I think there is aa need for Unions in the Public Sector. I just don't think the power balance is right. It's not that Unions can change things but they stymie reform and delay change. In any organisation with 120,000 employees there will be scope for rationalisation. There is massive duplication of process all over the State Sector and within the HSE in particular. The problem is that because Public Sector employees in effect can't be made redundant it is not possible for those in charge to manage their most valuable resource, their people, to give the greatest benefit to those who consume their services.
I know two nurses who left here to work in London because of the frustrations of working in our grossly inefficient health service.
I know a woman who moved back to Ireland from England having worked in their health service. She assesses houses for grant supports for special needs children, hoists, lifts, wet-rooms etc. In England she used a Tablet, taking photo's and filling in the details on-line. She then emailed it to her boss for approval and the work was done. She was audited each year and knew she would be sacked and criminal charges brought if she was fiddling the system.
Back here she takes photos on her phone, emails them to herself, prints them out and types up a form which then goes through 2 committees before the grant is approved. She said the overhead costs are more than three times as high here than in the UK and it takes up to a year longer to have the grant approved. She asked if the system could be changed and was told to shut up and do her job. That's the sort of waste that needs to be addressed but it would involve reducing numbers, laying people off.