Wednesday, July 1, 2015

HSE corporate plan, vision, programme, policy er, more of the same?

Analysis of ‘the HSE Corporate Plan 2015-2017’ and ‘the six step programme.’
I picked up the ‘Health Matters’ magazine, (Summer 2015 edition)
I note the following people are on the 'six step programme' where "the HSE plan is to keep the Service User at heart of all it does".
This 'Health Matters' magazine is for the professionals, we do not get access to this, other than when it’s lying around.
The panel includes you M and also MM , MMM and also PP. There is too SS
All of whom I know.
MM is the 'service user representative’ that is sweeping, for I know him as a disabled person, not representing me per se, so how does he represent the Service users?  
The fact that MM has always been at the helm in this area and who never speaks to my twin and myself, who refuses to, is she also keeping the Service User at the heart of what she does, this woman has been overseeing our care, which we describe as four years of  "HELL ON EARTH"
Make no mistake about it; it’s been hell on earth.
We have implications all across the board on transparency with the make up.
Dear M, I leave you out on this as too PP, but certainly the rest I have known to try and get help and none have been forthcoming but all have been positively obstructive and in our terms, abusive and causing damage, physical and psychological leading to decrease in health, care and increasing trauma to such a degree I fail to sleep at night and have not done so for four full years of this hell, none are well meaning by any stretch of imagination.

Pat Healy The Director of Social care states we must keep at all times the Service User at the heart of all it does.
This is supposed to be what has been happening since the Social model of care was adapted in 2005/7.
We are supposed to have a part in our own care.
The problem being, we have it in principle and then when the HSE is 'found out’ it promises, to repent and be good little men and women.
Is this six step programme new from the Social model or more of the same, meaning, paper taking ink, or what service users consider lipstick and gloss?

I supposed the biggest failing in convincing myself (for which the magazine is not aimed at) being the Director General's piece at the front, the intro.
A beautiful piece of scriptwriting, but not HSE policy because as a service user, this too is on the Patient's charter, Fundamental Rights, the Disability Act 2005 and now the Six Step programme not to mention we are instigating the new Draft plan for disability services, when we have one already in place which has never been implemented and took ten years I believe to get to that point and now we are having another consultation process for a new draft plan, which will take me up to my death possibly and still not having something stated as policy fifteen years ago never implemented - the Social Model!

You look at all this as an intelligent individual and say to yourself:  'do they really believe this stuff?
Or, 'do they think, really think we came up with the mushrooms?

So back to the beginning on the Corporate Plan 2015-17 (is this also a new plan apart from the social model 2005, the fundamental rights, the Barcelona accord, the Draft plan never put into place and the new draft plan to be under the consultancy process of all disability groups not to mention the six step programme and now the Corporate Plan 2015-2017.

We have come up with the mushrooms!

'We need first rate health services available to people where and when they need them.  This plan acknowledges the need to provide people with the best outcomes possible, as this is what they expect and deserve.  It is also what health services staff wish to provide.'   For centuries now, this has been the ethos of healthcare provision, not only in Ireland but the whole world.
This equates to giving every healthy child under six the access to free healthcare when every person over the age of 70 who ALWAYS have healthcare needs do not get this at all, and far from it!
This is actually where and when it is needed, that is services available, with of course minimum costs and tight budgets.
So the healthy get it first not the most needy, which is basically what this means or is a contraction in terms?

The next staggering quote and paragraph in this same piece from the Director General is I quote  ” A healthier Ireland with a high quality service for all” states simply what we want to achieve.  I recognize this is an ambitious vision.  There is a gap to be bridged if we are to achieve this vision. And in reality there has to be this gap as the plan is about what we want to achieve in the next three years and not where we are at today.'
There should never have been a gap, How did this gap occur, it certainly wasn't a sinkhole suddenly appearing.
It was created and caused, up to the present day and increasingly getting worse.  We know this, we see it in action.  Its happening and its unstoppable.

Ok, we had another vision at one was called 'vision for change’ how long ago was that for the mental health services?
Yes, what happened that vision, this new vision is for three years time, that last vision was I think has been ten or fifteen years still a vision, but that vision was given seven or five to be achieved, vision is still a vision, and we are still speaking of having to change thinking about mental health, sure I thought that was what 'vision for change' was about, cos I participated in the formulating of it, as of course a mental health service user!
What more, the mental health budget per capita is going down and down.
It was last year I believe, the whole budget for mental health was absorbed into the full healthcare budget and not kept for mental health at all!
This is called 'robbing peter to pay back Paul.'  Absurdity isn't in it.

I have not come up with the mushrooms to believe that in three years time (when I hope I will be alive) to see a healthcare realized and not just a vision as in 'vision for change' the first one, for the second one will be exactly the same.  This isn't visionary, it’s delusional.

To achieve this Mr. O'Brien states is 'we have to rebuild relationships, truly engage in reform and service improvement and have trust that things will get better as I believe they truly will.
How are we going to achieve this we ask Mr. O'Brien, who answers this in the next paragraph, its called  'the Mission statement' which outlines how 'we can accomplish this vision.'
Here it is:
The values of Care, compassion, trust and learning....
This isn't a new Mission Statement I would argue.
Its what is taught (learning) in every discipline in every college of higher education teaching the disciplines and has been there since the disciplines have been devised and developed, I name medicine, physiotherapy, occupational therapy, psychology, psychiatry, and far more besides.

You enter healthcare to provide care.
It’s a mission statement in itself.
So how is it now we need a value to the mission statement which is call 'healthcare provision’ its there in the name itself.

You have lost all this because of burocracy gone mad.
You have lost it because you chose to blame the patient, the client and just about everything and everyone bar yourselves, for sure you have this love for all of us at your heart, the core of your calling.

They say trust has to be earned.
To date, and only in recent years have I lost it.
But these years we were already working under the Social model and the Patient charter and the Fundamental rights, so if we have all these as principles and basically  'mission statements,' how did my trust leave me, because they construct the model according to their own ends, not to mine the client, which is what the mission is about and the mission of 'the social model,' 'the patient's charter, and 'the fundamental rights!'

Mr. O'Brien, to me is speaking to an audience not to me.
The relationship I have with the HSE couldn't be worse.

It is a violent one.
It is not benevolent and bears no relation to the ethos of what the workers in the healthcare services are supposed to be trained in, caring, please see mission statement of the six point programme ' (care, compassion, trust and learning).

We have a system intent on making the patient/client appear the instigator of dysfunction rather than the other way round!
We have the healthcare providers which maybe Mr. O'Brien is speaking about on the level of managers etc who are being now trained or should have been trained to be that builder of relationship actually breaking it down and breaking it down by breaking the clients and patients down.

This is far short of 'the six step programme 'keeping the Service user at the heart of all it does.

I wish to remind Mr. O'Brien that maybe its unwise to use a six step programme which is half the twelve step programme for recovering alcoholics, and as their twelve steps programme reminds all, that once an alcoholic always one!

"We will try to live our values every day and will continue to develop them over the course of this plan"
So what happened 'Vision for Change"  "the Social Model of Care'  'The disability Act 2005’ the Barcelona Accord, the Fundamental rights and the Patient charter?

We should also remind Mr. O'Brien, it’s a bit like confession, we promise not to sin no more!
Who was found out on that one?

Each value is defined by statements that explain how we can recognize, demonstrate and live these values, it is essential we work together, determined to try our best to live and practice our values every day.

They taught similar in the seminaries.
It takes a lot of points to get to most of the medical courses now in Ireland and it has done for decades, yet still we are having to explain in baby steps how we actually do things, such as 'keep the client at the centre of all we do.'
Its sort of basic I think when we are in the health caring professions, or have the services, "lost the run of themselves, or lost their way or missed the points and came in the back door?

It does get better I think and we see real hope towards the end of the monologue from the Director General, here it is:

The corporate plan envisages significant changes across the health services by 2018.
These changes will include:

Creating an empowered and accountable health delivery system through the establishment of the community healthcare organizations, the Hospital Groups, and the reform of the Primary care reimbursement service and the National ambulance service.
Building and designing models of care, which are patient-centred, evidence-based and clinically led the whole service.

Can we take one of these to suggest a point - Primary care?
Primary care as a concept is new, but not that new, so its relatively new and now we are talking about reforming it!
In my area we have no Adult psychology services - in the community, no social worker, for disabled people, no OT in this community care area.
And the post for psychologist has not been filled because of the embargo on recruitment.
We have no OT, I guess for the same reason and no social worker for the same reason or because there isn’t one anyway to fill it.
They have all jumped ship or asked to take voluntary redundancy, early retirement and whatever.

Reform is the operative word.
So you dismantle an organization so fast over three or four years and then speak of reforming it?

You tire of this.
It does take some longer to tire than others.
It didn’t take me long.
To dismantle me, my trust and my care has been an earth shattering traumatic life changing event which took all of three years, most of that in one area alone namely greystones.
This is testament to what happens, Irish style, to an individual, in Irish healthcare when they are sick.

CAPs used instead of names for confidentiality reasons

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