Showing posts with label HSE. Show all posts
Showing posts with label HSE. Show all posts

Monday, November 30, 2020

A Covid-19 Christmas

 


There are two schools of thought in dealing with a pandemic. There is the medical, which favours shutting everything down, never leaving the house, and boiling your extremities daily. And there is the economic, the laissez-faire capitalism approach where people die or do not, and the state has no part to play other than ensuring that the process of buying and selling continues uninterrupted.

The government have done some in-and-out running with regard to which school they’re following in their pandemic strategy. In April or May, at the end of first, full-duck lockdown, Taoiseach Varadkar believed nothing could be so terrible as to open up and then have to close again. When Doctor Holohan returned to NPHET and advised that the lockdown needed to be tightened in October, Tánaiste Varadkar pronounced that the advisers advise and governments govern, and that should be the end of it. Doctor Holohan’s advice was implemented two weeks later.

Now the government are four-square behind a different Christmas, but a good Christmas. A Christmas Ryan Tubridy can be proud of, and with no gloomy medicos acting as bad-news bears to spoil everybody’s fun.

Does the government ever wonder if Covid-19, the novel coronavirus, know it’s Christmastime at all? Is the government at all concerned whether or not Covid-19, the novel coronavirus, can tell if any particular environment is a wet pub or the perfume counter in Brown Thomas?

The government is betting that the people’s need for a “normal” Christmas, and the economy’s need for Christmas business, is greater than both the people’s intolerance of a third lockdown or the potential crisis caused by the HSE’s unknown ability to deal with a surge of post-Christmas cases.

Pat Leahy made the case for the economic benefit in a recent Irish Times column. The problem is that those economic arguments were no less true during the time the government locked down as they are now when it wants to lift lockdown. What is different? What is it about now that is was not the case a month ago, other than political opportunity? Could we, perhaps, save some money by not burning it on the altar of the Children’s Hospital instead?

On the people tolerating another lockdown, that seems to be a fifty-fifty proposition if an Ireland Thinks poll in yesterday’s Mail on Sunday is to be believed. If Ireland Thinks polling is anything like their website that may not be a worry. If the poll is on the level, then the government, and the political establishment in general, have badly misjudged the public mood.

How much the government suffer in consequence of this depends on how much the people suffer, which itself depends on how toasty things get for the HSE.

The HSE is not having a good pandemic. The HSE doesn’t do well in normal times – what hope have they in times of pandemic? This is under-reported in the press. There may be different reasons for this, but there can be no doubt that the government are handing out green jerseys at official and unofficial briefings morning, noon and night, and urging the media to “act responsibly” for the good of the nation.

But keeping schtum on the dysfunction of the Health Service does not serve the good of the nation. It serves the good of those who benefit from that dysfunction, to the detriment of the good of the nation. The media can only serve the good of the nation by keeping the nation informed of what the nation needs to know. And the nation needs to know that if there is a spike in cases to which the government is slow to respond, RIP.ie is likely to see a lot of business.

The argument against this is that the virus is not as deadly as it was. There are two possible reasons for this. The first is that the virus has mutated, about which your correspondent knows nothing, quite frankly. The second is that treatment has improved as the medical world has had a year to study the thing. This is demonstrably true.

Against this is the remarkable sloth and inertia of the Health Service in Ireland. Change comes dropping slow in the HSE. Its ability to triage cases in an epidemic situation has never been tested but reader, as it creaks so badly at the best of times, what hope has it of surviving the worst?

A state’s ability to ease lockdowns in times of epidemic is proportional to the state’s ability to trace outbreaks to their origin. In New Zealand, they’re able to trace down to the cluster. Thirteen cases at a wedding in Wellington. Twenty-five cases at the Ruby Princess Cruise Ship in Hawke’s Bay. 

The highlight of Ireland’s case-tracing came in August of this year, when we managed to trace an outbreak to somewhere in Offaly, Laois, or Kildare. This does little for confidence in an agile response to a post-Christmas outbreak.

The importance of speed of response, again, is critical because of the speed with which the virus is propagated. A quick example. Let’s say you decided to walk north up O’Connell Street, and give yourself six minutes to do it, which is about what it takes at an average walking speed of five kilometres an hour.

If you travel at that speed, after three minutes you’re a little past the spire and the next three will see you at Parnell Street. But if you’re not travelling at that speed – if you’re travelling at an R-number of 1.1, say – you reach the spire only after 5 minutes, 53 seconds. You then cover the remaining half of the street in seven seconds. In another minute, that rate of acceleration will have you in Belfast.

The R-number doesn’t map exactly to rates of cases, of course, but it is useful in showing how quickly a health system can be overwhelmed if infections aren’t spotted and dealt with it in time. 5’53” to the Spire. Seven seconds the rest of the way. One minute more to Belfast. Happy Christmas.

Thursday, July 02, 2015

Priorities in the Health Service

July 1, 2015
HSE management 'clearly incapable', say Portlaoise parents
http://www.irishtimes.com/news/health/hse-management-clearly-incapable-say-portlaoise-parents-1.2218094
Families who lost children told to 'go away and have more children', health committee hears
The HSE refused to advertise a helpline for patients on the night of the Prime Time programme, as requested by Patient Focus, because it didn't believe it would attract many calls, Cathriona Molloy of the patient organisation told the committee. The organisation was forced to use its own phone number for a helpline, which attracted hundreds of calls in the days after the programme, she said.

July 1, 2015
Hiqa to review Tusla over concern for at-risk children
http://www.irishtimes.com/news/social-affairs/hiqa-to-review-tusla-over-concern-for-at-risk-children-1.2259121
Records obtained by The Irish Times earlier this year showed thousands of reports of abuse, neglect and welfare concerns over children at risk were waiting to be allocated a social worker. An internal report presented to the board of Tusla said backlogs were so acute in some areas that hundreds of extra staff are needed to bring numbers back to 'manageable' levels.

June 22, 2015
HSE orders review into nine maternity cases
http://utv.ie/News/2015/06/22/HSE-orders-review-into-nine-maternity-cases-39584
The HSE has recommended a full review into nine maternity cases at three separate hospitals. A team examined 23 cases from the Midland Regional Hospital in Portlaoise, three from the Midland Regional Hospital in Mullingar and two from the University Maternity Hospital in Limerick between 1985 and 2013. It found that nine cases should be subjected to a full systems analysis review.

June 15, 2015
'Cloak of secrecy' around abuse of intellectually disabled
http://www.irishexaminer.com/ireland/cloak-of-secrecy-around-abuse-of-intellectually-disabled-336948.html
Fine Gael's Fergus O'Dowd made the claim after the Irish Examiner revealed 21 HSE workers have been sacked or suspended for alleged sexual, physical, and financial abuse of residents at care facilities for adults with severe intellectual disabilities since January 2014. Details published on Saturday show that, over the past 18 months, HSE management has been aware of serious incidents at seven such facilities.

June 12, 2015
What the hospital scandals teach us about management
http://www.independent.ie/opinion/comment/what-the-hospital-scandals-teach-us-about-management-31296032.html
HR policies are such that managers will tell you they are powerless to deal with people who ought to be sanctioned even for quite serious reasons.
It can take six months to replace a nurse through the shared HR services centre in Manorhamilton.
There is no effective performance management system for managers. Management structures are in a state of constant flux; many managers don't have the delegated authority they need to do their job; and some support functions are too centralised.
Compared to the HSE, the hospitality industry in Ireland has a better system for the training and cultural formation of hotel managers, sending them to the best hotels around the world on a carefully structured development programme. The results speak for themselves.

March 5, 2015
HSE 'Gave Contracts to Former Staff' Without Tender
http://www.todayfm.com/HSE-gave-contracts-to-former-staff-without-tender
The claims are understood to mostly centre around cases where contracts were awarded to companies led by former HSE staff, or where ex-HSE workers are now on the payroll. They include cases where the HSE has paid former staff members for spaces in care homes, without first investigating whether better deals could be found elsewhere. Committee chairman John McGuinness says some former HSE staff members have made huge money from unadvertised contracts.


These are just some of the reasons that the HSE has been in the news lately. And what is the Government doing about all this? Why, it's providing free healthcare for children less than six years old WHO AREN'T EVEN SICK IN THE FIRST PLACE. This isn't just an inefficient use of resources. This is immoral in every way and I don't know one politician who's had the stones to come out and say that, for fear they'd lose votes in leafy suburbs or roasted by a "Mums Outraged .." headline in the Indo or the Daily Mail.

Banana Republic. Will anything ever change in this godforsaken country?


Wednesday, May 20, 2009

Bushing Lushing with the HSE


If the current wretched weather has a benefit, then at least it’s keeping the nation’s young people indoors and not out al fresco drinking, which would be their recreation of choice. The rain is certainly doing a better job of keeping them off the sauce than the HSE’s current campaign is likely to do.

You’ve probably seen the ad on billboards around the country. An Spailpín has spotted it on Batchelor’s Walk in Dublin, above the car park in Sandycove and on the final billboard as you’re leaving Longford, heading east. What An Spailpín can’t figure out is what exactly that image is meant to do.

The guess is that it’s to discourage young people sitting on walls, drinking. How exactly it’s going to do that is harder to guess, because that image, especially in its five foot by ten foot incarnation, is up there with Édouard Manet’s déjeuner sur l'herbe as a portrait of bliss naturel. The perfect depiction of a perfect summer’s evening of conviviality and friendship.

Look at the thing – isn’t it gorgeous? Wouldn’t you feel like popping down to Centra yourself for a six-pack and hopping up on the wall along with them? Have you registered how sophisticated the girls are? This isn’t some bunch of nyuks here – these are the cool kids at school, the Fonzes, the Buffys, the Blair Waldorfs.

An Spailpín doesn’t have the figures for how much the campaign cost, and is too stricken in years to wait for a answer through the freedom of information process, but it’s a reasonable guess that the HSE would have blown between half and one million Euro on this ad campaign. And it’s reasonable to ask what exactly they wanted to get for all that money.

Did they want an ad campaign that warns the comfortable middle classes of south Dublin – themselves, in other words – that their offspring may enjoy an alcoholic beverage of a summer’s evening, or do they want to protect vulnerable children from making a very bad lifestyle decision, one which may cost them the rest of their lives?

The sickening thing is, of course, that one single ad could have taken care of both their own worries over Sodhrcha or Uirlis bushing lushing in Herbert Park and the actual children at risk – all you need is a still from the movie The Snapper of Sharon up on the bonnet of a car getting knocked up by Georgie Burgess while Sharon is comatose with drink. You then splash a head across this that reads: “Not alright, Sharon,” and put the contact details about who to talk to at the bottom.

This is a time when the money spent on these ads could be spent on not closing down wards in Crumlin Children’s Hospital. This is serious. Lives are at stake. This sort of stupidity is not good enough.






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