lack of communication

UHG has been rated one of the worst in the country - No surprise there. Considering it takes at least a ten hour wait in A&E to get answers.

Too many overpaid executives managers and consultants and the fact they have spent millions on advisers, well it says it all.

The HSE is a law unto itself and they answer to no one.

I suppose the answer is self-evident. The old Health Board system needed reforming but to abolish eight health boards and subsume them into one big unwieldy quango was a recipe for disaster. At that time my postings on this site stated that it was obvious to me what was going to happen. If an ordinary citizen with no inside knowledge can see what was going to happen why couldn't Mary Harney with her army of advisors, management consultants and spin doctors?

I spent the day in A&E Naas with my mother on Monday. The staff are run off their feet and nurses don't have time to nurse. We nursed my mother. She waited all day to see a surgeon before being told that he was there on Monday and he wasnt even in the building, he is there on a Tuesday. My friends were laughing at me because I brought a fold up stool to sit on. My 70 year old father had no where to sit when he was with her. The health system seems to be teethering on collapse. What will happen when Govt starts reducing budgets for the HSE?

The hospital itself isnt a bad place and neither are the staff. its the lack of money and understaffing that is causing all the problems.

It's time to give praise to all those who work in our hospitals, from reception staff to porters and those who provide the meals and the cleaning. Having the benefit of hindsite those of us who have experienced the professionalism and good natured attitude of the staff in Our Lady's Hospital, Navan who always put their patients first, I speak from practical experience. The expenses paid to management consultants are wasted. Having spent four periods in Navan Hospital over the last three years my advice to the management of the Hospital is to listen to your qualified Staff Nurses. Trust them

It was designed to be a cop out for the minister for health. Its a disaster

Health service, HSE, jobs for the boys, not my fault, no one told me. I am off duty now, so it goes. every one is to blame but me. What a bloody mess. And Tuesday may well add to it all, and still no one will be at fault.

The problem with the health service is simple. people will not do the jobs they are paid for. The consultants have beaten mary harney. The gps and the consultants decided to mess up the system at the expence of the public. they should be fired. Now that the country has not the money swift decisions should be taken. hospitals that do not perform should be closed. managers who can not manage should be fired. If they can sort out the hospitals in northern ireland then hire them down here. keep--it--simple--stupid.

emcg

The HSE has lost whatever plan may have existed at its inception. Its management has become a self serving bureaucracy, going through motions and processes, which have little or no relevance to the person needing or accessing clinical services. One hundred new primary care teams - alternatives to in-patient/A&E hospital responses - show me where they are?

As a society, we are silent as Government hands over health care to those motivated by private or for profit vested clinical and business interests. This is the reality at primary and specialist care levels. Management capacity needs to be looked at. Good managers struggle. Other ludite and weak minded people in management positions facilitate the malaise.

the old health boards should never have been changed. the HSE have no idea of how to treat anyone let alone sick people but when you have a state like ours to live in what surprises us anymore? gone are the days when Ireland cared for its people. now all we are is number after number on some stupid system. who needs a government?

The HSE was set up to insulate the minister, so as she can hide behind them. There is no point in calling bodies new names. All the staff are still there a lot of them doing nothing. When there is cut backs they get rid of nurses, no mention of getting rid of office staff.

HSE was a "necessary evil" when invented. I take the view that the Health Board system of "local tuaithe" had more than outlived its usefulness. It was necessary to centralise health service administration to allow the nation to get an overall picture of our health and morbidity status; what needs are; what resources we are putting into health and where they are going; whats working and not working and developing a capacity to benchmark all of this against international experience.I believe it is evident that HSE has yielded a lot of these good results but they seem rather abstract in the face of waiting lists; tragic mistakes and proven incompetence among institutions and practitioners in a small number of cases.

HSE is now 4 years old - in terms of services that were totally politicised and rotten with vested interests ( most of which are still very strident ) that is not a long time. Most all of the problems HSE has faced were inherited. At this point we have clearer health data and we are making some progress with developing cancer and primary care services. We continue to entertain the inherited bloated bureaucracy and it appears HSE is hamstrung to address this by the conundrum of finding financially viable ways to finance significant necessary redundancies.

Most of what will dictate the future of Irish health services is money and politics - whats new. But in the light of HSE we can now see the wood more clearly from the trees and we are faced with clear political choices and as a people we dont like that.

Some of these choices are: Single Tier or Multiple Tier Service delivery? Access to world class specialist hospital services at national and international levels or local delivery of less competent specialist services? Pay more in insurance or taxes for Scandinavian/Canadian levels of service or settle for complaining about inadequte services for many while those who can afford buy into private insurance schemes? Pay Doctors in particular grossly inflated salaries or allow them to train and work overseas where they will happily work for far less money while we import doctors of world class standing who are accustomed to working for less.

Its money and politics stupid - necessary for health!!!!!! And there are more than 2 million voting politicians in this republic. We have choices to make!

ps HSE is only an instrument of organisation. If it needs to be changed again after 5 years lets do it, but remember money and politics.

The root cause of things being run badly is called 'management' or should I say 'bad management of the HSE'

I agree with opinion of John Williams. I was a member of one of the health boards for five years and was most impressed with the way it worked. There was constant connection with the public via the politicians of the board and the presence of doctors and nurses meant that proposals had to pass their inspection.

Ideas were debated in public and if necessary a vote was taken on the spot. Lengthy minutes were taken and discussed at the start of the next meeting. Reports of the meetings were published in the local press, so the general public were well informed about what was going on with their local health sevice. Meetings were often held in the hospitals and all were visited and committee reports were also discussed at the meetings.

Now a remote HSE meets behind closed doors and minutes are brief and the general public, doctors and nurses never know how decisions are being made. At the time the health boards were being abolished everyone familiar with how the boards worked knew that replacing them with the HSE was a mistake.

John Williams is right - the real answer was not to form another quango with its endless committees that can't make decisions - reform and rationalisation of the old boards and reform of hospital management was needed and is needed more now. MH tried to sort out the selfish doctors and nurses representatives that have been bought off so often by her predacessors but they have dug in too deep and refuse to budge strangling all effort to reform. They dress up their selfish interest and greed and easily fool the general public into supporting them.

Maybe now that we are beginning to see greed and waste for what it is, in our new financial reality, some sole searching will be done and reform for the good of all can start.

The Mater public hospital blood test centre used to be unsatisfactory, with dozens of people milling around awaiting tests. Now, with the appointment system in operation, tests can be conducted in an orderly manner. Typical example of better administration.

In the same hospital the X-ray department begins processing patients earlier in the morning- a much more sensible approach to maximum utilisation of expensive equipment.