Do you have any research or data to back up this claim? Is it really a good idea to sack people like this? What about things like training? or coaching? or other development approaches?
How do you know the pencil marks are from four years ago?
How does she know what they said?
Would it also depend on the individual hospital(s) you go to? Not the whole Irish Health Dept. overall?
Did this take place in Ireland or England?Probably upgraded her hearing aid to tell her, then downgraded again.
Maybe she could lip read.
Do you think a privately owned and operated health system with universal health insurance would be more efficient?
I am in favour of a public health insurance system where hospitals are paid a fee based on the procedure that the carry out or the ailment that they treat. That way both private and public patients would be a source of revenue for the hospitals. At the moment only private patients are a source of revenue whereas public patients are a drain on resources.
Both the PD's and the Labour party have voiced their support of this sort of system in the past so I don't see it as an ideological issue.
I don't have any objection in principle to all hospitals being private, that's not important as long as the HSE can licence the way they are run and audit them effectively to make sure that the rules are followed. Whatever system we have is will need to be regulated by the HSE or some branch of government. That's the theory but in practice we could not pull it off so we should stick with what we have. If and when the state becomes able to regulate a public service that is delivered by the private sector then things can and should change but I think that is a long way off.
Hi Purple. All well and good so long as people recognise that when you go down the route you swiftly encounter the problems the UK system is now experiencing with the future health of the nation mortgaged to PPP's (public-private partnerships) and taxpayers' money already in the coffers of private equity. There is beginning to be a research-base showing that after a year or so the pace of improvement declines. For example contracted-out minor surgery units initially mop up overspill from the hospital system but there are logistical difficulties when the immediate geographic population has been sorted. These are huge national systems and the administration is as complex and as costly as the present - public - systems.
There are also difficulties with concepts like 'audit', 'clinical governance' and 'evidence based practice'. Who audits the auditors? These are usually government quangos. From experience I can confirm the 'evidence based practice' is a euphemism for cost-cutting and implementation of politicial decisions at local level. The UK now has a quango called (ironically!) NICE (National Institute for Clinical Excellence) which decides what treatments will be available from all possible treatments and rations them out, deciding who will receive them.
The problem is - there is no utopia. Without objective deep analysis of current systems any replacement for them will contain the same - or worse - elements.
My own experience of the Irish healthcare system is that it is patchy; some parts work very well, sometimes. There is definitely a 'two-tier' system in operation which ironically may lead to a reinstatement of the old "Union" system for the have-nots.
I'm not so sure that you can commoditise health services in this way. What happens when a particular patient needs 5-days instead of the 3-day agreed fee? Will the accountants be discharging the patients?
What happens when the patient has a mental health condition? How do you set a fee for treating depression, or schizophrenia?
No, the accountants will not be discharging the patients. That's not what happens in other countries that use a reimbursement system. I'm surprised that you didn't know that. I do not know the mechanics of how the system should work here but I support the idea that private patients are treated as a source of income for hospitals, not a drain on resources.
Why do you think there would be a three day agreed fee for a procedure? Why not a cost per day or a cost per day and a top up for medication and tests? All of which can be audited on a regular basis.
The same way you set the fee now in the private wings of our mental health hospitals. It's been done for decades.
I'm not suggesting that we go down the UK route. Why did you think that?
Auditing is carried out across many sectors and industries. The FDA in the USA probably the most famous body that sets standards and enforces them through auditing. The FDA carry out hundreds if not thousands of audits in this country every year.
The NSAI (National Standards Authority of Ireland) carries out thousands of audits every year. They are a government body that audits private and public companies very successfully in many sectors. Why do people think that it's any more difficult to establish a matrix for the health sector? The idea that an auditing body will just become a political quango does not stand up. It will have to be subject to parliamentary oversight, an all party committee for example, but it's up to our legislator to construct a system that does not allow that to happen.
I agree.
I also agree
J
Jaid79
Guest
Do you have any research or data to back up this claim? Is it really a good idea to sack people like this? What about things like training? or coaching? or other development approaches?
Private hospitals are far less tolarent of unprofessional behavour and poor attitudes and work ethics than most public hospitals, I have a number of firends that are nurses. It has been their personal experiences of the above.
How do you know the pencil marks are from four years ago?
I asked two members of staff when the new build had been completed and if any further refubishment works had been carried out.
I personaly have had on a vast number of occasions seen nurses, care aisistants, cleaners wearing their uniform in and out of hospital, this in its self is a major issue due to potental contamination of the hospital.
MRSA is increase at an alarming rate in Ireland, this is largley due to bad procdures and pactices by Irish public hospitals and lack of staff training.
Private hospitals are far less tolarent of unprofessional behavour and poor attitudes and work ethics than most public hospitals, I have a number of firends that are nurses. It has been their personal experiences of the above.
How do you know the pencil marks are from four years ago?
I asked two members of staff when the new build had been completed and if any further refubishment works had been carried out.
I personaly have had on a vast number of occasions seen nurses, care aisistants, cleaners wearing their uniform in and out of hospital, this in its self is a major issue due to potental contamination of the hospital.
MRSA is increase at an alarming rate in Ireland, this is largley due to bad procdures and pactices by Irish public hospitals and lack of staff training.
To be honest, I'd suggest that firmer, independent evidence would be required before any policy decisions could be based on this approach. The only people that I know personally who got MRSA were in private hospitals, but I wouldn't attempt to draw definite conclusions from this anecdotal experience.
Flimsy, at best.
J
Jaid79
Guest
RainyDay,
Ì wasnt suggesting a new policy nor was I suggesting my opinions where based on hard facts. They are based on my personal and friends experiences.
Irish Public hospitals are below par on most levels, MRSA and cleanliness are major issues in Ireland. I'm unaware of any other EU country (apart from the UK, possibly!) that have a problem quite as big as Ireland.
Below is a quote from the last minister for health last year.
"The Tánaiste and Minister for Health, Mary Harney, has described hygiene standards in Irish hospitals as unacceptable.
Ms Harney was speaking at a conference on hospital hygiene in Dublin today arranged by the Irish Patients' Association.
She said it was incumbent on every hospital to ensure that cleanliness is improved, particularly in relation to hand-washing, which is regarded as vital to tackling the spread of illnesses like MRSA.
Ms Harney also suggested that hospitals should consider restricting visiting hours in an effort to improve hygiene.
A recent audit found that just 9% of Irish hospitals meet basis standards of cleanliness and hygiene, with the other 91% falling short of the mark."
If the people at the top can see a problem, why cant you?
Do you really think Ireland has a good health system, if so I think your a bit
Purple has made some great points and if such things come to past, Ireland in the future may have the chance of having a health system to be proud off.Jaid
Because you suggested "where hospitals are paid a fee based on the procedure that the carry ou"
Fair enough. AFAIK the way the system works in Germany is that if this happens the hospital will loose money on that particular procedure but over a year it should balance out.
aircobra19
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My personal experience and those of people that I know, is that MRSA is very common, and people I know died from it. My opinion of the hospitals I've seen is that they are poorly cleaned, and audits are in the main paper exercises that are not carried through on the ground. The standard of caring is poor unless you happen to get the "right" person working. Everyone seems to do things to cover themselves from a legal point of view, and if patient care suffers so be it seems to be the attitude.
The Irish health service is in dysmal state in my opinion. Its badly managed and run. Thats from the Govt down to the lowest level. Huge budgets and money is wasted at every turn and yet patients are suffering from low resourcing.
So what's you suggestion on how to fix it?
aircobra19
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Bring in accountablilty. Bring in someone from another countries hospital that has a proven track record of running hospitals properly. People like Maurice Neligan make a lot of good sense too. But no ones listening. The Govt and especially the minister have proved in inept. We needed to vote them out.
Hasn't the title/role of 'matron' largely been done away with?
Older relatives who formerly worked in the health service have told me that "this was one person you did not cross" & "God help you if things weren't up to scratch" etc etc.
Sounds like the reintroduction of a role like this, together with less contracted services (e.g. catering, cleaning) would help with accountability.
And of course have people who actually know about management managing a hospital - not a 'promoted' consultant or something - with respect, what would they know about running a hospital?
I can't see this being possible in our public health system. What it requires it that there are consequences for underperformance/incompetence up to and including dismissal. It is effectively impossible to be dismissed in the public sector, and certainly not for such a ridiculous reason as incompetence!