The new takeover plan by @HSELive @roinnslainte. Some thoughts @SusanMitchell_ @DonnellyStephen @ciarakellydoc

1. So once again it starts. The narrative from the DOH and HSE that the public system can’t cope. And it’s hard to dispute that fact. The public system is broken

2. Brilliant capable and hard working colleagues working hard in a system that doesn’t function. We pour billions into the public health system every year, a budget that is increasing most years.

3. But do we see the return of that investment as taxpayers? What metrics do we use to see the use of the billions, the value, the efficiency? Over 70% of the total budget is spent on salaries, yet 45% of those employed in the HSE are not doctors, nurses or healthcare assistants

4. So we have fewer nurses, fewer doctors, less and less people that wish to return from abroad to a post in the hse. For years great consultant colleagues have been fighting to get paid the same as their colleagues (on older contracts) for doing the same work @ProfSuperJunior

5. Nurses have been applauded in recent months for the incredible work they do, but sadly I expect they will also be fighting once more for better pay. Doctors and nurses continue to emigrate with no desire to return home.

6. And all the while in these recent years, the hse has recruited more and more non medical and non nursing staff. More managers.

7. And even if a new consultant came home, he/she will often start in a post and inherit a 1-2 waiting list ! How can one possibly catch up with that. And since diagnostics, and theatre space etc is already “full” then how can he/she make a dent.

8. More docs and nurses is important, but only equally as important as making sweeping changes in the public system. Premium hardware like CT and MRI must run 18-20 hours a day, theatres must be run 24/7 even for elective work.

9. The beds that have been permanently closed must be reopened. In fact we have almost 10000 less hospital beds now that we did 20 years ago, despite an older and larger population. We have over 500 consultant posts unfilled.

10. Nearly 20% of our critical care beds remain closed - why is this? For years the doh/hse have been told we have one of the lowest number of critical care beds for our population. So why are they closed ?

11. Why does an mri scanner routinely stop scanning in the public system by 5pm? Why does it lie idle for 12-14 hours a day? It’s infuriating. It’s inefficient. Its wasteful.

12. We must demand better use of the billions spent on healthcare, more transparency, more efficiency. Let’s #openclosedbeds #stopclosingbeds and ensure #efficiencybeforecapacity