An Excerpt from the “Bitter Pill” or what is wrong with Ireland(RoI) Healthcare system.

Here is a excerpt from the “Bitter Pill” on what is wrong with Ireland’s Healthcare system. Verbatim

“The Two Tier System

No discussion of the Irish health system can take place without an examination of its foundations. It is built on the two -tier system of public and private healthcare. At the heart of this system is a blatant lie about choice, one that is propagated by the government and vested interests in a system that rewards private practice and penalises public patients . The two-tier system is the single greatest obstacle to improving the level of healthcare provided in the country. This is because it leaches off resources paid for by the taxpayer and gives little in return to the public, while providing incentives to neglect their public duties. As such it is a system that services no one other than those who profit from it, and it works fundamentally against the improvement of public health services. Yet as long as this system prevails, those who can afford to rightly feel they have little choice but to purchase private health insurance.

 

The Power of Consultants

The two-tier system, in turn must be understood in terms of the role of consultants and, more specifically the power they wield within the health service. Consultants are paid by the State to work a normal working day in their public capacity, but they retain complete discretion over when they choose to be in the hospital and when they chose to leave. Consultants who complain about having to work long hours often neglect to mention that many of those hours are spent looking after private patients to supplement their income. Considering  that the Irish taxpayer is paying salaries of upward €140 K * to these men and women, there is a major question to be asked about accountability.

It is a well- established and universally accepted fact that accountability is a key factor in achieving the standards of best medical practice.’Measuring practice’ and comparing it ‘against existing standards’ are key components in the audit cycle , the gold-standard for evaluating and improving medical practise. Yet in the ‘Medical Consultants Report’ , published in March 2007 by the Comptroller and Auditor General, it was found that no record is kept of how many hours consultants devote to public service as compared to private work, and that the prioritising of private patients is leading to a neglect of public care”

*Book was published in 2007

Prime Time Public healthcare Vs Private.

Just a note on something I watched during the week, Primetime Investigates Public Vs Private, the battle for care. It was not the usual run from Rte and looks like they put some effort into investigating and making their documentary. They focused on how the big waiting list in the public systems are made worst by the consultants “moonlighting”  for the private sector as well, often at the expense of their public patients. Seemingly the consultants who are suppose to work 4 days- 37 to 39 hours, work as little as 13 hours in the public system and often too busy with their private practices to look after public patients despite being paid to do so. Public patients are often told to “go private” to beat the long ques that exist despite the taxpayer paying for the doctor’s salaries. the junior doctors, nurses and other staff plus the equipment and the premises as well. The first question patients are asked is do they have private health insurance which is paying on the double or maybe on the triple.

The public gets bad value for money, patients are often stressed by long waiting lists and the hospitals are ran badly by inept management, who pays people for a job they are not doing- no-one except the Irish health service the only ones who can do it. A book I read a few years ago “The bitter Pill” was written anonymously “Doctor X”  by a foreign doctor on the Irish health service was scathing on how it was run and said one of the biggest problems was a private sector which was “leaching” off the public sector, which wouldn’t be profitable if it didn’t. Another comment was the sending of patients off for private scans when the cheapest thing to do, was to buy the bloody scanner. The writer had a long list of improvements at the back of his book which is well worth a read. In a few years things will come to a crunch in the Public Vs Private systems.

Successive Irish governments had done their best to run down the public health care system and foist an “American style healthcare” system onto the Irish public. The public healthcare system can’t be seen to work as then they would no need to go private. No big money for anyone especially the politicians who get big backhanders from healthcare companies.

A better run public system is badly needed and wanted by the Irish public but seemingly government’s with different Agenda’s are the main problem to the “fix”. Until this changes the mess will continue.

 

links of interest:

Prime Time: Public V Private – The Battle for Care