Saturday, May 6, 2017

Complicated Ireland purposely complicated Ireland

it is such a complicated little island.
everywhere i look now i see that not a lot is 'simples' any more.

Lets take Health, ah but it would be me to chose that first as my baby subject of interest, so much so i think i will work on getting a PhD on 'quality and quantitative research on Irish health care management.'

its about management i believe and its not simple, but complicated.
who was the wise one who did the daft thing and separated the Department of Health from the HSE?

it hasn't worked, that's the first observation which is not really rocket science actually.

Management, it is NOT the fault of Simon Harris TD Minister for Health that its all going pear shaped, its a monster in the shoebox affair we have in health care Ireland.
so many things are lacking and so much is both secretive and non transparent it beggars belief.
you would be forgiven in believing the Health care service isn't about health at all in this complicated country of mine certainly its not operating as one.

in the hope of sorting the chaos, mess, dysfunction and mistrust they bought in a bevvy of new management, an extra layer lets say, to sort this mess, chaos, and our distrust of the HSE as an organization - to bring back both advancement in actual delivering health care and the nations trust in the HSE.
it did neither.
so that knocks two of the so called answers to pressing questions.
whose fault is it?  - it is NOT Simon Harris TD!
how well did new Management layer work?  - one word - malignant
Management again and on this one we take the role of the client/patient with management and the hospitals.

very heavy stuff this is and contentious for its complicated by both the Department of Health and also the HSE.
the HSE does a heck of a lot of policies and guidelines and structures, and visions and graphs, and projections and so forth adnauseum 
in most if not all, it claims WE COUNT YOU IN!  as part of the deal the patients, clients are part thereof the structure, dynamic, projections, guidelines et al - we are there in partnership (that's a great one so it is), we are there to be heard (nope) and we are there to be helped (nope) but also the HSE is there to be empathic (nope), be a listening ear (no) to listen to the needs you have (no) and to put in place a person centred care plan and package that is individualized to the disease burden (start laughing, i have).

From the ordinary man in the street, even the road sweeper to the top of the pint, the cream, we will name Prof. O. Hardiman who is shrewd, knows what she is talking about and says it as it is, but all know, the sweeper will say the same as Prof. Hardiman, but won't be heard, won't be believed but he will 'understand as equally well, the dynamic, the chaos, the melee and the dysfunction of delivery of health care in Ireland - no brainer that one.

why are we cynical and dejected and let down and lacking a health care system at all.

Make no mistake we have no health care system, there is no system in operation, i mean SYSTEM.
a System i guess is how you deliver, right, there is none.
from hospital trolleys, to overcrowding, religious debacles, religious divide and public/private divide, cuts, austerity, savage cuts and then billions added and subtracted, moved from one area of health to file a gap in another and a drain of resources as in personnel as they go elsewhere to take up better paid employment and better working conditions.
so there isn't a system.
management too jumps as equally precariously as the money pot, or honey pot.  A manager may be in charge of mental health one week and fill a gap in Disability manager the next, and we have 'acting head of...' and then that person disappears for another to take her/his place and the jack in the box pops a spring just about every hour of the day.

no wonder no one knows who is running the show.

try making a phone call to a department within either the Department of Health or the HSE.

the main issue is you can have a clear picture of who you think can answer a question you have, that is 'the protection of vulnerable adults and children' is overseen by the director of the National director of the protection of vulnerable adults and children' but no, that department deals with policies and planning not the individuals.

the individuals are dealt with at source, base line, very base line, the local areas.
these are not skilled people who are also plucked from somewhere to fill this gap.

you can have a guy in charge of this in your area and decide without ever seeing a vulnerable adult that a case, by degree is harmless when in fact many who understand psychology will know, no case involving the abuse of vulnerable adults or children can be quantified by degree of harmless or harmed.

the management structures lack stability, style and insight into real people's lives, they barely meet them and get whopping big briefs to deal with cluster groups of sickness when they may never be trained or understand how to begin to approach it all.
a manager coming from mental health can clearly say when suddenly co-opted into management of disability 'when you get the wheelchair, will that be it?'  a bit of a strange question to a person with a progressive neurodegenerative disorder.

the understanding of health and safety for disabled people too also goes sort of pear shaped with a mental health practitioner manager who decides to leave the above woman without a bath chair aid to get into a bath for two years, no insight that with muscle wasting, leaving such a lack or gap means the person can or could or may crack their head open if they lose footing or grab of the grab rails.

there seems no insight, and that is massive problem within health care services.

if you do not understand cause and effect you will fail hopelessly to manage well.

Managing money.  this is a huge issue.
we have all and sundry claim the biggest wastage in the funds is that funds are wasted within the HSE.
we have this from the driver of the vans delivering the same bed a second time to the same person when the bed was supposed to have been a very different bed, from the repair man who comes for the umpteenth time to mend a wheelchair on its last legs by adding maybe a bolt, screw, or duct tape, yes i have seen this used copiously.

many at the coal face will name 'wastage' as being the biggest issues for failure to deliver proper care and appropriate care to the people.
if you waste it, its gone, nothing has been used for the main purpose intended.

I asked a question the other day about money and the HSE.
we all know that its a bit of a mantra these days to hear there isn't any around, none, as in Nada but then how many groups, organizations, individuals and managers have been told 'there ain't no money'  so if all of the disadvantaged, the sick, the disabled, the elderly, vulnerable and the td's are told there isn't any money in the HSE to deliver what they are mandated to do, where is the money going?
because i have never heard anyone saying their needs are being met.
they very much are being under met and many are on their knees, begging, to the point of sit downs outside dail eireann and far more.
others say it goes in the wages.  we have a top heavy managerial structure with too many captains, whose underlings, do not even know what the answer to a question could be, they get floored when asked a question if you ring the appropriate department to have a young person hesitate badly as so much is changing before her eyes too she doesn't know where to go with the question.

of course we could blog this out in a slog slog and slogging fashion, but to all intend and purpose, we haven't a health care system.

How is it that if you have private health insurance you can get a CT scan immediately for a suspected stroke, that is a bleed in the head F's, and if you are public you are put in a room on a ward and told 'the CT scanners are not manned over the weekend (Friday you arrive), so sweat it out mate, and lets hope you haven't had a stroke, it will be manned on Monday, i kid you not!
OK so.  its that bad and that's the divide, so the scanners ARE there, they ARE being used, they ARE operational for those paying, but not for those depending on the state.
this is so wrong.
the scanner in the hospital i attended, was closed for the weekend.
for all i know it may well have been opened for private patients, i am not to know.
but sure as eggs the anxiety in a side room with a possible stroke event is worrying.
the scanners are within walking distance and you are panicking as a sick person with a suspected stroke and no consolation can be had from the statement 'ah sure you probably didn't have a stroke.'
no one should have to wait three days to find out, when if you have money it could be three hours or three minutes and problem solved or crisis begins!

i do not see how we equate living and dying with the amount you have in your pocket, society will always have the poor and life needs all types of people in it to function as a society.
not everyone can be a doctor, or lawyer and pay insurance, you also need builders, brickies, and writers, artists and road sweepers.
all work is viable and needed, therefore i contend that health care should be provided for all, all contribute to society in some shape or form, and they should be looked after.
well my fingers ache as they clap along the keyboard, so i am ending this.
i pretty much just stated the obvious, but maybe some countries don't know the obvious.
bloody nice scenery but don't end in an Irish a'e.
i have to add - especially if you are a woman and poor.

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