Like everything there is good and not so good. All those with professional responsibility are generally doing their best. Really very few go to work to do a bad days work. But we could lets say, be better. In Texas it feels like there is almost a hospital floor for every resident. We are not quite there perhaps. So where to start.....
Firstly all involved must put a hand-up and say in some large or small way they are part of the problem and that they FULLY commit to helping to fix things. Thats a start, no blame, only forward focused...any persons not wishing to be constructively involved must go, be paid off, whatever, each surgeon no matter the hospital must be enabled to do the same number of operations...this 100% is not the case at present - I won't go into the reasons but if the hat fits...please allow us move forward, we can't have people suffering and dying for petty politics or vested interest
We dig out recent benchmarking reports and quickly establish where we need to get to....progress.... a VISION, which is compelling and stretched but doable with lots of the right behaviours and values, if necessary we bring in the experts from overseas who HAVE A PROVEN TRACK RECORD OF ON-TIME/UNDER-BUDGET delivery.
Ok, we know where we are going, now for the elephant in the Irish room - project management/delivery - right so before we go anywhere we need to know the budget available from treasury going forward....a recent HSE spend review I saw did not look ideal....to put it kindly it did not exactly look like money well spent or value for money....so 80/20, simple, always works, 20% of the activity normally comprises 80% of the spend, it might be surgeons, it might beGPs/Clinic Businesses, it might be the cost of prescribed drugs, it might be missed appointments which had necessarily been scheduled years forward...who remembers those?
Right what do we know, back to everyone trying to do their best in a kind of unconnected disorganised way. Euro 3000 a heart stent, euro 65/15 min appointment, 25 surgeries a week one place, very few in another place.
A hospital build/add-on way late and way over-budget. This surely has to stop. no more of these behemoths in Ireland. Its just not necessary. With a litttle competence, integrity, transparent tendering and award processes and stretched project plans with clear accountabilities (no excuses).
We must just also check the processes of the pharmaceuticals sales incentivisation schemes but the prescription drugs we purchase MUST surely cost the same or less per unit than the best in Europe
So we have the vision, big, ambitious, feasible, best in class and published by way a promise to the people of Ireland, we're about to go from zero to hero.
Believe me I know where good and perfect is, having lived, worked and studied all over the world.
Ireland is an incredible country but we need to tweak a few areas.
Why not do something we will all be proud of.
We have 500,000 new workers in the country. No excuses. Just get them trained, organised and off we go. We have looked hard at budgets, retired inefficiences, blockers and wobbly processes and now we have double to treble to spend.
The plan can now be ambitious, ridden of skeletons, handbrakes and compromised positions. 8 new hospitals delivered within the......YEAR, yes lump-sum, turn-key; Budget is Euro X, Scope is Y, can you do it, Yes or No?
Move on, deliver. We have got to surely embrace a more socialist lack of greed mentality, by way of Modus Operandi?