@Loretta stiletto: Bring your own trolley is actually a great idea. Or better still bring your own fold up bed, admit yourself, and head straight down to the ward. You might also have to operate on yourself – instructions available on YouTube – and discharge yourself the next day. I can’t see and problems.

@DaisyMay: well they are freezing cold and like two pillows so I’m sure they aren’t thinking of bed bugs etc. Place is filthy anyway.

@Sean: great idea

@Picture This: We shouldn’t allow private scans. This allows rich people to jump the queue and leave people who can’t afford it to die. If everyone including the Taoiseachs mother was in the one system it would be fit for purpose.

@SC: if can pay for it. I want to be first on the queue. If I end up in ED on trolley my VHI won’t pay out…I won’t allow them to and I’m not going to be out of pocket because the hospital can provide what,I’m willing to pay for. I recently had surgery. I had it when I needed it as opposed to when they could fit me in…because I could pay for it. I work in a hospital I see the people on trolleys…I see the people who don’t need to be in hospital but in step down facilities that are not there. Primary care and respite care would take the trolleys out of hospitals . Acute hospitals are not long term care facilities. The hospitals will run fine if we can keep the people who don’t need hospital care out!

@Paul Murphy: your right there’s a lot of people mainly elderly and people with mental health problems who are in acute hospitals for months as they have nowhere else to go. There needs to be separate facilities for the elderly and mentally ill people of this country. My mother is elderly and has dementia and hasn’t eaten solid food for years but recently was given a chicken sandwich for her tea now I’d love her to eat chicken sandwiches but she is unable and would choke if given it but they gave it to her.

@Loretta stiletto: my brother in law had his gall bladder removed in south tipperary general last year — he had to WALK to the operating theater as there were no porters available because it was a bank holiday – while recovering from the operations he had to wait for over half an hour for his lunch as there was not enough cutlery to go around – he is hyperglycemic and could easily have gone into a fit — meanwhile the hospital spent over 200,000 euro on new ‘electronic doors’ for the main entrance — there was NOTHING wrong with the original doors and they had only been installed about 5 years before during alterations to the hospital — thats why our hospitals are in such a bad state – the money is being spent on ‘follies’ and ‘pipe dreams ‘by incompetent boards and managers . cut the number of clip board warriors and pen pushers and spend the money on patient care instead !

@Picture This: im waiting to have an m.r.i. scan on my knee – my gp tried to get it done at our local hospital — but they don’t do scans for medical card patients and the cost to get one done privately is almost 300 euro -that is more than a weeks disability payment for me so its way out of my affordability — the sickner is that around 8-10 years ago there was a series of marches and protests held locally to SAVE the hospital from closure -and along side those protests was a ‘fund raising ‘ effort TO BUY AN MRI SCANNER ! both campaigns were successful so where is our mri scanner ? is it the same one this private company is using and charging us for ? or did the board of directors never buy the equipment we raised the money for ? either way someone ,somewhere is pulling a con !! i have been told that i will have to go to waterford hospital for a scan now – but because waterfords ‘policy’ is not to accept gp referrals for scans etc – i have to go and see an orthopedic consultant first — and then the o,c will order a scan — there is a waiting list of up to 3 years for the scan — and a waiting list of 18 months to see an orthopedic consultant — so a total of around 4&1/2 YEARS to get a scan !!! by that time my knee could be so badly damaged it could be beyond repair !!!

@SC: “We shouldn’t allow private scans”

Why not? If I choose to pay for my own scan, that removes me from the public queue.

@Eric Davies: it’s like a comedy sketch except it’s not funny for the sick. The waste in hospitals is scandelous I agree I’d say we don’t know the half of it.

@Eric Davies: So the fellas making you wait (Radiologist or Ortho Surgeon) work both public AND private.

There’s a flat salary for the public work so they’ll get paid no matter if you’re sorted or not. So why bother? Wait long enough maybe you’ll crack & pay the same fella at the private clinic.

What a scam.

@Chin Feeyin: Private scans are fine in private hospitals and clinics, private patients should be kept out of public hospitals unless they wait like everyone else

@Seanboy: that is the case now.

@Derek Poutch:
Salaried doctors just doesn’t work. If you’re surgeon does 2 hip operations a day or 6 a day the pay is the same so why bother? Public hospital is a mess anyway.

Private clinics are way more efficient cos their pay is performance based. Why can same surgeon can bang through private cases faster than in his public job? It’s called money.

@Michael Cunningham: The one thing you’re missing is that the surgeon needs an operating theater to operate in, an anesthetist to anesthetize the patient, theater nurses to assist and hospital beds for the patient to recuperate in afterwards. In the public system, surgeons are greatly limited by 1. getting sufficient theater space/time/staff and 2. getting sufficient beds for elective patients. In private hospitals, there are none of these limitations. Same for clinic slots, hospital beds etc.

@Milk The Drones:
Well as Minister for Health he couldn’t wait to exit the department. Simon Harris seems to be totally disinterested in doing anything except the abortion agenda, doesn’t bode well for any prospect of improving the health service.

@Alanjturing: Daft you say, well If there own families had to go through this charade you would soon see the problem solved. It doesn’t affect them so it’s not so daft after all.

@Damon16: What policies have SF or the SD enacted while they were in power? Oh wait, the ones that have been in power for 100 yrs are in fact FF and FG, with a little bit of Labour thrown in. Both FF and FG destroyed the Public Health Service between them. No One Else.
And neither have any intention of fixing it.

@Damon16:
Change the system of payment. Each department is headed by a specialist. Pay that specialist for each person they treat/operate rather than the current flat salary scale.

Also stop letting docs work both public & private. Who thought that wasn’t a conflict of interest.

Turns out Ireland do not have the only healthcare system in the world. The Canadians sorted this out and it costs much LESS per person. Persisting with the current system is a madness.

@Michael Cunningham:
Oh guess who else pays per patient seen? Private hospitals.

Somehow that same doc seems to get through more patients/procedures/scans/operations in the private clinic than down in the public.
Nobody ever wonder why that is?

@Michael Cunningham: In the current system, each patient is viewed as an extra burden on the system as hospitals operate on fixed budgets and the overriding aim for HSE bureaucrats is to stay within budget. This system dis-empowers patients. Hospitals should be paid per patient seen/service rendered. Its simple cause and effect.

@shay o’brien: That’s not the narrative for the INMO. Heard a lady on the radio yesterday had to go to Limerick A&E. Two other patients in the A&E and when she was leaving still only two.

@Damon16:
So why are the MRI scanners open later in private hospitals than in the public?

They’re equally as safe but one is a lot less efficient. Interestingly the same radiologist seems to have enough time to read both sets of scans.

*enough time to read more private scans.

@Michael Cunningham: because private hospitals are paid per scan performed. The more they do, the more the hospital earns. That encourages efficiency – they hire enough staff, pay them well and prolong operating hours to boost efficiency and therefore increase hospital income. Its supply and demand. The HSE doesn’t operate according to the rules of supply and demand.

@Damon16: I had scan in the galway clinic at 1am some years back with no delay getting results. How come the private hospital can do this and not hse. Because private must keep machines working all the time to make them pay with half the staff doing the same tasks. Hse just pulls the plug at 4.30 because they won’t put on another shift of staff to work the machines

@Albert Brennerman: agreed, the waste on admin staff is huge. The creation of the hse should have left to massive economies of scale but no one lost their position. Also no one lost their position in the dept of health after the hse took over some of it’s functions. These extra staff have created jobs to justify themselves and this normally leads to increased workloads and reporting by Frontline staff.
There is a need to change work practices across the board. Unions shouldn’t fear this as we keep hearing that Frontline staff are leaving to move abroad because of better systems in other countries.
Also we need extra bed capacity, the population has grown and is aging. This does not need to be acute beds but rather step down beds.
Basically we need to get rid of alot of the staff to free up budgets to hire the staff where they are needed. We spend enough on the service and shouldn’t increase budgets until changes are made.

@Paul Murphy: He didn’t say that they didn’t need any administrative staff, just that the ratio of bureaucrats to clinical staff is ridiculously weighted in favour of office people and I can’t disagree with that.

@The next small thing: If you go back 25 – 30 years in most Irish hospitals they’d be largely half empty during the Summer months and then fill up again during the busier Winter months. But, again, it would be perfectly normal for wards to have empty beds. Not anymore. That day, as we know, has gone.
So, what’s the solution? Over the years we’ve ‘lost’ substantial amounts of hospitals beds and staff and, during the same period, our population has risen enormously by about 25%. Any one of these could cause a problem, together they combine, with other factors, to cause a disaster. The only hope is to somehow reverse them.
Unless we’re prepared to build for a lot of extra bed spaces – and staff them, then we’ll have to get used to trolleys on corridors at times of crisis.
Almost all of our hospitals are running beyond their capacity, that is at over 100%, the staff working in them are constantly trying to cope with levels of patients they’re not equipped for. They have to find additional beds, food, linen etc. all the while being criticised by a public blaming them for something that isn’t their fault.

@Fifty Shades of Sé: and he hasn’t a clue…..if you don’t have supports required in place the clinical staff will end up spending more time doing their own admin work. We saw this during the recent recess6wberetbe freeze on recruitment meant nurses were doing mundane thins like answering phones on wards. Hardly the ideal use of a clinician. Where I work we have 8 admin people in x-ray…..each deals with a different aspect…we have a waiting list for non elective scans into next year….Not because the admin haven’t process the patients to highlight the list…but because we can’t get radiologists to take up short term contracts to cover maternity leave. It s great to make great sweeping statements but until you see what it takes to make it work on a daily basis…don’t bother

@Albert Brennerman:
I think you’ll find short of the hospital CEO, the heads of each department are doctors. Lead clinician of clinical directors. Yes the non medical staff in each dept is bloated.

My point is that you can make it more efficient by changing specialists salaries to make them performance-based. Oh, absolutely stop them from working in the Private Sector at the same time. An obvious large conflict of interest.

Where is this wild and crazily efficient program being used? Down the road from Vincent’s Public in a place called St Vincent’s Private, as well as in the rest of the private hospitals!

Oh, turns out other countries have healthcare systems. Try Canada. It’s much faster and way cheaper than ours.

@Michael Cunningham: Did you say Canada? Sure it’s better than ours, Burundi’s is better than ours.
Canada’s is all paper over the cracks though. I was there this year, the local regional (won’t say which) closed radiography for two months … staffing budgets.
My buddy over there, did PM on their new HVAC system for their admin building. A two million project, originally, … his company alone, trade union controlled, has extracted five million so far in un-quibbled cheques. And there are other companies involved. Sounds a bit Irish, doesn’t it.

@Paul Murphy: The point is that there shouldn’t be so much administration in the first place…I tried to get dental work done in the CUH Dental School, I spent most of the time filling forms and queueing, it turned out to cost less than half as much to have it done by a qualified dentist in Poland, I had to fill in less forms to have the operation done there than I did to have a 5-minute consultation here, and I wasn’t complaining about that. Nobody goes to hospital asking to fill out forms.

@Fifty Shades of Sé: our litigious society has made all the firm filling a requirement. HIQA and the likes demand tracebility. Next time you go for an operation just count the amount of times you answer the same questions to different people and sign their forms. It’s a by product of the failures of the past.