Nov 172015
 

Today I finally understood the reason why our Health Service Executive is unable to deliver a modern health service.

Today I accompanied an elderly relative to hospital for a simple outpatient procedure, and I saw a highly-trained specialist nurse wasting a full half hour transcribing information from one file to another by long-hand. I saw a highly-trained professional struggling to read notes written by a doctor who, in his infinite arrogance, couldn’t be bothered to write clearly and who therefore endangered a patient.

This is the country Enda Kenny claims is at the leading edge of information technology, and yet our health service doesn’t know what its patients are doing unless a vital highly-paid professional laboriously writes it out time and time again.

Database systems have been in existence for many decades. Most developed societies have properly-designed computerised records of patients available to all health professionals at the touch of a button. This is not some sort of groundbreaking new technology, except in Ireland, so why was I surprised at the 1950s technology still pervading our public health system?

I shouldn’t have been surprised, since the reality is that the 1950s technology is also the 1950s mindset.

The people who run the Health Service Executive are trapped in the past and until the government understands this, nothing will change.

I’ve been talking about the malaise at the heart of the system for many years but at the same time it’s easy to blame systems when in reality it isn’t a system that humiliates or disrespects a patient.

The system doesn’t disrespect patients. People disrespect patients. Bad nurses disrespect patients. Arrogant doctors disrespect patients. Slovenly domestic staff disrespect patients. Sniffy administrative staff disrespect patients. And all of those people should know better but many can’t be bothered.

Ultimately, though it isn’t their responsibility, since a properly-functioning system should do three things:

A working system should educate them to understand that respect is vitally important.

It should warn all health employees that they are the employees, not the masters.

A functioning system should impress on medical consultants that they are simply employees paid by the public and that they are obliged to show respect to their customers.

If none of that works, a properly-functioning system should remove people  from their jobs when they fail to meet the appropriate standard, but ultimately, none of this works if disrespect and sloppiness are at the heart of our society.

Is it as simple as that?

Do we tolerate doctors with a god complex (people whose education we paid for) and administrators who treat us like dirt because that sort of thing is embedded in the nature of who we are?

Do we tolerate condescending receptionists and gruff nurses because that’s how it has always been?

Are we simply a disrespectful society? Are we a bunch of ill-mannered boors and is that why we have a boorish, ill-mannered, incompetent arrogant health service?

Sadly, I suspect we are.

I  suspect that the Health Service Executive is no more than a reflection of the sloppy, arrogant, class-ridden, incompetent, slovenly society we have created for ourselves.

Isn’t it time we changed not only the Health Service Executive but the way we behave?

  6 Responses to “Health Service Executive has disrespect and sloppiness at its heart”

Comments (6)
  1.  

    A few years ago I went to visit a friend in Limericks regional hospital. I enquired at reception as to his whereabouts and was told by the receptionist after checking her system, which ward he was in. I got to the ward and could not find him so I asked at the nurses station as to his whereabouts only to be told that he had been discharged the previous day… !!

  2.  

    Hi Bock.You have touched on something i have become aware of over the years.In many situations,ordinary citizens are held in contempt by the state , its civil service and politicians.The Gardai are an extreme example but local authority staff aren’t far behind them.For commercial reasons,many doctors have unwillingly feigned a better bedside manner.
    Nama and Irish water are the newest official purveyors of contempt and enjoy the support of the Government in their actions.The senior management of our state-supported banks speaks for itself.
    The only sign of progress is the Catholic church which has experienced a sharp decline in it’s power and influence and ability to control gullible believers.

  3.  

    What you have experienced is the system.The system is designed for the many and not for the individual and because of this you encounter as a individual tired,uninspired,beaurocrats who whether right or wrong,nice or rude,able or not fit for employment are not held responsible.They still have managed to get jobs with big pensions and salaries at tax payees expense and nobody to be answerable too.We are treated as mere numbers,stats,it does not matter to these people who clock out and plot there long awaited retirement day.We the individuals are the ones left in the situation.These people dont want change,even in the face of blatent wrong these people defend there actions and instead of an example been made for wrong doing they rally together ,close ranks,threaten strikes,to defend there actions.Good people in these institutions who try to make a difference don’t succeed and a sidetracked with careers over.The funniest example of what we deal with is the nurses,who treat you with distain,rude,obnoxious as if you are some kind of an inconvenience to them,then get there pay rises which is most of the yearly hospital budget,then when they get busy go on strike and state it a patient safety issue.

  4.  

    The nurses we met were professional, courteous and overworked.

  5.  

    The health service is about Pay, Pensions, Power, Position and lastly and I mean lastly Patient care. It serves itself. The majority of senior HSE employees will have private health insurance. that’s like Sony employees only buying Panasonic or Samsung products for their private use. As to 1950’s work practices in health care, there are a number of reasons why there is continued adherence to old paper-based filing and recording systems. Firstly it is more difficult to audit outcomes patterns and performance where much of the data is recorded in paper form. Secondly there is a distinct lack of leadership when it comes to information technology – witness private nursing homes, GP’s and private hospitals which are not directly employed by the HSE–these groups are using state-of-the-art electronic medical records and are groaning under the weight of illegible handwritten prescriptions, discharge summaries and handwritten Tosh spewed out by a dysfunctional HSE. Lets not forget that much of the management structure of the HSE involves political apparatchiks whose sole objective each day is to ensure that the self-serving status quo remains intact. The solution is short-term renewable contracts for all HSE staff ( indeed all public service staff) based on performance – just like in the real world.

  6.  

    Spot on BOCK.

    In probably every floor level in the local hospital and probably in hospitals nationwide too, there are office size areas called Nurses Stations. In these stations a common sight is a large group of nurses holding very large sized files or folders where many records are written and recorded by hand. These ‘meetings’ take place several times each day in every Nurses Station and commonly seen in almost every such area too will be a computer standing idle.

    Luckily, it’s been almost two years since I’ve observed this, but clearly it’s what nurses are obliged to do instead of looking after patients.

    I have no idea what the thousands of administrators actually do but recently a local administrative initiative has begun whereby ‘members of the public’ are offered the opportunity to join as part of a group who will be permitted to make comments which the administrators may utilise to bolster stability for their own positions, producing vital reports which will inform the media et al.
    In whatever manner suits the administrator group.
    Lunacy in full flight.

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