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## Purple (8 Jan 2015)

Deiseblue said:


> Leper , I would tend to agree with you.
> 
> The OECD report Health at a glance : Europe 2014 shows that on health spending per capita basis we are 9th overall & on a spending per GDP basis we are 16th & bottom of all the Western European Countries with the exception of Luxembourg.


We all know that Irelands GDP is distorted and is a bad measure of economic activity so using it as a measure in this discussion is disingenuous, to say the least. The only country in Europe with a bigger disparity between GDP and GNP is Luxembourg...


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## Firefly (8 Jan 2015)

it would be interesting to know how much it costs the HSE to treat patients in A&E. VHI Swiftcare charge 150e I think, make a profit, and see you within the hour. Given the waits in the HSE I would hope that it costs significantly less, but the skeptic in me is doubtful.


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## Deiseblue (8 Jan 2015)

It would appear that it is becoming increasingly obvious that it proving extremely difficult to recruit front line staff , hopefully the Labour Court recommendations for improved terms & conditions for junior doctors will be followed by improved terms & conditions for all front line staff.

I must admit that I was most surprised to garner from the above mentioned OECD report that we are ranked 9th overall in terms of health spending per capita in Europe  , comments elsewhere would have led me to believe that Ireland was way ahead of the pack in this regard - is there any basis for such an assertion ?


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## Deiseblue (8 Jan 2015)

I misread the graph , we are ranked 12th overall in health spending per capita in Europe after you include the non EC countries - Norway , Switzerland & Iceland .


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## Purple (8 Jan 2015)

Deiseblue said:


> It would appear that it is becoming increasingly obvious that it proving extremely difficult to recruit front line staff , hopefully the Labour Court recommendations for improved terms & conditions for junior doctors will be followed by improved terms & conditions for all front line staff.
> 
> I must admit that I was most surprised to garner from the above mentioned OECD report that we are ranked 9th overall in terms of health spending per capita in Europe  , comments elsewhere would have led me to believe that Ireland was way ahead of the pack in this regard - is there any basis for such an assertion ?


Have a look at this report; http://www.oecd.org/eco/growth/46508904.pdf .
It is also interesting that we spend such a comparatively high proportion of the total budget on wages.

Someone might like to quote this post as Deiseblue has me on his ignore list because I don't like unions.


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## Firefly (8 Jan 2015)

Purple said:


> Have a look at this report; http://www.oecd.org/eco/growth/46508904.pdf .
> It is also interesting that we spend such a comparatively high proportion of the total budget on wages.
> 
> Someone might like to quote this post as Deiseblue has me on his ignore list because I don't like unions.



Interesting.

How do you know if you're on someone's ignore list btw?


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## Purple (8 Jan 2015)

Firefly said:


> How do you know if you're on someone's ignore list btw?


They tell you.


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## ashambles (8 Jan 2015)

A&E departments are always crammed at this exact time of year. It's used by certain groups to further their own agendas but the biggest reason is due to hospitals doing a partial shut down over Christmas. 

I've been in hospital over Christmas and it was running at maybe 20% of capacity for one week and possibly longer. Clearly not maternity, emergency, etc.. but it does seem a large amount of hospital visits can wait a few weeks. We're not talking a 2 week hiccup either, to clear out the wards the hospital needs to be restricting admission earlier in December. 

Getting a hospital back up to full capacity takes time, to get a bed people often have to come in via A&E so inevitably you've a problem. 

I doubt if we can afford to design A&E to be large enough to deal with up to a months worth of patients in one week. I'd predict today that on January 5/6 of 2016 we'll be hearing the INMO telling us again we've several hundred people on trolleys. 

I don't know if this can be fixed - certainly can't be fixed if no one admits it's a problem - perhaps if hospitals ran at closer to full capacity patients would opt to wait until January anyway? 

I'd be interested to know what happens in other countries hospitals around Christmas?


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## Sophrosyne (8 Jan 2015)

Purple said:


> I'd like to see that done for the entire health service.



There was a time when I might have agreed.

However, over Christmas I spent 5 hours in A & E with a relative before he was eventually seen by a doctor.

The relative had an infected cyst which needed to be drained. We first went to the local pharmacy, which told him to go to his GP.

The GP would not touch it; neither would the doctor in the VHI Swiftcare clinic. So we had nowhere else to go except A & E, even though we tried everything to avoid it.

My relative was mortified, sitting among relatives and friends of people who had suffered strokes, heart attacks, really serious injuries, etc., and when eventually seen, apologized profusely to the doctor for presenting in A & E with such a comparatively trivial complaint. The doctor was excellent and very kind, a complete gentleman. The procedure took about 40 minutes.

In reply to our questions, the doctor said that this could have been handled by either the GP or the VHI Swiftcare clinic, but it depended on the competence and experience of the doctor. He also said that the length of the procedure might deter some GPs as they could see several patients during that period.  

Also, the triage nurse, whom we saw first, seemed to be sick and tired of patients being foisted on A & E, in particular by VHI Swiftcare clinics, with complaints they should be able to handle themselves and in addition charging patients €75 for the privilege of doing nothing other than writing a letter of referral.


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## Purple (8 Jan 2015)

Sophrosyne,

The fact that GP's in Ireland do such a limited scope of work in comparison to their counterparts in other parts of Europe (while getting paid so much more) is a major part of the problem.
The fact that GP's don't do out of hours calls any more is also a major factor. If you call a doctor at night you could get a proctologist looking down your neck or an ENT doctor looking up your This post will be deleted if not edited to remove bad language. They don't have the confidence to do their job properly and so refer people to A&E who could and should be treated at home.
As for VHI Swiftcare clinics not being up to the mark etc.; who regulates them? If an A&E consultant sees a patient that has been referred by a GP or VHI Clinic but should have been treated by the GP or VHI Clinic then where is the mechanism to sanction the GP or Clinic? Who does the Consultant complain to? How does an audit of the GP or Clinic get triggered? Effectively a private business is foisting the cost of their incompetence onto the state. Why does that stand?


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## Firefly (8 Jan 2015)

Great posts by Sophrosyne & Purple.


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## Purple (8 Jan 2015)

Firefly said:


> Interesting.
> 
> How do you know if you're on someone's ignore list btw?


To clarify, he didn't like my use of the phrase "Bearded Brethren" to describe Union leaders. I told him that I would stop using it but I forgot and used it again. That was the last straw, as it were.


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## Sophrosyne (8 Jan 2015)

Purple,

Your summary is excellent. The situation obtains because we are too passive and have put up with this rubbish system for too long. Myself included!

A Health Minister by himself or herself cannot solve this.

You know, during the 5 hours + in A & E, I was thinking that who I wasn’t going to complain to wouldn’t be worth talking about! A few weeks on and I’ve calmed down!

However, I don’t think I am going to let this go.

I can write to the Health Minister and the VHI, but would it also fall within the remit of hospital administrators to monitor A & E traffic and set up a structure to take action about unnecessary referrals?


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## Leper (8 Jan 2015)

Sophrosyne said:


> There was a time when I might have agreed.
> 
> However, over Christmas I spent 5 hours in A & E with a relative before he was eventually seen by a doctor.
> 
> ...



Probably the most relevant post on the subject on this thread.  But, it points to one major cause why A&E's  are busy.  Add in the drug abusers and alcohol abusers that are foisted on the A&E service every night taking up valuable time of professional health care people.  When the abusers sober up towards daylight most usually just walk out of the hospital and have no notion of paying anything. The hospital system is a tolerant (and even sypathetic) system, it's bursting at the seams and nobody will cry halt.


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## Purple (8 Jan 2015)

Hi Leper,
I agree with you but what's the solution? I don't believe that it is to throw more money at it.
If we need to spend more as part of a concrete solution then I'm all for it but not as things stand.

If you has a pension fund and your fund manager consistently screwed things up would you find it acceptable to contribute more and more to the fund just to stay on track with your neighbours funds or would you seek to ensure you got a better return on your investment?


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## Leper (8 Jan 2015)

Purple, There is no problem that cannot be solved.  But, to solve fully the problems of Ireland's health service it would be immediate political suicide for any political party.  And whether we like it or not political support is required to correct what has been let happen to the health service. I'm not going to throw my tuppenceworth in here because drastic problems need drastic solutions and even when viable solutions are offered there is the You-can't-touch-the-whatever brigade thereby ensuring nothing happens and the like of us offering suggestions on the forum would be branded with every taint possible and a firing squad despatched to take us out of the equation.


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## Leper (8 Jan 2015)

Purple said:


> To clarify, he didn't like my use of the phrase "Bearded Brethren" to describe Union leaders. I told him that I would stop using it but I forgot and used it again. That was the last straw, as it were.


Ah! shucks Purple, I don't think Déise Blue has anything (personally) against you.  You are entitled to your views, but you keep harping away at the unions on every post that will accept your print.  Would it not be better for you (or anybody else) to set up a thread and call it "The Case Against Trades Unions" and the argument can then be hammered out separately and squarely?

I promise although we occupy the same square but move in different circles, I won't eliminate you from my Christmas Card Mailing List.


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## Purple (8 Jan 2015)

Thanks Leper, nice to see grown ups who can stand adult debate. 

I suppose the reason I don't confine my distain for Unions to one thread is the same as other posters don't confine their distain for the government to one thread; they are part of so much of the problem.


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## Leper (9 Jan 2015)

Purple said:


> Thanks Leper, nice to see grown ups who can stand adult debate.
> 
> I suppose the reason I don't confine my distain for Unions to one thread is the same as other posters don't confine their distain for the government to one thread; they are part of so much of the problem.


I think it fair to say that we use this kind of media mainly for some fun (although some posters get a bit heated occasionally, me included).  I do not speak for Déise, but I agree with much of what he says.  Furthermore, I have a love for Waterford having lived there years ago.  

In case you think I'm going soft, I hardly agree with any of your trades union bashing, but I accept your right to vent accordingly.  Also, I know you give me some respect (and I know you're not going soft either) and when my use of the forum was curtailed by you-know-who some time ago you gave me an email of your concern. I think it was a four month curtailment and I added a further eight months self curtailment, just to keep up my leprous pride.  Lepers can be proud, you know.


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## Sue Ellen (9 Jan 2015)

Leper said:


> Lepers can be proud, you know.


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## Leo (9 Jan 2015)

Isn't it a little strange that hospitals whose A&E departments weren't overcrowded when all this hit the headlines have been eerily quiet since? Suddenly all those must visit A&E cases have gone to their doctors, or taken a paracetamol.


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## Purple (9 Jan 2015)

O


Leo said:


> Isn't it a little strange that hospitals whose A&E departments weren't overcrowded when all this hit the headlines have been eerily quiet since? Suddenly all those must visit A&E cases have gone to their doctors, or taken a paracetamol.


Agreed. The GP's might actually be doing their job properly and treating people rather than referring them to A&E.


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## Delboy (9 Jan 2015)

An email to Newstalk (I think it was) yesterday from a nurse said the NY annual surge was as much down to the Hospital shut downs for 2 weeks over xmas as anything else. All take holidays and only minimal cover is in place, all Working groups meet in mid December and then don't meet up again until mid-January. Thought it was an interesting point.


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## dereko1969 (9 Jan 2015)

It seems that the tail is wagging the dog in the health service yet again. An A&E consultant on the news the other night was *asking* the nurses to allow an extra bed be added to wards to alleviate pressure in A&E and then the Minister said the same thing the next day. Why are Nurses dictating this, why aren't management insisting on it?


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## Purple (9 Jan 2015)

dereko1969 said:


> It seems that the tail is wagging the dog in the health service yet again. An A&E consultant on the news the other night was *asking* the nurses to allow an extra bed be added to wards to alleviate pressure in A&E and then the Minister said the same thing the next day. Why are Nurses dictating this, why aren't management insisting on it?


Good question!
Does Liam Doran make the decisions? If it’s not him then who is it?
Why don’t we know the name of the person in charge of each Hospital? Why are they not on the news? Indeed, is there such a person?


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## Firefly (9 Jan 2015)

I saw on the news today that social workers are resigning at a rate of one per week. The representative questioned, can't remember his name, mentioned putting forward a proposal to introduce an exit interview process! Just bleedin ask them!!!!!


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## Deiseblue (9 Jan 2015)

dereko1969 said:


> It seems that the tail is wagging the dog in the health service yet again. An A&E consultant on the news the other night was *asking* the nurses to allow an extra bed be added to wards to alleviate pressure in A&E and then the Minister said the same thing the next day. Why are Nurses dictating this, why aren't management insisting on it?



I think you may be wrong , current union/ management agreements mean that under extreme circumstances an additional bed is permitted , however what Management are currently seeking is an unprecedented 2nd extra bed which causes huge pressures on staff - such is the pressure that staff in Beaumont are currently voting on a work to rule policy .

And yes Leo has to request the INMO for permission to install a 2nd additional bed as the mutually agreed management/union terms does not allow for a unilaterally enforced change to such terms.


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## Purple (9 Jan 2015)

Deiseblue said:


> I think you may be wrong , current union/ management agreements mean that under extreme circumstances an additional bed is permitted , however what Management are currently seeking is an unprecedented 2nd extra bed which causes huge pressures on staff - such is the pressure that staff in Beaumont are currently voting on a work to rule policy .


In other words they have to ask the nurses...


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## dereko1969 (12 Jan 2015)

Deiseblue said:


> I think you may be wrong , current union/ management agreements mean that under extreme circumstances an additional bed is permitted , however what Management are currently seeking is an unprecedented 2nd extra bed which causes huge pressures on staff - such is the pressure that staff in Beaumont are currently voting on a work to rule policy .
> 
> And yes Leo has to request the INMO for permission to install a 2nd additional bed as the mutually agreed management/union terms does not allow for a unilaterally enforced change to such terms.



So what part of what I stated is wrong? Basically the Nurses in the wards are deliberately making life more difficult than necessary for their colleagues in A&E and for the patients and families of patients sitting on trolleys. Surely as a temporary measure this should be allowed?


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## Deiseblue (12 Jan 2015)

An additional bed ( it is this bed that I thought you were referring to ) is allowed under the extreme conditions that pertain at the moment , due to the difficulties that the introduction  of an additional 2nd bed both management & unions have reached an agreement that a 2nd bed is not viable.

This remains the position of the INMO & management are constrained by the terms of the mutual agreement .


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## dereko1969 (12 Jan 2015)

Deiseblue said:


> An additional bed ( it is this bed that I thought you were referring to ) is allowed under the extreme conditions that pertain at the moment , due to the difficulties that the introduction  of an additional 2nd bed both management & unions have reached an agreement that a 2nd bed is not viable.
> 
> This remains the *position* of the INMO & management are constrained by the terms of the mutual agreement .


Positions change due to exigencies, perhaps the INMO might consider the needs of patients and their other members in A&E for a short period until the bed-blockers are removed from the system. Do you have a position on this or are you going to just parrot the INMO?


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## Purple (12 Jan 2015)

dereko1969 said:


> Positions change due to exigencies, perhaps the INMO might consider the needs of patients and their other members in A&E for a short period until the bed-blockers are removed from the system. Do you have a position on this or are you going to just parrot the INMO?


You cannot undermine your Comrades no matter how self-serving they may be. Do you not understand how vested interest groups work?
I hope you don't have a beard!


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## Deiseblue (12 Jan 2015)

Certainly I agree with the INMO position , the wards are understaffed & placing 2 additional beds in such wards is unsafe & simply moving the problem from one area to another .

It should be noted that Galway University Hospital have now joined their nursing colleagues in Beaumont in voting for a work to rule in protesting against what must be unbearable working conditions for staff & appalling conditions for some patients , in both Hospitals the vote amongst members for such action was unanimous , I presume that would include nursing staff on both wards & in A & E.

The reason I quoted from the INMO position was to clarify why hospital managers could not simply move a 2nd additional bed into a ward & to answer your question as to why nurses had to be asked in this context  , after all such managers had previously agreed that such action was not viable.


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## Purple (12 Jan 2015)

Deiseblue said:


> The reason I quoted from the INMO position was to clarify why hospital managers could not simply move a 2nd additional bed into a ward & to answer your question as to why nurses had to be asked in this context , *after all such managers had previously agreed that such action was not viable*.


It is disingenuous to suggest that a position negotiated by the Union is the limit of what's safe.
The function of the Union is to get the most money for their members for the least amount of work.
If they could force the hospital management (if such a thing exists) to employ twice as many nurses to do half as much work then they would. They have no interest whatsoever in patient safety  or conditions ; they only represent nurses and midwives.


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## Deiseblue (22 Jan 2015)

It's not going to get any easier for Leo !
Junior Minister Kathleen Lynch has stated that approx 1,000 nurses are to retire by June 2015 , the Government's main strategy at this stage is asking them to stay !
This is unlikely to cut much ice as under the Haddington Road Agreement the cut off point for keeping previous pension entitlements is June 2015.
The Head of the Hospital consultants association has also stated that despite recently improving terms & conditions for the 200 consultant vacancies such improvement is not sufficient to attract them to these jobs & with newly qualified nurses being attracted abroad by better pay & conditions Leo is really up against it.


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## Purple (23 Jan 2015)

Deiseblue said:


> It's not going to get any easier for Leo !
> Junior Minister Kathleen Lynch has stated that approx 1,000 nurses are to retire by June 2015 , the Government's main strategy at this stage is asking them to stay !
> This is unlikely to cut much ice as under the Haddington Road Agreement the cut off point for keeping previous pension entitlements is June 2015.


Is the recruitment embargo reason for the lack of nurses or is it that they have vacancies that they can’t fill?
If it’s the former then pay levels are not an issue. If it’s the latter then pay levels are an issue.
If there are more places than suitable applicants then they are underpaid. If there are more suitably qualified people seeking to be employed as nurses than there are nursing places then they are overpaid and the state is wasting money that should be used on patient care. It’s simple supply and demand economics.
The best and most equitable way of addressing pay issues is a modest cut to salary and pension payments for existing nurses so that their newer colleagues (or comrades in Union speak) can enjoy the same pay levels. Fair days pay for a fair days work and all that.



Deiseblue said:


> The Head of the Hospital consultants association has also stated that despite recently improving terms & conditions for the 200 consultant vacancies such improvement is not sufficient to attract them to these jobs & with newly qualified nurses being attracted abroad by better pay & conditions Leo is really up against it.


The same applies here.
It would also help of the quality of care, quality of training and quality of administration was also up to international standards. That in itself would attract more doctors.
I'm not saying that Irish doctors or nurses are not up to international standards (though clearly there's nothing "world class" about them). I am saying that the structures they work within are not fit for purpose.


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## Firefly (23 Jan 2015)

Purple said:


> The best and most equitable way of addressing pay issues is a modest cut to salary and pension payments for existing nurses



Have you lost your MIIINND young man?


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## Purple (23 Jan 2015)

Firefly said:


> Have you lost your MIIINND young man?


I didn't say it would happen. I said it was the fairest and most equitable thing. We all know there's no chance of it happening, just as there's no chance of having a patient centred health service.


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## Deiseblue (23 Jan 2015)

Figures obtained by Morning Ireland show that 4,000 Nurses left the HSE between 2010 & 2013 , the " yellow pack " graduate scheme has proven disastrous despite the fact that the Haddington Road Agreement went some distance towards addressing the pay imbalance between 2010 & 2011 graduates.

The HSE had embarked on a recruitment process which generated 3,700 applicants , much of these applications would appear to be simply on " a registering of interest basis " as evidenced by the fact that 
both Ms. Lynch & Mr. Varadkar are appealing for Nurses to not only postpone retirement but to return from the UK where terms & conditions are better .

The INMO point out that some graduates are being offered 3 month contracts by the HSE whilst the UK are seeking 20,000 full time positions.

There is speculation that the HSE is to proceed with a further recruitment drive but unless terms & conditions improve I fear that it must be accepted that the majority of our nurses will seek more favourable terms abroad.

Nursing Homes Ireland  ( NHI ) have stated that the nursing shortage crippling healthcare delivery in hospitals will spread to nursing homes unless major recruitment is delivered.


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## Firefly (23 Jan 2015)

Deiseblue said:


> Figures obtained by Morning Ireland show that 4,000 Nurses left the HSE between 2010 & 2013 , the " yellow pack " graduate scheme has proven disastrous despite the fact that the Haddington Road Agreement went some distance towards addressing the pay imbalance between 2010 & 2011 graduates.
> 
> The HSE had embarked on a recruitment process which generated 3,700 applicants , much of these applications would appear to be simply on " a registering of interest basis " as evidenced by the fact that
> both Ms. Lynch & Mr. Varadkar are appealing for Nurses to not only postpone retirement but to return from the UK where terms & conditions are better .
> ...


Hi Deise,

I'm supposing (as I don't know) that if nurses' salaries were increased then there would be a orderly line formed pretty quickly at the doors of the HSE by others looking for "their" increase. That seems to be the way it works, like an episode of the Late Late Show..."someone for everyone". Hence the system is pretty inflexible in meeting market demand for labour and probably explains why so many agency staff are being used. 

Firefly.


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## Deiseblue (23 Jan 2015)

Absolutely Firefly , no sooner had the Labour Court approved improvements to the terms & conditions being offered to new consultants been announced then Unions representing the lower paid in the HSE were making the not unreasonable point that their members should have come first when it came to improved terms & conditions.

Unions are sensing a change in Government attitudes & pressure will continue to be applied in order to improve terms & conditions for ALL multi sectoral members  , mind you the forthcoming election & the fact that the Government are placing such emphasis on economic recovery & social dialogue helps !


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## Firefly (23 Jan 2015)

Deiseblue said:


> Absolutely Firefly , no sooner had the Labour Court approved improvements to the terms & conditions being offered to new consultants been announced then Unions representing the lower paid in the HSE were making the not unreasonable point that their members should have come first when it came to improved terms & conditions.
> 
> Unions are sensing a change in Government attitudes & pressure will continue to be applied in order to improve terms & conditions for ALL multi sectoral members  , mind you the forthcoming election & the fact that the Government are placing such emphasis on economic recovery & social dialogue helps !



So basically, if we want to fill nursing posts we will need to increase wages across the HSE? Can you not see the bind this puts the government in given its finite resources?

Or to put in another way, where do you think the government should take resources from in order to meet these wage demands?


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## Purple (23 Jan 2015)

Deiseblue said:


> Figures obtained by Morning Ireland show that 4,000 Nurses left the HSE between 2010 & 2013


The impression given here is that 4,000 nurses got a pain in their collective backsides and quit. How many of the 4,000 retired and how many left? When someone retires they don't "leave" their job, they retire from it. If in fact some or most of the 4,000 retired then this is yet another example of Trade Union disinformation. It could be a Nevin Institute statistic!


Firefly said:


> Or to put in another way, where do you think the government should take resources from in order to meet these wage demands?


 Now who is being silly. The solution is simple, they just need to "tax the rich" so that "they" pay their "fair share". Never mind that we already "tax the rich" more than any other country on earth (at least what Unions consider the rich) or that increasing that tax burden will damage the economy even more than it is already doing.
The bottom line is that the INMO doesn't care where the money comes from. they don't care who suffers or if patients die. Their only interest is getting as much money as possible for their members. The same applies to all unions so this shouldn't be a surprise to anyone.


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## Deiseblue (23 Jan 2015)

Firefly said:


> So basically, if we want to fill nursing posts we will need to increase wages across the HSE? Can you not see the bind this puts the government in given its finite resources?
> 
> Or to put in another way, where do you think the government should take resources from in order to meet these wage demands?



Not only in the HSE but across the public sector

The Government have indicated that they will be meeting with public sector Unions in the short term to discuss the possibility of restoring pay cuts gradually together with reducing/abolishing the pension levy bearing in mind the removal of FEMPI legislation & the end of the Haddington Road Agreement .

The Government are playing the cards of economic recovery , the increasing tax returns & the decreasing unemployment figures in order to increase their standing with the electorate , this is of course a twin edged sword in that it raises expectations which is where the Unions sense opportunities , two senior Ministers calling for social dialogue will also be seen by the Unions as a positive step.

" Finite Resources " is not a phrase that is likely to feature in pre election engineering & with Mr. Dragi sweating buckets over the printing press more funds are on the way !


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## Purple (23 Jan 2015)

Deiseblue said:


> Not only in the HSE but across the public sector
> 
> The Government have indicated that they will be meeting with public sector Unions in the short term to discuss the possibility of restoring pay cuts gradually together with reducing/abolishing the pension levy bearing in mind the removal of FEMPI legislation & the end of the Haddington Road Agreement .
> 
> ...


Yep, like I said;


Purple said:


> The bottom line is that the INMO doesn't care where the money comes from. they don't care who suffers or if patients die. Their only interest is getting as much money as possible for their members. The same applies to all unions so this shouldn't be a surprise to anyone.


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## Firefly (23 Jan 2015)

Deiseblue said:


> Not only in the HSE but across the public sector
> 
> " Finite Resources " is not a phrase that is likely to feature in pre election engineering & with Mr. Dragi sweating buckets over the printing press more funds are on the way !



I think this is a misconception. QE might enable governments to borrow more, but it's surely a short term measure.

The government has 2 ways to cover its expenditure:

Taxation - we're pretty much there at this stage if the Irish Water protests are anything to go by

Borrow - we're bound by rules on this now. Without the backstop of the ECB I'd shudder to think of how high our bond rates would be. 

The other side of the equation is to reduce expenditure. There have been cuts for sure but not nearly enough.

I'll have to dig up references for this but the USC is currently bringing in 4bn a year in tax for the government. The interest on our national debt is now 3.75bn. The banking bailout is estimated to be 40bn, which is roughly 20% of our national debt.

This means that around 75% of the tax collected by the USC is going to pay the interest on the non banking bailout portion of our national debt. Sobering when one looks at one's next pay slip.

AND we're still borrowing AND youe think we should borrow more to increase wages - you couldn't make it up!


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## Leper (23 Jan 2015)

We are all jumping to conclusions of what happened to the nurses.  The bottom line is that existing nurses were taken for granted, had their wages reduced, lost some premium payments, weekly working hours were extended, some lost 2 days annual leave, increments put on hold and added to these was almost a total embargo on recruitment.

Resulting in:- Extensive drop in morale, employment of Agency Nurses @ at least 50% dearer per hour, Additional Overtime (anything up to double the hourly rate), additional sick leave, rush to retirement of many nurses especially those 60 years of age and older.  And the nursing agencies will recruit them to work (probably back in the hospital from which they retired) again for their existing wages multiplied by 1.5. Whatever way you look at this the costs of nursing soared as a result.

Then:- Before Christmas stalls from hospitals to recruit nurses returning home for Christmas were set up in our airports.  The nurses returning home on holidays from the UK read the smaller details and considered applying for a moment, then remembered in the UK they are receiving a €2000.00 Relocation Allowance, Overtime, Better Working Conditions, Free Courses (that they would have to pay for in Ireland), Better chances of promotion.  The vast majority of the nurses thought to themselves "Hey! I'm Nora the much praised nurse in Northampton, not Deborah the underachiever in Dublin."  In my mind there was no contest and all headed through Departure Gates smiling after the New Year.  And who could blame them?

Enter Leo de Min and Kathleen the Red (neither with beard) and they crawl to nurses who are pondering retirement.  Hey Troops! All is forgiven, we want you to stay on (and defer your pension, of course) and work for us.  We know you made the ultimate sacrifices, but we conned you before and we want to con you again!  Now these nurses would be on half pay on on retirement in receipt of their pensions and now (if they volunteer) will work for less than half pay considering the tax and PRSI, deductions etc.  Pensions would be put on hold and as soon as they are not needed the nurses will be discarded again. Nurses ain't stupid, you know.

. . . and the consultants will save us!


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## Deiseblue (24 Jan 2015)

Firefly said:


> I think this is a misconception. QE might enable governments to borrow more, but it's surely a short term measure.
> 
> The government has 2 ways to cover its expenditure:
> 
> ...



But that's what is going to happen.

The Government has hailed the end of austerity , the emergency no longer exists & therefore the FEMPI legislation is going to be unwound , unemployment is down , tax revenues are up & Mr. Draghi's bag men are on the way.

Such is the scenario being portrayed & we should remember that Mr. Howlin's stated intention to hold talks with the PS Unions as early as March on issues such as a gradual reversal of wage cuts & a reduction/abolition of the pension levy & his further stated belief along with Minister Noonan that a  dialogue with social partners deserves support are both initiatives driven by the Government as employers & NOT BY THE UNIONS.

It seems to me that this Government are determined to reward the responsible social & fiscal attitude shown by Unions & their members in recent difficult years by gradually & moderately reversing the pay cuts & by involving Unions in discussions into the future on wage & taxation matters , the alternative is to leave the Unions outside the tent until the general election looms & the auction politics begin.

I am pleased to see that the work to rule at Beaumont Hospital has been called off as the board have agreed to increase staffing levels with recruitment to begin immediately , it will be interesting to see at what level of the nursing scale such vacancies will will be offered at as there isn't a hope of garnering sufficient applications at the yellow pack graduate level , let's hope the other 7 hospitals threatened with a work to rule respond in the same way as the Beaumont boards and staffing problems are resolved and patients benefit.


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## Purple (24 Jan 2015)

Deiseblue said:


> But that's what is going to happen.
> 
> The Government has hailed the end of austerity , the emergency no longer exists & therefore the FEMPI legislation is going to be unwound , unemployment is down , tax revenues are up & Mr. Draghi's bag men are on the way.
> 
> ...


It's amazing to see someone taking such relish in a vested interest group bullying and blackmailing the elected representatives of the people into actions that hurt the country in general, and the sick and poor in particular, in order to feather their own nests.


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## Delboy (24 Jan 2015)

Purple said:


> It's amazing to see someone taking such relish in a vested interest group bullying and blackmailing the elected representatives of the people into actions that hurt the country in general, and the sick and poor in particular, in order to feather their own nests.


It's the party line and I can tell you from dealing with and listening to Trade Union reps over the years, they are the best at reading the diktats from Liberty Hall and repeating them ad nauseam. No point arguing or even debating with them- they've got their lines and they'll stick to them...kinda like a work to rule!!!


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## Deiseblue (25 Jan 2015)

I do think you are being a bit harsh here Delboy !

There can be no doubt that it is the Government who are initiating discourse on ameliorating the pay cuts & suggesting broad support for social dialogue on wage & taxation matters.

Pat King of ICTU has confirmed that as yet she has not received an invitation to talks on either matter.


Beaumont hospital have confirmed the INMO's stance that staffing levels need to be addressed & recruitment is to begin immediately & surely it's not too much to hope that other understaffed hospitals follow suit ?

I do understand that some people are concerned at the thought of Public Sector wage cuts being reversed & at the fact that social dialogue is being mooted but if that's the way the Government want to proceed then I'm sure the Unions will meet them half way !


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## Delboy (25 Jan 2015)

The way the Govt want to proceed or the way Labour want to proceed


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## Deiseblue (25 Jan 2015)

The social dialogue concept has been broadly supported by both Mr. Noonan & Mr. Howlin , the proposed talks mooted for March on the question of pay cut reductions & a future pathway on the expiration of the Haddington Road Agreement are obviously going to be hosted by Mr. Howlin under whose ministerial bailiwick this falls .

Given the scope & effect that such matters are going to have on the economy there can be little doubt that both Government parties have given their blessing to such proposed talks.

It should be remembered these matters are being currently solely driven by the Government -  ICTU have received no invitation to talks .


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## Leper (25 Jan 2015)

Déise, You are wasting your time and giving yourself an ulcer.  Some of the contributors on here when it comes to the Public Service just want more cuts no matter what.  Anything that will take any pressure off the private sector will do, it's nothing short of begrudgery.  Don't tell me you didn't know that the Private Sector is the panacea of all ills. The Public Sector is an easy target.  I tend to make an exception in Purple's case though; he speaks from his point of view but recognises others to have their views also.  Just remember that Ian Paisley while a Unionist and through his bigoted speeches did more recruiting for the IRA than they could ever do themselves.


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## Purple (25 Jan 2015)

If increases in pay, or pay rates in general, were the root cause of the problem, or if they would solve the problem, then I'd be all in favour of them. The thing is that we all know they are not. I find the stance of the INMO and the way they use any excuse to push for pay increases for their members to be despicable.
The fact is that if anyone in the health service deserves pay increases it's the hated clerical staff. The fact is that by EU and OECD standards our "front line" staff in health, education and policing are relatively well paid and our non front line staff is not quite so well paid.

If we had a well run, well structured and efficient health service we'd have no problem hiring all the suitable people we need. Why don't we fix it rather than having to pay people a premium to work in a rubbish service? Who knows, we might eventually end up with a health service who's primary goal is to provide a decent, efficient service to the public.
I detest Unions because they are hypocrites and they hurt the poor, the sick and the vulnerable but they are not the only vested interest group which does that.


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## Delboy (25 Jan 2015)

Leper said:


> Some of the contributors on here when it comes to the Public Service just want more cuts no matter what.  Anything that will take any pressure off the private sector will do, it's nothing short of begrudgery.



Could you possibly be referring to me?


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## Deiseblue (26 Jan 2015)

Good news & bad news .

A recruitment drive is to be undertaken at Limerick Hospital to address staffing shortages & 12 additional beds are to provided in Lourdes Hospital to address overcrowding issues - these are 2 of the hospitals where INMO members have overwhelmingly voted in favour of a work to rule .

On the debit side the Irish Times is reporting that kidney donations may have to be sent abroad as there are only 4 transplant surgeons in the renal unit in Beaumont - half the recommended staffing level , two recruitment drives have failed to recruit suitable applicants as the starting salary of € 109,000 is not attractive.

It does appear that the 30% cut in new consultants salary is going to be reversed via the Labour Court & an increasingly pragmatic Government , it cannot surely be long until the disastrous yellow pack nursing graduate scheme is replaced in order to deal with the increasing nursing staff shortages ?


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## Leper (26 Jan 2015)

Delboy said:


> Could you possibly be referring to me?


My Gawd, Del! - Don't ever go to Bingo, 'cos if somebody from the Public Service won even a line, you'd be picked up off the floor seething into Jack-the-Ripper mode.  Keep it up, you'll drive people back to trades unions.


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## Leper (26 Jan 2015)

Purple said:


> If increases in pay, or pay rates in general, were the root cause of the problem, or if they would solve the problem, then I'd be all in favour of them. The thing is that we all know they are not. I find the stance of the INMO and the way they use any excuse to push for pay increases for their members to be despicable.
> The fact is that if anyone in the health service deserves pay increases it's the hated clerical staff. The fact is that by EU and OECD standards our "front line" staff in health, education and policing are relatively well paid and our non front line staff is not quite so well paid.
> 
> If we had a well run, well structured and efficient health service we'd have no problem hiring all the suitable people we need. Why don't we fix it rather than having to pay people a premium to work in a rubbish service? Who knows, we might eventually end up with a health service who's primary goal is to provide a decent, efficient service to the public.
> I detest Unions because they are hypocrites and they hurt the poor, the sick and the vulnerable but they are not the only vested interest group which does that.



You see, Purple the Government's plan is to privatise the Health Service.  You probably noticed that private hospitals are extending their services into areas where the HSE reigned supreme (well, probably not so supremely!).  What is happening in Aer Lingus now is what will be happening to our Health Service a few short years down the road. The Health Insurance companies will be running our Health Service and wait for the cost.  It's too late to reverse the process at this stage and like the turkeys we the Irish cannot wait for Christmas.


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## Purple (26 Jan 2015)

Leper said:


> You see, Purple the Government's plan is to privatise the Health Service.  You probably noticed that private hospitals are extending their services into areas where the HSE reigned supreme (well, probably not so supremely!).


 I have no problem with a privately delivered health service, if that offers the best value and quality to the public. If a publically delivered service is the best option then I have no problem with that. I simply want the best service we can afford. Structural deficiencies within the health service require capital expenditure. If we spend the money on pay increases instead then we will not be able to address those issues.
What are your views on how the INMO represent and mis-represent every issue in the health service as an excuse to agitate for pay increases for their members?


Leper said:


> What is happening in Aer Lingus now is what will be happening to our Health Service a few short years down the road. The Health Insurance companies will be running our Health Service and wait for the cost.  It's too late to reverse the process at this stage and like the turkeys we the Irish cannot wait for Christmas.


 Aer Lingus has greatly reduced its costs and is one of the few airlines in Europe making a profit. That’s all down to competitive pressures. It’s very hard to move from an organisation which has no culture of competition or efficiency to one that does but after a while it just becomes part of the culture. It’s a bit like getting physically fit. It is interesting that the unionised civil servants in the department of transport and the unionised management in Aer Lingus would rather sell the company to a unionised British airline than a non unionised Irish one.


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## Firefly (26 Jan 2015)

Leper said:


> Some of the contributors on here when it comes to the Public Service just want more cuts no matter what.  Anything that will take any pressure off the private sector will do, it's nothing short of begrudgery.



Hi Leper,

Just in case I am included in this group, I'd just like to state that my primary concern (and always has been if you look at my posts) is that I don't want our children inheriting our generation's debt, the vast majority of which was not to bail out the banks.

Anyway, I've banged on enough about the National Debt I think, who knows, maybe Deise is right, maybe Draghi will just disappear away all our problems with that "Magic Money Tree" printing press of his!

Firefly.


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## Delboy (26 Jan 2015)

Leper said:


> My Gawd, Del! - Don't ever go to Bingo, 'cos if somebody from the Public Service won even a line, you'd be picked up off the floor seething into Jack-the-Ripper mode.  Keep it up, you'll drive people back to trades unions.


Whatever!
What if it was myself that won at the Bingo....would I be seething with self-loathing seeing as I have worked in the PS myself for many years and therefore feel well placed to comment on threads that are so related. Or were you not aware of that and are just firing a generalism to back up your own beliefs/biases?


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## Purple (26 Jan 2015)

Delboy said:


> Whatever!
> What if it was myself that won at the Bingo....would I be seething with self-loathing seeing as I have worked in the PS myself for many years and therefore feel well placed to comment on threads that are so related. Or were you not aware of that and are just firing a generalism to back up your own beliefs/biases?


That threw them!


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## Leper (26 Jan 2015)

Delboy said:


> Whatever!
> What if it was myself that won at the Bingo....would I be seething with self-loathing seeing as I have worked in the PS myself for many years and therefore feel well placed to comment on threads that are so related. Or were you not aware of that and are just firing a generalism to back up your own beliefs/biases?


Gee Delboy, thanks for opening my eyes.  I didn't realise what a liability and embarrassment we Public Service employees are to the state.  Tell you what,to make it up to you and whoever else (not Purple though as there's hope for him) I suggest that another levy should be inflicted on the Public Service to allow all those smug hard working conscience of the state private sector experts go to bingo weekly at our expense.  Also, I suggest no Public Service person should attend these bingo sessions just in case they might win something.


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## Delboy (26 Jan 2015)

Leper said:


> Gee Delboy, thanks for opening my eyes.  I didn't realise what a liability and embarrassment we Public Service employees are to the state.  Tell you what,to make it up to you and whoever else (not Purple though as there's hope for him) I suggest that another levy should be inflicted on the Public Service to allow all those smug hard working conscience of the state private sector experts go to bingo weekly at our expense.  Also, I suggest no Public Service person should attend these bingo sessions just in case they might win something.


Jeez no, we've enough levies etc in the Public Sector- don't be giving ideas to the Private sector boyo's... we must stand together Leper!!!


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## Leper (27 Jan 2015)

Delboy said:


> Jeez no, we've enough levies etc in the Public Sector- don't be giving ideas to the Private sector boyo's... we must stand together Leper!!!


Del, you have put my mind at ease.  There I was thinking Purple and myself going down the road for a pint and a chat about the economics of a wet shave over a dry shave and suddenly you want to join us.  Now, I'm really worried. Eddie Hobbs will want to join us next!


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## Delboy (27 Jan 2015)

You bring Eddie, I'll get Marc Coleman....some night ahead


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## Purple (27 Jan 2015)

The problem isn’t public sector employees. They are no more or less likely to work hard than any other employees. The problem is that they work in inefficient organisations who run inefficient processes and systems. There is little reward for hard work and little sanction for laziness or incompetence. In short the system is set up to encourage mediocrity. The fact that most people in the public service do a good job is very much to their credit and says a lot about the strength of their character as individuals.
Another problem is that because of a strongly Unionised workforce there is little mobility of labour and so shortages in one area cannot be plugged by reallocating resources from areas where there is an oversupply. An example of oversupply was shown when 2000 unnecessary staff from county councils were transferred to Irish Water at a cost of €92,000,000 a year. This is paid for by the people of Ireland through their water bills. That’s €92,000,000 that is not being spent on infrastructure (fixing leaks). Given that there are over 100,000 people employed by the HSE one can only imagine how much bigger the problem is there. The multiplicity of contracts for nurses and other employees also adds a significant administrative and general HR cost.
That leads on to another problem; bad capital infrastructure. Because of the undeniable lack of capital investment in our health services through the 60’s, 70’s and 80’s, exacerbated by the fact that the state doesn’t actually own many of the hospitals in the public health system, our physical infrastructure is grossly inefficient. Parochial concerns about keeping what are in effect village hospitals open have also stymied the ability of the HSE to modernise and move towards best practice.
So the problem isn’t lazy and/or overpaid staff. The problem is that the inefficiencies within the structures and systems mean that vast amounts of money is wasted. Therefore there is no money left for patient care or pay increases. If people want pay rises they have to show how the money can be saved within the organisation. I’d love to see real and auditable efficiency targets agreed with pay increases tied into those targets being achieved. The targets should have to be based on structural reform and measured by an independent body which has no tied to the unions or management. It is undoubtable that fewer staff will be in the system when it is finished but there is no reason why in this very small country we shouldn’t have the best healthcare system in the world. The problem is that it is dependent on the constructive engagement of the people who know best how to fix it; the people who currently work in it. Unions and politicians and other vested interest groups will, unfortunately, stop it from happening.
It is worth remembering that those who fear change know that they do not have what they have on merit.


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## Purple (27 Jan 2015)

Leper said:


> Del, you have put my mind at ease.  There I was thinking Purple and myself going down the road for a pint and a chat about the economics of a wet shave over a dry shave and suddenly you want to join us.  Now, I'm really worried. Eddie Hobbs will want to join us next!


What's this about a pint?!


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## Leper (27 Jan 2015)

Mine's a Guinness . . .


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## Purple (27 Jan 2015)

Leper said:


> Mine's a Guinness . . .


So is mine!


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## Delboy (27 Jan 2015)

Leper said:


> Mine's a Guinness . . .


I'd have put you and Deise down for Champagne drinkers


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## Purple (27 Jan 2015)

Delboy said:


> I'd have put you and Deise down for Champagne drinkers


I'm no socialist, though I do like smoked salmon 
Where does that leave me?


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## Deiseblue (28 Jan 2015)

Delboy said:


> I'd have put you and Deise down for Champagne drinkers



Mainly due to the excellent work of the IBOA champagne is well within my price range 

However my tipple of choice is a large bottle of Guinness with a paddy & red chaser .

I presume you are still a bailey's & cherryade man with the obligatory umbrella ?


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## Purple (28 Jan 2015)

Deiseblue said:


> Mainly due to the excellent work of the IBOA champagne is well within my price range


 and, for the same reason, not within the price range of many others.



Deiseblue said:


> However my tipple of choice is a large bottle of Guinness with a paddy & red chaser .


 A good "wurking class" drink. Do you drink it because you like it or so as not to be a "class traitor"?


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## Firefly (28 Jan 2015)

Deiseblue said:


> Mainly due to the excellent work of the IBOA champagne is well within my price range



I'm more of a Crémant man myself!

Firefly.


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## Purple (28 Jan 2015)

Firefly said:


> I'm more of a Crémant man myself!
> 
> Firefly.


I had to look that up.


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## Deiseblue (28 Jan 2015)

Good news , the Labour Court improved pay & career structure for consultants has been accepted by IMO members & 200 consultant posts are to be advertised.

The recruitment of nurses continues slowly , mostly in cases where the INMO have raised concerns on under staffing & have voted in favour of a time limited work to rule - encouragingly such recruitments are being generally advertised on a salary negotiable basis or on a pretty wide 35,000 to 45,000 basis ( presumably based on a time served & qualification basis )


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## Leo (28 Jan 2015)

Deiseblue said:


> On the debit side the Irish Times is reporting that kidney donations may have to be sent abroad as there are only 4 transplant surgeons in the renal unit in Beaumont - half the recommended staffing level , two recruitment drives have failed to recruit suitable applicants as the starting salary of € 109,000 is not attractive.



Did the Times mention anything about theatre availability within the viable lifespan of the organ. Or the overly political nature of having to deal with the HSE?


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## Deiseblue (28 Jan 2015)

Not in the front page article , however in Paul Cullen's analysis piece on page 4 he pointed out that the Irish Times reported last year that 2 of the 10 operating theatres in Beaumont were closed at any given time due to a lack of anaesthetists .

He went on to further suggest that the blunt edged sword taken to new consultant's pay although popular has caused huge problems which will take years to resolve with matters getting worse before getting better.

You are not Leo V I trust ?


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## Leo (29 Jan 2015)

Deiseblue said:


> You are not Leo V I trust ?



Not even close! But this thread title really grabs my attention every time I see it! 

But I know people working there, so I know a lot of what both sides of the argument are saying is spin on reality, and ignoring many of the real issues and causes thereof.


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