Ultimately as minister for health Mary Harney is responsible for all health care in this country. However for the past number of years she blames all wrongs on the HSE but takes credit for all the good news (as limited as it may be).

Mary Harney has been the worst thing that has ever happened to Irish healthcare followed closely by Brendan Drumm and the HSE. Reforms  have not happened, the problems have gotten worse and now we are cutting front line staff and services. This is all approved by Mary Harney and the sooner she goes the better and when she goes it should be with her head heald in shame at the mess she leaves behind

Our health service or Ministers for health have never been popular over the years, no matter what political party they represented. As a former public servant, it was always regarded as the "poison chalice" department for a Minister. I cannot understand why Mary Harney has opted for it not just once, but at least twice. You have to admire her courage. She obviously intends giving it her best shot. Fair play to her.

Mary Harney of course. She has political and financial responsibility for healthcare. I am old enough to recall all the health ministers going back to Noel Browne (pity he is not with us now) and Harney is by far the worst. It is not courage she has but arrogance. She knew nothing about healthcare when she looked for the job (and has learned very little since) and rather than learning about the job she went straight into the neo-liberal agenda. This agenda is trying to turn the Irish health system into a carbon copy of the dysfunctional United States one, with the wealthy having a top class system and the rest making do with a third world system (or worse). Cowan must take blame too. He knows she is not up to the job but he cynically leaves her in it so at the next election he can blame Harney.

Just shows how she thinks and it was not courage that made her take the job twice. There are many other names for it but not courage.

This appalling vista is plummeting ever deeper. Like the recession it has no end in sight although it is ahead by 5 years since the initial deliberate dismantling of the system since 2004. Inequalities and creeping privatisation will ensure an elite service for the elite and Crumlin will disintegrate under the pressure of market forces and Government policy. 

Mary Harney bows to the elite medical profession all the time, and ignores everyone else.

Does Mary Harney ever use the Health Services ? or is there some gold-plated service available for Ministers, TD`s and their families ?

My conscience is clear. Pity I cant say that for all the Fianna Fail / Yellow voters. We all know FF and the corruption within that party but the yellows. They should know better. They will not win a single seat in a general election.

Hey lets reduce social welfare and starve our poor & their kids. That is what is next. Hey lets get rid of childrens benefit altogether and have our kids begging on the streets. Inflation is down because mortgate interest rates have TEMPORARILY been reduced from 4.85% to 1.6%

I am a doctor so my opinion is obviously not that relevant but here goes....

The Irish health care system is run by the HSE which is a massive Stalinist bureacracy. There is no oversight on wasteful practices. When he budget hits the wall at the end of the year, cuts are made willy-nilly and people die as a result.

There are too many people wandering around the hospitals looking busy but doing very little for their money i.e porters, radiographers, lab technicians. There are too many nurses in Irish hospitals because they spend half of their time doing paperwork. One quarter of nurses are hard-working and committed and the rest vary between the " couldn't give a crap if the patient is dying, my shift ends in 10 minutes" variety to the blank stare, take no responsibilty for anything type.

Non-consultant hospital doctors are generally inadequately trained for the specialty they are working in as they are often just passing through. Almost half of the NCHDs are from far-off countries who have come to Ireland for the money and have no interest in patients or medicine. They are needed to plug the gaps in the healthcare system left by many Irish doctors who are ambitious and therefore go to the U.S. for training in their specialty. (You can train intensively and be a consultant at 28 if you go to the U.S..that is not possible in Ireland where your job is to wheelbarrow patients in and out of the wards and the clinics. Also, many NCHDs lack the knowledge or experience to make a decision so they have to confer with their senior team members which wastes time. This again goes back to inadequate training.

Why is there inadequate training? Firstly, the consultants in Ireland are not remunerated to teach so most of them don't give a crap about teaching as most of their junior team members will not be staying in the specialty. Secondly, the training grant for essential courses and exams such as Advanced Cardiac Life Support for Adults and Children is being pulled and since these courses cost hundreds of Euros, many doctors cannot afford to pay for them.

Well Badger 5079 your right it couldn't be the doctors fault, all too dedicated and hard working. Get over it  the Irish health system is a disaster because it is poorly run, staff are not motivated because any new ideas that are not generated in a managers mind are never considered - they are after all managers and they must know everything. It is top heavy and when cost cutting is needed it is front line staff and services that are gotten rid of. We have now gone back to a semi health board system with the appointment of 4 national directors on a min salary of €99,000. I ask what is Prof Drumm doing? Nobody seems to know, even him

In terms of training why dont consultants make the effort to train properly and drive excellence instead of hoping that the US will do it and send the experts back to us. It might make a lot more of our own juinor doctors stay here. Or once again is it a case of they want even more money.

As for the training grant especially in regard to ACLS every hospital in the country has resus training staff as well as a number of qualified instructors it should cost nothing. Also at least up until now doctors got training grants. I have worked in the health service for 15 years and have just finished a degree which I paid entirely myself along with any other training courses I want to do that will improve my skills and hence patient care.

My point is that those consultants who could make the biggest impact for good on the Irish healthcare system are not being trained in Ireland. If you want to get the best training, you go to the U.S. The training grant is about to be pulled from doctors and the ACLS course costs 500 Euros. Membership exams cost the same. Of course there is also the little matter that it can be extremely difficult to get time off to do such training courses since the HSE usually don't employ any doctors to cover you when you are training or sick. That crap would not happen in the U.S. where training of doctors is taken seriously.

Doctors are paid a fair wage for the work they do, why should they have to be lured by the promise of even more money in order to train their juniors? No wonder the healthcare system is so tattered if those working within refuse to even scratch themselves without the promise of financial compensation.

Buzz I agree to a certain extent but not all of us in the health sector look for additional monies every time something new or different is asked of us.

My point however in my last post was that a large majority of consultants in Irish hospitals were trained in the US so why can they not apply the same standard of training to the juinor doctors that they are responsible for here. Maybe then the would not need to go abroad to train. Am i just being over simplistic about this or is it the maybe the simple solutions are sometimes the best!!!

I do know however from many years of experience the the HSE etc does not listen to it's staff, it is always dictated down what should happen this just gets peoples backs up. Feedback is rarely invited. I have come across so many people with good ideas for service improvements but where is the forum or pathway for these people to put their ideas forward.

I could go on about this for days but as a front line HSE staff member I have just been given a bonus to get off this chair and see a patient!!!!!!!!!

The pay that consultants receive is unaffected by their dedication to teaching medical students and NCHDs at the bedside, by and large. This is largely the case for NCHDs. Consultants have a lot of work to do. Some of them are willing to spend time that they don't get compensated for in training junior staff but many don't. If they don't get any compensation for their time, then the reality is that they won't give up time that they could be using to clear waiting lists, doing operations, self-education or making money in their private clinics.

Your judgement on what is a "fair wage" for consultants could be applied to any sector of society but the implications would be communism.