Health and Social Budget overruns - making the rest moot


#121

Yes very interesting… this paragraph is an ideological scatter gun making no sense.

I guess we must defer to common sense. If most health systems struggle, especially ours, then clearly they are unhealthy in current form i.e. very very sick.

Therefore the answer is not balancing a budget here and a budget there, but designing a new system, based on a simple vision of care and compassion through ordinary and abundant human innovation. Extrapolate that out to the whole and you get my point. The thing that everyone is trying to avoid. While it may appear the path is something that is hard, it is not impossible. What has been chosen is what seems easy but is actually impossible in reality.

You have one section unfit for anything dictating to another unfit for anything and so so forth. Divided therefore conquered and on it goes never evolving into anything other than an endless crisis. Who does that benefit?

Clearly not those it is designed to help.

Budgeted for Ignorance and then some more, we can no longer afford.


#122

irishtimes.com/life-and-styl … -1.1842348


#123

Irish health spending among highest of developed world; Consultants best paid - Michael Hennigan -> finfacts.ie/irishfinancenews … 7881.shtml


#124

Surely these data show that health spending in ireland is among the lowest in the developed world?


#125

Pardon? Are you being sarcastic?


#126

This may be true of those already in the system but for new consultants I doubt it is true.

The basic starting salary for a consultant on a B contract is just under €110,000 before pension levy. Net pay would be much lower than many countries.


#127

No I am not. The data clearly show that health spending in Ireland is among the lowest in the developed world:

“Total Irish health spending accounted for 8.9% of GDP in 2012, slightly less than the OECD average of 9.3% but Ireland’s rate as a ratio of GNP (gross national product which mainly excludes the profits of active foreign-owned affiliates in the economy) was 10.9% - - with the US at 16.9% of GDP, Netherlands 11.8%; France 11.6%; Switzerland 11.4%; Germany 11.3%; Austria 11.1%; Denmark 11% and Canada at 10.9%. The UK and Norway were at the OECD average of 9.3%. Finland’s ratio was 9.1%”.

So just to spell it out Irish health spending is proportionately lower than the US, the Netherlands, France, Switzerland, Germany, Austria, Denmark and the same as the rate in Canada. It is higher than the UK, Norway and Finland.


#128

I still don’t follow. Health spending is lower than only seven (7) very wealthy countries and in some of those Countries the spending is paid for directly by the recipient of the care e.g. US, Germany, Netherlands and I guess Switzerland too.


#129

No. fallacy.

it gets far far worse when you factor medical cards in ( I don’t think it is ).

Yes, there is absolutely fking awful management information frameworks but it has had a sea change in the last decade, look at the quarterlies coming out on the HSE website.

On the budget/spend side it is constantly getting fking worse because Reilly took control but not responsibility for execution back from the HSE which was actually not doing a bad job … This was the main reason Harney created the HSE - to avoid fuckwit politicians controlling by the next vote and to do the best possible within the budget it had.

Yet we get arsehole-topia like U6 med cards ( Oh thats a votegetter ) rather than dealing with the difficult stuff - why are Doctors still sole traders mostly instead of salaried employees like NHS - you want cost control you deal with that stuff in the long run otherwise its deckchairs on the titanic, but with an ex-head of the IMO as Minister, you can be guaranteed that every symptom will be attacked but the root problems will remain.


#130

Bingo.
The game is to see how much you can reform the system without leading to any changes.


#131

That comes out very clearly in conversations I have had with people working in healthcare. Individuals themselves don’t see it themselves though, there’s a blinkered “There Is No Other Way” approach as a default bias (and of course some are more or less victims of that).


#132

Nothing unique here. This is typical of hierarchical systems throughout the full spectrum of human activity. Parkinsons Law had it down. We have successfully adhered to and built a state, nay an almost way of life on these very principles of failure.

There are myriad solutions existing outside the system and only require the employ of imagination to navigate the oceans of potential, put getting past the straits of fear requires help and vision, something else to believe in.


#133

New estimates suggest HSE will face deficit of €450m-€500m for the year

irishtimes.com/business/new- … -1.1877337

No suprise really


#134

The Comptroller & Auditor General released this week Special Report 83. Managing Elective Day Surgery

Press Release
audgen.gov.ie/viewdoc.asp?DocID=1882

Report
audgen.gov.ie/documents/vfmrepor … urgery.pdf

Basically, this could save a tonne of money but over crowding and limited resources mean it ain’t gonna happen. I heard Liam Doran, INMO say day cases often get cancelled last minute because over crowding uses up the day case beds

Media Coverage

Irish Times
Varadkar needs to put down firm marker on hospital budgets
irishtimes.com/news/health/v … -1.1902833

Varadkar welcomes report saying surgical patients could go home on same day
irishtimes.com/news/politics … -1.1900734

Indo
Rates of day surgery still vary in our hospitals
independent.ie/irish-news/he … 21246.html

The Journal
More patients should go home on the same day as having surgery (and Leo agrees)
thejournal.ie/patients-home- … 3-Aug2014/

Dept of Health
Health Minister welcomes C&AG Report on Elective Day Surgery
health.gov.ie/blog/uncategorized … y-surgery/

Herald
Hospitals fail to hit target for day surgeries
herald.ie/news/hospitals-fai … 20920.html


#135

Latest Dept of Finance stats for Gov Depts to end Agu 2014

finance.gov.ie/sites/default … 2014_0.pdf

Social Protection
I thought they were a good bit under budget with the improved employment figures?
They are actually over budget by +13m or +0.1%

**Health **
+309m over budget or +3.5%
(this jumped from 208m in July, a massive +101m in one month alone!)

Transport, Tourism and Sport
+57m over budget or +7.4%.
Surprise. Wonder why? Any sneaky extra subvention to CIE?


#136

It time for another memo to minister, don’t cut my budget or else . . . Angola keeps swallowing more money and the private insurance gold mine is running low and it still demands more more, more . . .

Beaumont Hospital declared ‘unsafe’ by hospital CEO - -> independent.ie/irish-news/be … 69514.html

Health officials: Plans to scrap HSE ‘unworkable’ - -> irishexaminer.com/ireland/he … 85218.html

‘No more cuts’ - Budget warnings from Health and Education ministers - -> independent.ie/irish-news/po … 57549.html

HSE chief warned Reilly on cuts - -> irishhealth.com/article.html?id=23992

Health insurance figures still falling - -> irishhealth.com/article.html?id=24007

Call for health insurance companies to freeze policy prices - -> independent.ie/irish-news/ca … 69494.html

James Reilly says controversial health service reform proposals were part of agreed Government policy - -> irishtimes.com/business/jame … -1.1920963

Mount Carmel closure adds pressure - -> imn.ie/index.php?option=com_ … &Itemid=28

HSE buys Mount Carmel Hospital for reported €11 million - -> irishtimes.com/business/hse- … -1.1920742

Dad hits out at HSE incompetence after he receives 13 medical cards for his seriously ill young son - -> irishmirror.ie/news/irish-ne … ce-4176315

HSE blows €4 million a week on beds for patients who should be discharged - -> irishmirror.ie/news/irish-ne … ek-4096702

Doctor in baby death probe ‘vindicated’ after HSE report is quashed - -> independent.ie/irish-news/do … 57579.html

HSE to send out over 4m letters - -> imt.ie/news/latest-news/2014 … tters.html

HSE to advertise for consultants on higher pay rates - -> irishtimes.com/business/hse- … -1.1909534

Unpopular prescription charge is a healthy €120m HSE earner - -> independent.ie/irish-news/he … 00106.html

Union to meet HSE over hospital protest - -> irishexaminer.com/ireland/un … 82953.html

Just 25% of GP trainees plan to stay in Ireland after graduation - -> irishtimes.com/news/health/j … -1.1913591

IMO calls for new Government approach to free GP care - -> irishtimes.com/business/imo- … -1.1915603


#137

New secretary general for Health Department

irishtimes.com/news/health/j … -1.1924413


#138

Latest Dept of Finance Net Voted Expenditure to end Sep 2014

finance.gov.ie/sites/default … 2014_0.pdf

AGRICULTURE, FOOD AND THE MARINE
+103m over budget or 15.1%

HEALTH
+231m over budget or +2.6%

PUBLIC EXPENDITURE AND REFORM
+12m over budget or +2.1%

TAOISEACH’S
+3m over budget or +2.6%

TRANSPORT, TOURISM AND SPORT
+52m over budget or +7.2%

Total Net Cumulative Voted Spending
+14m over budget or +0.0%


#139

Saw benefits street on Ch4 last night and all talk was about the introduction of the benefits cap by the UK Govt.

Can you imagine some party advocating that here?


#140

231million for health only equates to 2.6% overrun.
That’s a monster of a Department and warrants extra attention as it is the Country’s biggest cost centre.