I’ve been saying all along this was Mark Wahlberg’s fault. I fucking knew it… finally, vindication
There needs to be a huge cull in the HSE. I don’t give a shit what the unions say. Mary in the head office who doesn’t know how to use a computer but is “good craic” is out the door. No more passengers. If you’re not producing, you’re gone.
None of this will happen though.
The HSE is far far far too top heavy.
Debbie the dinosaur in admin should not be getting paid more than the nurses on the floor, especially not when she can’t do her fucking job, and is an active *hinderance* to the progression of our National Healthcare.
I’ve a family member who works for the HSE, she gets over 60k a year to literally sit on her hole doing nothing, while nurses are struggling to get by.
This is one of the *many* reasons Irish healthcare workers (the real ones, not Debbie) leave in droves.
“Bad actors” is obviously a euphemism for managers and unwritten union “rules” throughout the organisation.
The HSE is a lost cause
From the outside looking in they don’t have either the right team or any incentive to lead a project of this side.
The current CIO claims to have experience in transformational projects but only ever within the HSE. The tech/information etc. roles in the HSE are not even close to competing with the private sector so you are not getting anywhere near the level of talent you would want to have to start this. When you tender the project you need people working for HSE/eHealth who know what they are talking about.
There is no incentive to deliver transformation of this complexity. If you deliver it at this stage then people will say it too too long and cost too much. It’s all around easier not to start this, patch as you go and sit in front of the Oireachtas committee and make excuses.
This thread should be top of the sub today and this month. He was brought in as a proven expert who had succeeded at a senior level at a global business level. We were lucky his sense of public duty brought him to the post. Now he has told us what the problem is.
What should happen now is that he is reappointed with an extra mandate: he can fire all those who created roadblocks. Just fire them. Pay the WRC fines and get rid of the roadblocks.
I don’t even want to imagine how many excel sheets are being used in that place
>Digitisation of health service is being impeded by ‘bad actors’, former department head says
a.k.a. “the management”
Well, having read the comments, it seems the problem is women. Debbie, Karen and Mary all need to be sacked and we need to get some men in to do everything properly with all computers and then it’ll all be fine.
Unless you’ve worked in these places it’s hard to understand the mindset that a large percentage of the employees (and managers) have. I worked in a County Council a few years ago and to say some people were dinosaurs is insulting dinosaurs.
It’s a mix of pure laziness and stupidity, they get paid every week, so why do anything new?
I have an acquaintance who works in a related department to the HSE and could not recall one person being fired in the 30 years they are there.
For my mental health, I got out of the place before it killed me or I did someone in.
The HSE admin roles are graded from entry level grade 3 to senior grade 8 and then on to manager level. Middle manager levels grades 5, 6 and 7 are internal promotion only. This means that the mid level can only be filled by people with 2 years experience inside the HSE or an equivalent organisation. It is literally filled with people not equipped to do the jobs they have
Can’t they get the actors that were nominated for the Oscars? They seem pretty good.
The problem is ultimately political.
The HSE employs over 100,000 people in one form or another. Massive reforms will lead to political conflict.
At the last election, SF got 535k, FF 485k, FG 455k. 100,000 votes is insanely important.
If one party claims they’ll fire all the useless dross, you can be guaranteed one of the others will attack the plan and win the votes. It’s one of the main reasons the HSE is unreformable, alongside local opposition to rationalisation of smaller facilities.
I can offer a unique perspective on this.
I work for a company that several hospitals in the country outsource some of their IT management to. We’re trained in the use of onsite, in house tech the hospitals use for things like file backups. It is not the modern cloud backup technology my company offers but extremely old, outdated and unsupported applications that have many performance issues.
The filing approach is chaotic and I frequently face tickets attempting to retrieve lost files that we’re never backed up, I repeatedly have to remind them that backups fail due to a lack of space to store them but they never even attempt to order more storage.
Despite attempts to migrate them to a more modern system that would be more functional and cheaper to operate they simply do not want to change.
I work with the HSE daily. I’m a support vendor for one of their systems. The sheer, absolute gombeenism rampant in the HSE is staggering. An entire hospitals system wiped because one of those mary in the back office types thought her computer was a little slow, so had it replaced by IT ( We told them multiple times they needed backups, but thats ITs job and we can’t do it for them as we don’t have direct PC access thanks to the cyberattack). The reason these people don’t want to digitalise the HSE is because then their rampant lazyness, stupidity and downright thievery of public money will be laid bare.
The HSE as an organisation needs to be closed and a new one opened in it’s place. Cull all the fat from the middle and modernize the entire thing. It is happening at a glacial pace.
I worked in IT support up North for the NHS for a couple of months.
One of the things I noticed was there was a huge resistance to process change. Not just in IT, but in any other process. Of course though, if you want to keep your IT systems safe, secure and effico change happens much faster.
Rolling out a small change e.g. an extra button here or there on a form, or maybe changing the font on a print out would result in multiple complaintss and demands that everything was put back the way it was — even though the change might have been announced months previously.
The craziest one was when a decision was taken to reduce the auto screen lock time from 5 minutes to 2 minutes. This was done with security and patient privacy in mind and we were following best practice. A load of senior consultants forcesd us to change it back.
My sister spent 3 days waiting in A&E in Naas purely because of an issue in the IT system. She just needed to be transferred to tallaght.
You can bet you’re arse it’s due to bad actors. If they want to close a hospital but it’s politically costly they will just stop funding it and making appropriate investments until it is politically viable. This costs lives.
The lack of a unified digital health record system creates massive inefficiencies. I saw the Mater is going to invest a huge budget into one for their hospital network only.
Ireland’s health services, both primary and hospitals, are shockingly poor – outdated, inefficient and disorganised compared to many Asian countries (which I am more familiar with). We have been using digital health records under unique universal patient IDs and chipped cards for almost 20 years already.
I also saw that the govt (HSE?) have hired MS to run the cyber security for the health service. One of the few wise decisions out there.
Honestly Ireland would be better off with large integrated private hospital networks built from the ground up than the current shitshow.
To summ up the HSE and administration in most Irish hospitals:
Mary’s job is to carry the files in the green folder from the office on floor 1 to the office on floor 2.
Anne’s job is to carry the files in the blue folder from the office on floor 2 to the office on floor 1.
Anne can’t touch Mary’s files when she is on her way back to Floor 2 having dropped off the files on floor 1 because that’s Mary’s job and ONLY Mary can do it.
If management attempt to get Anne to the job because Mary is out the the Union shop steward screams at them for 30 minutes until they just give up on the idea.
Best of luck getting an IT system in place to actually REPLACE Mary and Anne
There is one line about bullying being a well recognised problem in the hse. Its just in there like a throwaway, never mentions it again or elaborates
Large swathes of the public sector are a glorified dole, where people actively work against any form of change for any reason. Politicians are too afraid to touch it because of the huge voting heft they have. Good people often leave or become beaten down by the system while just trying to pay their mortgages.
This is virtually common knowledge at his point. Ive heard from individuals in the HSE there was an audit years, possibly decades, ago done by an 3rd party, at huge expense, that said the HSE could realistically and easily operate with about 10% of its admin staff. The advice to cut the useless 90% was ignored, because its better to have them ruining the health service than straining the social welfare.
Can’t blame staff for being reluctant after the devastation caused by the HSE hack. It’s still recovering.
I was in a Waterford hospital there lately. All the patients’ info where I was, was just written down in a paper ledger, no computer in sight. It was like the 1950s. I’ve have had lots of dealings with hospitals over the years and the amount of time paper based records are lost or not updated is insane. An elderly family member had surgery in Cork, I rang to find out when his review would be – they tried to tell me that he never had surgery (even though I was there a the time). Luckily the consultant’s secretary had her own notes which had the important details in it. Like what the absolute fuck. If he didn’t have an advocate, he would never have made a proper recovery all because of Stone Age methods of data management.
Too many managers. Ive seen it myself first hand, half (actually probably 90%) of the managers in the Public Sector could be replaced by an excel spreadsheet.
The main duty of middle managers is to find ways to justify their jobs, hence why they refuse digitisation and streamlining workflow as it would completely eliminate the need and justification for their jobs. David Graeber wrote an entire book called ‘Bullshit Jobs’ give it a read.
Shows how so many departments and government organisations are stuck in a rut, and not willing to take expertise like this on board. Too used to doing things the same old way, which isn’t necessarily the best or most efficient way!
I have worked with some HSE admins and other some limited work with other health care systems. First off there are a lot of people who just want to help and do a good job, really there is. However to say that are risk adverse is a massive understatement, technology scares them. Also in the past solutions were delivered that were not fully thought through and mistakes were made. This increases the fear of change.
Also based on my experience a lot of doctors and nurses are really against technology, especially the older ones. And god help you if the Unions get involved. Or the porters and especially the porters union. There is a massive amount of waste but people don’t know what to cut or sometimes even the point of the work that some do. The biggest problem IMO is that there are a lot of senior people who don’t understand the benefits that technology can bring. They just see it as a cost not as something that will help them long term.
I have been on the other side as well, you have managers who are promising that this new system will make everything better and that everything will be different this time. And you just know that the work to get the system started was not thought through and when you question for those reporting to you, you get called out on it. And Guess what it makes it harder to work for those fuckers. But this was a software company in the private sector. Bad management is everywhere.
Digitalising health services is incredibly hard and expensive. There’s always mistakes, dead ends, and a ton of regret cost… And that’s even with mostly motivated talented people.
I’ve seen a similar legacy culture problem in the private sector. Their solution was to build an entirely new central organisation from scratch, complete with shiny new digital tools, with new people, and gradually transfer over responsibility and services. They planned for it to take a decade.
I still have memories of an aul’one who was so convinced that 4g/wifi was a problem that they actually rented out space in a totally different building and assigned her there along with a pc just for her and her co-worker.
Altho given her personality it’d be even odds they enthusastically latched onto the idea just to get her out of the main office.
They just need to get good actors on the job then. I’ve watched some shit plays with bad actors. When I watched the same plays again, with good actors, I found them far more enjoyable.
31 comments
I’ve been saying all along this was Mark Wahlberg’s fault. I fucking knew it… finally, vindication
There needs to be a huge cull in the HSE. I don’t give a shit what the unions say. Mary in the head office who doesn’t know how to use a computer but is “good craic” is out the door. No more passengers. If you’re not producing, you’re gone.
None of this will happen though.
The HSE is far far far too top heavy.
Debbie the dinosaur in admin should not be getting paid more than the nurses on the floor, especially not when she can’t do her fucking job, and is an active *hinderance* to the progression of our National Healthcare.
I’ve a family member who works for the HSE, she gets over 60k a year to literally sit on her hole doing nothing, while nurses are struggling to get by.
This is one of the *many* reasons Irish healthcare workers (the real ones, not Debbie) leave in droves.
“Bad actors” is obviously a euphemism for managers and unwritten union “rules” throughout the organisation.
The HSE is a lost cause
From the outside looking in they don’t have either the right team or any incentive to lead a project of this side.
The current CIO claims to have experience in transformational projects but only ever within the HSE. The tech/information etc. roles in the HSE are not even close to competing with the private sector so you are not getting anywhere near the level of talent you would want to have to start this. When you tender the project you need people working for HSE/eHealth who know what they are talking about.
There is no incentive to deliver transformation of this complexity. If you deliver it at this stage then people will say it too too long and cost too much. It’s all around easier not to start this, patch as you go and sit in front of the Oireachtas committee and make excuses.
This thread should be top of the sub today and this month. He was brought in as a proven expert who had succeeded at a senior level at a global business level. We were lucky his sense of public duty brought him to the post. Now he has told us what the problem is.
What should happen now is that he is reappointed with an extra mandate: he can fire all those who created roadblocks. Just fire them. Pay the WRC fines and get rid of the roadblocks.
I don’t even want to imagine how many excel sheets are being used in that place
>Digitisation of health service is being impeded by ‘bad actors’, former department head says
a.k.a. “the management”
Well, having read the comments, it seems the problem is women. Debbie, Karen and Mary all need to be sacked and we need to get some men in to do everything properly with all computers and then it’ll all be fine.
Unless you’ve worked in these places it’s hard to understand the mindset that a large percentage of the employees (and managers) have. I worked in a County Council a few years ago and to say some people were dinosaurs is insulting dinosaurs.
It’s a mix of pure laziness and stupidity, they get paid every week, so why do anything new?
I have an acquaintance who works in a related department to the HSE and could not recall one person being fired in the 30 years they are there.
For my mental health, I got out of the place before it killed me or I did someone in.
The HSE admin roles are graded from entry level grade 3 to senior grade 8 and then on to manager level. Middle manager levels grades 5, 6 and 7 are internal promotion only. This means that the mid level can only be filled by people with 2 years experience inside the HSE or an equivalent organisation. It is literally filled with people not equipped to do the jobs they have
Can’t they get the actors that were nominated for the Oscars? They seem pretty good.
The problem is ultimately political.
The HSE employs over 100,000 people in one form or another. Massive reforms will lead to political conflict.
At the last election, SF got 535k, FF 485k, FG 455k. 100,000 votes is insanely important.
If one party claims they’ll fire all the useless dross, you can be guaranteed one of the others will attack the plan and win the votes. It’s one of the main reasons the HSE is unreformable, alongside local opposition to rationalisation of smaller facilities.
I can offer a unique perspective on this.
I work for a company that several hospitals in the country outsource some of their IT management to. We’re trained in the use of onsite, in house tech the hospitals use for things like file backups. It is not the modern cloud backup technology my company offers but extremely old, outdated and unsupported applications that have many performance issues.
The filing approach is chaotic and I frequently face tickets attempting to retrieve lost files that we’re never backed up, I repeatedly have to remind them that backups fail due to a lack of space to store them but they never even attempt to order more storage.
Despite attempts to migrate them to a more modern system that would be more functional and cheaper to operate they simply do not want to change.
I work with the HSE daily. I’m a support vendor for one of their systems. The sheer, absolute gombeenism rampant in the HSE is staggering. An entire hospitals system wiped because one of those mary in the back office types thought her computer was a little slow, so had it replaced by IT ( We told them multiple times they needed backups, but thats ITs job and we can’t do it for them as we don’t have direct PC access thanks to the cyberattack). The reason these people don’t want to digitalise the HSE is because then their rampant lazyness, stupidity and downright thievery of public money will be laid bare.
The HSE as an organisation needs to be closed and a new one opened in it’s place. Cull all the fat from the middle and modernize the entire thing. It is happening at a glacial pace.
I worked in IT support up North for the NHS for a couple of months.
One of the things I noticed was there was a huge resistance to process change. Not just in IT, but in any other process. Of course though, if you want to keep your IT systems safe, secure and effico change happens much faster.
Rolling out a small change e.g. an extra button here or there on a form, or maybe changing the font on a print out would result in multiple complaintss and demands that everything was put back the way it was — even though the change might have been announced months previously.
The craziest one was when a decision was taken to reduce the auto screen lock time from 5 minutes to 2 minutes. This was done with security and patient privacy in mind and we were following best practice. A load of senior consultants forcesd us to change it back.
My sister spent 3 days waiting in A&E in Naas purely because of an issue in the IT system. She just needed to be transferred to tallaght.
You can bet you’re arse it’s due to bad actors. If they want to close a hospital but it’s politically costly they will just stop funding it and making appropriate investments until it is politically viable. This costs lives.
The lack of a unified digital health record system creates massive inefficiencies. I saw the Mater is going to invest a huge budget into one for their hospital network only.
Ireland’s health services, both primary and hospitals, are shockingly poor – outdated, inefficient and disorganised compared to many Asian countries (which I am more familiar with). We have been using digital health records under unique universal patient IDs and chipped cards for almost 20 years already.
I also saw that the govt (HSE?) have hired MS to run the cyber security for the health service. One of the few wise decisions out there.
Honestly Ireland would be better off with large integrated private hospital networks built from the ground up than the current shitshow.
To summ up the HSE and administration in most Irish hospitals:
Mary’s job is to carry the files in the green folder from the office on floor 1 to the office on floor 2.
Anne’s job is to carry the files in the blue folder from the office on floor 2 to the office on floor 1.
Anne can’t touch Mary’s files when she is on her way back to Floor 2 having dropped off the files on floor 1 because that’s Mary’s job and ONLY Mary can do it.
If management attempt to get Anne to the job because Mary is out the the Union shop steward screams at them for 30 minutes until they just give up on the idea.
Best of luck getting an IT system in place to actually REPLACE Mary and Anne
There is one line about bullying being a well recognised problem in the hse. Its just in there like a throwaway, never mentions it again or elaborates
Large swathes of the public sector are a glorified dole, where people actively work against any form of change for any reason. Politicians are too afraid to touch it because of the huge voting heft they have. Good people often leave or become beaten down by the system while just trying to pay their mortgages.
This is virtually common knowledge at his point. Ive heard from individuals in the HSE there was an audit years, possibly decades, ago done by an 3rd party, at huge expense, that said the HSE could realistically and easily operate with about 10% of its admin staff. The advice to cut the useless 90% was ignored, because its better to have them ruining the health service than straining the social welfare.
Can’t blame staff for being reluctant after the devastation caused by the HSE hack. It’s still recovering.
I was in a Waterford hospital there lately. All the patients’ info where I was, was just written down in a paper ledger, no computer in sight. It was like the 1950s. I’ve have had lots of dealings with hospitals over the years and the amount of time paper based records are lost or not updated is insane. An elderly family member had surgery in Cork, I rang to find out when his review would be – they tried to tell me that he never had surgery (even though I was there a the time). Luckily the consultant’s secretary had her own notes which had the important details in it. Like what the absolute fuck. If he didn’t have an advocate, he would never have made a proper recovery all because of Stone Age methods of data management.
Too many managers. Ive seen it myself first hand, half (actually probably 90%) of the managers in the Public Sector could be replaced by an excel spreadsheet.
The main duty of middle managers is to find ways to justify their jobs, hence why they refuse digitisation and streamlining workflow as it would completely eliminate the need and justification for their jobs. David Graeber wrote an entire book called ‘Bullshit Jobs’ give it a read.
Shows how so many departments and government organisations are stuck in a rut, and not willing to take expertise like this on board. Too used to doing things the same old way, which isn’t necessarily the best or most efficient way!
I have worked with some HSE admins and other some limited work with other health care systems. First off there are a lot of people who just want to help and do a good job, really there is. However to say that are risk adverse is a massive understatement, technology scares them. Also in the past solutions were delivered that were not fully thought through and mistakes were made. This increases the fear of change.
Also based on my experience a lot of doctors and nurses are really against technology, especially the older ones. And god help you if the Unions get involved. Or the porters and especially the porters union. There is a massive amount of waste but people don’t know what to cut or sometimes even the point of the work that some do. The biggest problem IMO is that there are a lot of senior people who don’t understand the benefits that technology can bring. They just see it as a cost not as something that will help them long term.
I have been on the other side as well, you have managers who are promising that this new system will make everything better and that everything will be different this time. And you just know that the work to get the system started was not thought through and when you question for those reporting to you, you get called out on it. And Guess what it makes it harder to work for those fuckers. But this was a software company in the private sector. Bad management is everywhere.
Digitalising health services is incredibly hard and expensive. There’s always mistakes, dead ends, and a ton of regret cost… And that’s even with mostly motivated talented people.
I’ve seen a similar legacy culture problem in the private sector. Their solution was to build an entirely new central organisation from scratch, complete with shiny new digital tools, with new people, and gradually transfer over responsibility and services. They planned for it to take a decade.
I still have memories of an aul’one who was so convinced that 4g/wifi was a problem that they actually rented out space in a totally different building and assigned her there along with a pc just for her and her co-worker.
Altho given her personality it’d be even odds they enthusastically latched onto the idea just to get her out of the main office.
They just need to get good actors on the job then. I’ve watched some shit plays with bad actors. When I watched the same plays again, with good actors, I found them far more enjoyable.
​
Easy peasy, lemon squeezy!