I’ve been downvoted to oblivion a few times for pointing out that people who actually work in the health service (yes, doctors, nurses, consultants and everyone else) bear considerable responsibility for how badly it is run, as their unions and representative bodies try to ensure that everything is run to THEIR benefit rather than the public’s.
>Here is some more [evidence](https://www.irishexaminer.com/news/munster/arid-41145151.html). External consultants have been hired to try to improve services at CUH, and of course the unions are telling their staff not to cooperate with them.
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>Key staff at Cork University Hospital (CUH) have been told by their union not to cooperate with or even attend meetings with PWC consultants, hired to implement a “transformation and improvement” programme at the hospital.
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>The *Irish Examiner* revealed on Monday that €608,252 was paid to PWC Consultants between October and December in escalating monthly amounts. The arrangement remains in place, running up fees which could exceed €1m.
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>Hospital CEO David Donegan has insisted PWC staff have not been “asked to or authorised to or expected to” take on line management or operational management duties.
Two obvious points arise from this:
1. Why are these ‘key staff’ not cooperating with people trying to make things better for the public?
2. Why are those working in the management of the hospital not making those changes themselves? Why do they need to get external management?
This is just one small example of the public coming last in our health service, and I’m afraid pointing the finger at people OUTSIDE the health service has not seen any real improvements in the last 20 years, has it?
22 comments
Key staff means the union will throw a wobbler if they change anything. The union doesn’t care about the public, their responsibility is the staff.
If we paid nurses more, reduced work load and hired more. It would be of huge benefit to the health service. Also opening/reopening hospitals would help waiting times. Anyone who has used they system has nothing bad to say about the front line staff.
The HSE is fundamentally unfixable.
Every single part of it from management, staffing levels, procedures, etc etc basically needs to be updated & changed.
If someone did try to fix it? The level of changes required to fix the system would just turn into a nightmare with unions, unfair dismissals, the labour court, etc etc. Not to mention that it would take several government terms to fix. And the chances of sticking to a coherent plan through that? Not a chance.
The entire current system of the HSE needs to be demolished and rebuilt from the ground up. An entirely new system, new procedures, new wages, new staffing roles, new managers, different managerial structure, etc.
Not being funny but what do you think the role of a union is? Unions run off membership fees, why would their priority be service provision rather than their members’ needs?
Unions cause a fuss when they (and therefore their members) consider working conditions to be unsatisfactory, whether you agree or disagree is your own opinion but expecting healthcare unions to prioritise service provision is like expecting a factory union to prioritise employee output, it just doesn’t work that way.
In saying that, healthcare is a lot more high stakes than a factory so unions will often say their action will improve service provision (which it likely would e.g. increasing pay therefore increasing recruitment and retention) but don’t be misguided improving service provision is not their purpose or aim (nor should it be).
It’s not run at all
I’m sure the HSE is in dire need of reform but thinking that hiring a bunch of crooks like PWC would be anything other than a hatchet job would be delusional. Just Google “PWC scandal” and spend the next few hours wading through the mountain of crooked dealings that they are mired in. If it was me I’d feel happier if they hired the Kinahans to audit me.
I don’t pay my union to sort out the health service – I pay it to try and protect me from how bad a workplace it can be.
I pay taxes and pay politicians to sort out the health service, and that’s been going really, really well for the last few decades (sarcasm just in case no one missed it).
At the patient facing front line more is constantly being asked to be done with less resources, by an exhausted workforce.
You know what this reminds me of the other day, my pharmacy closes at 6pm, some guy ducks below the shutter as its closing and triumphantly waves a prescription at me with a “phew! Just in time!” expression on his face. I finished up the last patient I’d been dealing with and told the shutter-ducker that we’re closed and to come back tomorrow.
(Now I have to explain – when the pharmacy closes we don’t just go home. The girls have to cash up, clean up and do various tasks. I have to tidy my shit up, print and process an audit, secure the safe keys and various things too. A prescription takes a few minutes to do but to do it safely you need to take a mental break before the final check and so would safely take 10 to 15 mins)
But this guys eyes popped out of his head – “what? But it’s an emergency!” I glanced at the script, it’s from two months ago, and for aspirin and a calcium supplement, I repeated we’re closed call back tomorrow. The guy is let out and thunders about how im a disgrace and why am I not trying to help people and the country’s a joke and blah blah blah.
Fuck him and fuck this entitlement attitude. Healthcare workers are humans, we have lives and families. If I leave on time, if, I see my kids for about half an hour before bed. This asshat thinks healthcare = some charity vocation thing where we’re so nice we just put our lives on hold to help some lazy prick out.
Healthcare is a job, OP, like any other sector we have secured rights, bargaining power, unions, and every right to look out for ourselves and our families.
I’m surprised that anyone would think a public body in Ireland would be in anyway run efficiently or properly. Since the foundation of the state our public sector has been an abject disaster, why would anything change now. Try not to rely on them at all, that’s all you can do really, there won’t be any reform
During my internship I had to fill in an induction pack of material. A few documents. Included in that pack was a form for a pension product that no longer exists, with the southern health board logo on its header and currency notes was the Punt. I brought it to HRs attention and they simply said that’s the pack they print every year and there’s no issue. It speaks to the complete absence of thoughtful operation.
There is so much administrative tinder in the hse it’s insane. It’s only in the last couple of years there has been some degree on consolidation of admin for doctors. Even at that most hospitals will still get you to duplicate tasks you’ve done 10 times already. There is no fixing it, we need to start with one hospital and grow a parallel efficient service to overgrow the other. A new building, new staff, new computers and not so much as a letter head from the hse to come onto the property. It may take 50 years but the hse is a dangerous rickety building site made of cardboard, rust and wet paper.
Edit – a good friend of mine works for one of the big firms, not pwc. They approached the hse a few years ago with a proposal to help fix things and were told to jog on. Make you want to vomit.
A few points here –
1) The governance of CUH was called into question a number of years ago by the Consultants at the hospital when it became clear that the equivalent hospitals in Dublin were much quicker to get funding around infrastructure etc. An external group was brought in and heavily criticised governance structures amongst other things in the organisation. The direct result of all this was a new CEO, and a plan made involving many components including PwC consultancy to get the governance structures in place. The hospital previously had a very autocratic style of management where the ex CEO had to sign off on everything, and clinical directors were left powerless. This was a toxic culture and you cannot change that overnight or without external help. Having PWC involved is absolutely the right thing to do.
2) This has blown up locally entirely due to disgusting political opportunism by Sean Sherlock, Cork East TD, who was the one who contacted the Examiner to ghost write a previous alluded to article. Ask Sean Sherlock just how many times he had contacted the current CEO to discuss issues at the hospital. Zero. Zilch. Sherlock jumped on the populist train and claimed frontline staff were upset at why PWC consultants were being employed instead of nurses. He never once considered that both could be and are being done, and he never once attempted to frame the amount of money being spent as % of the overall daily budget of the hospital. It’s less than what CUH spends every day.
3) The direct result of Sherlocks intervention is that now unions are involved in a typically cack-handed way. It has nothing to do with the reality on the ground and everything to do with playing to the right political tune. All this noise around what PWC are doing in CUH is hopefully just noise. Because if it results in political pressure for them to step away, then the only losers are the patients and staff at CUH.
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Yes, the doctors are the problem. The doctors that are required to work 24 hour shifts, the doctors who are a higher risk category in car insurance because of how often they drive home completely exhausted and sleep deprived.
There are huge issues with the HSE but it is not the doctors and nurses that are overworked and underpaid. If it was such a cushy gig why would they be emigrating in droves?
We can agree that the HSE is a mess without blaming it on the people who suffer the most because of it.
What exactly would PWC know about running a health service? Do you not think the money spent on them would be better used to actually improve services?
>people who actually work in the health service (yes, doctors, nurses, consultants and everyone else) bear considerable responsibility for how badly it is run, as their unions and representative bodies try to ensure that everything is run to THEIR benefit rather than the public’s.
I’m sorry but that’s just an hilariously uninformed take.
The latest big agreement between the HSE and the IMO was basically asking the HSE to actually comply with EU law re safe working limits for doctors. The IMOs biggest bones of contention with the Health Service are around unsafe rostering practices and doctor burnout (2 sides of the same coin). If you read that latest agreement you’ll see that safe rostering practices make up the bulk of the document.
It is to the public’s benefit that their doctor isn’t making medical decisions when they’ve just worked for 24 hours straight with no sleep. It’s to the public’s benefit that their doctor hasn’t worked 15 days in a row and is rostered for another 4 before they’ll get a day off. It’s to the publics benefit that their doctor who has spent the last 4 nights working 9pm-9am isn’t called into work at 12pm the next day.
I ask you this question: if doctors, nurses, their unions etc are bending the health service to run to *their* benefit, to the detriment of everyone else, then why do we have such a severe shortage of doctors and nurses? If the HSE is serving doctors and nurses rather than patients, why are we loosing Irish Medical personnel to the UK and Australia every day of the week?
Also…
The answer to this…
>Why are those working in the management of the hospital not making those changes themselves? Why do they need to get **external management**?
May be answered here.
>PWC consultants, hired to **implement** a “transformation and improvement” programme at the hospital
>Hospital CEO David Donegan has insisted PWC staff have not been “asked to or authorised to or expected to” take on line management or operational management duties.
Those two statements are contradictory. You can’t hire a company to implement change but also say that company isn’t going to issue instructions or directions or tell people how to do their jobs. How do you implement change without telling people what to do? You’ve even called them “external management” yourself but supposedly they havent been given the authority to manage people.
It’s one thing to bring in an outside consultant firm to do a report and then have hospital management act on recommendations and implement changes. You could even understand them keeping the firm on the ground to monitor progress. But it’s a whole other thing entirely to bring in an outside firm and make them responsible for implementing changes. That’s just outsourcing line management duties to people who’ve barely been in the door a week and who have no relationship to the people they’re (not supposed to be) managing.
Maybe if the populace took a collective look at how decrepit the system is they could go about electing politicians that are actually up to the task and have their best interests at heart. But they won’t. Because they’re ignorant.
I see lots of references to “underpaid”….
Seems odd given the new consultant contract is for 200k+ for a 37 hour work week.
And they’re rejecting it.
“Angola” — Brian Cowen
Doctors and nurses are advised not to talk to external consultants and your assumption is they must be just in it for themselves???
The nurses and doctors aren’t exactly loving the system the way it is.
Pwc hahahaha. People with 0 knowledge about healthcare, who don’t care at all about patients or the long term viability of the service. Their advice would be for some solution that squeezes a few more drops out for a few more years but does absolutely nothing to address the long term issues that need fixing.
Nurses go on strike against unworkable conditions. 90% of nurses strike but patient safety is not in jeopardy. A payrise is announced for the nurses. Strike ends.
At least every decade the same thing. Staff just want more money, not extra ataff.
1. Because PWC will recommend drastic changes to their work.
2. Because they only care about themselves.
I’m not judging them either. I’d probably do the same.