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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Wed Jul 20, 2016 12:46 pm 
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FoI from The Examiner about HSE internal audits for July-December 2015.
Concern over award of €338k contracts
Contracts worth €338,000 were awarded to a private firm by a hospital group whose chief executive had a business interest in the same company.
Tusla: Dozens of pay and timekeeping issues
Payroll issues identified at three locations included a lack of written local payroll procedures or payroll sign off checklists; no records of training for payroll staff and incomplete staff details on time sheets. a ‘Gaeltacht Allowance’ was paid to 44 members of staff. In four of these cases, auditors were unable to find any written decisions signing off on the awarding of these payments, which ranged from €156.90- €427.58 per fortnight
Staff in single HSE region overpaid more than €815k
it appeared that “ in some cases the lines of responsibility as to who is responsible for tracking, following up, and monitoring of the recoupment of payroll overpayments needs to be more clearly defined and agreed”.
COPE charity contract: Salary at odds with medical grades
A doctor contracted to provide services to clients of COPE Foundation was paid €123,799 annually, at odds with Department of Health salary scales for medical grades.
Abuse centres Dublin: Risk of non-compliance at facilities
Some of the issues, included the absence of proper receipting, data protection issues, problematic financial controls, and Garda vetting concerns.


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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Tue Feb 07, 2017 2:13 pm 
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Bump for Coles2

Some of us don't watch rté :)
Besides, hidden health waiting lists are not a surprise. My GP told me about these so-called hidden lists years ago. It is only now that rté are covering it. It's akin to people removed from the unemployed live register onto jobbridge/ce schemes.


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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Tue Feb 07, 2017 3:12 pm 
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I've posted several times here about waiting lists; they are regularly manipulated both upwards and downward. The waiting list numbers do not represent the actual number of people waiting for a procedure at any point in time and are essentially used as weapons in internal politics.

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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Tue Feb 07, 2017 3:45 pm 
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temene wrote:
Bump for Coles2

Some of us don't watch rté :)
Besides, hidden health waiting lists are not a surprise. My GP told me about these so-called hidden lists years ago. It is only now that rté are covering it. It's akin to people removed from the unemployed live register onto jobbridge/ce schemes.
And housing completions statistics, or crime figures, or GDP growth figures and 'leprechaun economics'...

hmmm... I'm starting to see a pattern here.

With regards to improving the Public Health system, first you have to stop deliberately fucking it. Brendan Howlin let the cat out of the bag when he said that in order to create a private health care 'market' they needed the Public system to be inferior.

"Why else, if it was first rate, would people pay for a private system?'

Yes indeed.

Drive down the cost of living and you can drive down Public sector pay and pensions. If you have a stupid government policy to deliberately drive up rents and property prices and you can't reform anything. With a high cost of living you can't keep young nurses and doctors; you can't attract them from abroad. With high public sector wages the private health system can't compete at an economic level, insurance rates go through the roof, and the entire system fails. The problem is one of stupidity.


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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Thu Feb 09, 2017 2:42 pm 
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Harris promises cuts to waiting lists by the end of the year: http://www.rte.ie/news/2017/0209/851310 ... ting-list/

He can certainly deliver on that, based on how waiting lists are managed, without actually improving services for anyone.

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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Thu Feb 09, 2017 5:35 pm 
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Harris says:

Quote:
We have excellent management in the health services...


He still doesn't get it.


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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Thu Feb 09, 2017 8:32 pm 
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greentree wrote:
Harris says:

Quote:
We have excellent management in the health services...


He still doesn't get it.

He was trying to row back on comments yesterday where he blamed managers. I think he is starting to get it but doesn't have the balls.

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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Sun Feb 12, 2017 1:14 pm 
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Hospitals spend an average of €2.88 per dinner. Varies from €0.93 - €7.37 per meal
Prisoners get better food.
https://pbs.twimg.com/media/C4bKzYlXUAAimYB.jpg:large


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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Thu Apr 20, 2017 11:54 am 
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am I a raving bigot to think that giving out free anti-HIV pills is not a very good idea?

http://www.irishtimes.com/opinion/anti- ... -1.3054235
Quote:
Anti-HIV drug removes personal responsibility
PrEP promotes an attitude of play now, pay later among men who have sex with men

Currently in Ireland, PrEP can be obtained privately from some GPs at a cost of around €450 a month.
In London, the trend to buy the drug cheaper online has helped to make it more affordable, however, the high cost of PrEP remains prohibitive, making access a major issue as it must be taken every day in order to be fully effective.
It is clear that something needs to be done about the rise in the spread of HIV among the gay and bisexual male population in Ireland.
However, as someone who has been involved in education on this subject for the last 15 years, I believe the focus regarding long-term prevention should remain on taking responsibility for our personal behaviour when it comes to our sexual practices.


this is a contra to U*a M*llally's piece ssaying that
http://www.irishtimes.com/opinion/una-m ... -1.3050896
Quote:
Una Mullally: Anti-HIV drug must be made available


http://www.irishtimes.com/opinion/provi ... -1.3051756

Quote:
Providing Orkambi to CF sufferers will cost lives
Spend on high-tech drug could have more impact elsewhere in health service

Whenever the Government spends money on something it should improve people’s lives. From education to the justice system, building infrastructure to hiring doctors, governments need to make sure all of their policies do good. In an easier world, this would be the only requirement on governments when making a decision. However, unfortunately our resources are finite.
This leaves us in a situation where by spending our resources tackling one problem, we are in practice taking money away from somewhere else, and reducing one good in favour of another. So when government spends money on our behalf it should seek not only to do good, but to do the most good that is possible with every euro spent.


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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Thu Apr 20, 2017 12:00 pm 
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slasher wrote:
am I a raving bigot to think that giving out free anti-HIV pills is not a very good idea?


Probably not; it comes down to a cost/benefit at the end of the day. In an ideal world of course it would all be available free but in reality budgets are constrained so it's a zero-sum game. Presumably someone has done the sums.

CF patients seem to get a disproportionately large slice of the health spend pie though if were on that subject...

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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Sat Apr 22, 2017 6:15 am 
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Mantissa wrote:
slasher wrote:
am I a raving bigot to think that giving out free anti-HIV pills is not a very good idea?


Probably not; it comes down to a cost/benefit at the end of the day. In an ideal world of course it would all be available free but in reality budgets are constrained so it's a zero-sum game. Presumably someone has done the sums.

CF patients seem to get a disproportionately large slice of the health spend pie though if were on that subject...


I read Mullaly's article.

The cost-benefit pay-off is only as good as the likelihood that the drug gets actually taken by the people it's given to.

I am just not convinced that young men engaged in hedonistic and risky behaviour can be relied upon to take a preventive pill daily. I know I am generalising here a bit. But it's not the elderly on statins we are talking about.

For example women who claim to be on the pill still get pregnant all the time.


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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Sat Apr 22, 2017 3:19 pm 
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I certainly didn't read her article. But if they're not going to take the drug why would they ask for it? And presumably the adherence rate is factored into the effectiveness stat.

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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Sat Apr 22, 2017 7:59 pm 
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Here's the link to the PROUD study mentioned in the article.

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)00056-2.pdf

I don't know how much it costs here, but in the U.K its around £400 a month to buy privately.

edit: If a person does become HIV positive while taking PreP it can become more resistant to treatment if not diagnosed and given required extra drugs. So as part of regimen the drugs would need regular screening(would probably be mandatory for "free" drugs). It should increase the incidence of early detection, and detection of other STI's.


Last edited by A41 on Sat Apr 22, 2017 8:19 pm, edited 1 time in total.

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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Sat Apr 22, 2017 8:08 pm 
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Yep as expected

Quote:
The effectiveness was the net effect of efficacy, adherence, and any change in sexual behaviour as a result of PrEP

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 Post subject: Re: Health and Social Budget overruns - making the rest moot
PostPosted: Sun Apr 23, 2017 7:08 am 
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It is hard to paraphrase her argument as it is so weakly made. And anyway we all know that a puppy dies every time someone links to one of her articles.


Basically it's a bit like saying to boy racers that it's okay to drive without a seatbelt if you put an additive in your petrol tank every day.

Even if the risk reduction is the same, would you trust them to use it reliably?
And should the state fund it at €500 a month where the alternative is close to free?


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