Healthcare in Poland (and examples from other EU countries)

Quoting: daffy

a solution is to allow private companies run the health service - paid by the gov't rather than the gov't paying for an inefficient system. if the private firm fails to deliever you can sack them and replace - which i find is motivation to provide a quality service

daffyThreads: 40 Posts: 2,118 Joined: Feb 5, 07	May 7, 07, 10:36 / #
Quoting: BubbaWoo public health care is a brilliant idea... in theory... depends who you leave in charge... yea, in Ireland we have free public health but its under severe pressure and the gov't is trying to covertly promote private hospitals (by giving them land etc) not to mention contributary pensions stating that the state is just not able to afford it and you need to save for it the second point i can see, but healthcare i feel is the responsiblty of the state to provide all citizens. the pension, we should all save some more for this.

BubbaWooThreads: 46 Posts: 4,438 Joined: Sep 26, 06	May 7, 07, 10:42 / #
Quoting: daffy but healthcare i feel is the responsiblty of the state to provide all citizens. agreed - i believe that healthcare, among others, is the responsibility of the state to provide... however... i also believe that the state is rarely best at providing to the required standard... but this is perhaps another thread...

daffyThreads: 40 Posts: 2,118 Joined: Feb 5, 07	May 7, 07, 10:50 / #
Quoting: BubbaWoo agreed - i believe that healthcare, among others, is the responsibility of the state to provide... however... i also believe that the state is rarely best at providing to the required standard... agreed - but then in Ireland there are 5 admins to every 1 doctor/nurse. tis crazy. but a solution is to allow private companies run the health service - paid by the gov't rather than the gov't paying for an inefficient system. if the private firm fails to deliever you can sack them and replace - which i find is motivation to provide a quality service. Quoting: BubbaWoo but this is perhaps another thread... It can be i suppose but so far we've mentioned along the lines of things we miss/don't miss but we should go to a new topic to get further into it.

BubbaWooThreads: 46 Posts: 4,438 Joined: Sep 26, 06	May 7, 07, 10:55 / #
Quoting: daffy a solution is to allow private companies run the health service - paid by the gov't rather than the gov't paying for an inefficient system. if the private firm fails to deliever you can sack them and replace - which i find is motivation to provide a quality service this seems a straight forward solution but in practice i suspect not quite so simple... would probably end up with similar problems to the english rail system... but it could be the foundations of an idea on which to build... privatisation... now whereve i heard that before....?

daffyThreads: 40 Posts: 2,118 Joined: Feb 5, 07	May 7, 07, 11:01 / #
LOL the rail system is not privatisations best moment but look at the person service, a better example. It is still 'owned' by the gov't but the responsibility to run them has been in certain person, contracted to companies, like serco for eg. im not calling for privatisation of the health system, rather a gov't owned health system, contracted to private firms, whereby performance is linked with pay. As in the civil service this does not happen and look what we get (you can say the same of course of fully privatised institutions - but thats why i advocate a mixture.) Quoting: BubbaWoo this seems a straight forward solution but in practice i suspect not quite so simple... it does, and i too wonder why is it not so simple, what are the barriers?

BubbaWooThreads: 46 Posts: 4,438 Joined: Sep 26, 06	May 7, 07, 11:16 / #
ive little idea what the perceived barriers are daff... what are your thoughts...?

daffyThreads: 40 Posts: 2,118 Joined: Feb 5, 07	Edited by: daffy May 7, 07, 11:19 / #
Quoting: BubbaWoo what are your thoughts...? civil servants, political will. nothing in gov't can happen without them onside and to upset them is to bring administration to its knees. I would suggest that the current civil service be left untouched and that when any new positions required or vacancies need filling, that they be outsourced to private companies (following tender and meeting correct wages etc etc) And the when they dont do they job effectively we can replace with some one who will - unlike the current civil service. I suspect this is a condition of all civil services, Poland included.

BubbaWooThreads: 46 Posts: 4,438 Joined: Sep 26, 06	May 7, 07, 11:29 / #
again... a straight forward idea but i suspect that the earlier replacements would be ineffective, frustrated and unable to make the changes needed... perhaps a complete overhall would be more efficient and effective... which is of course a lot easier said than done...

daffyThreads: 40 Posts: 2,118 Joined: Feb 5, 07	May 7, 07, 11:32 / #
Quoting: BubbaWoo a complete overhall would be more efficient and effective... which is of course a lot easier said than done... exactly hence my little by little approach. the existing civil servants would have to work with them as they are not threatening ther jobs (no grounds for strike) as their jobs are secure but no more new hires to that system the new system would either work or be replaced. which is easier in a contractor envoirnment and ensures public money is accounted for and better spent. IMHO

BubbaWooThreads: 46 Posts: 4,438 Joined: Sep 26, 06	May 7, 07, 11:38 / #
yeah... but how long do you think it would take until the new members are in a position to make effective end worthwhile changes...? so long as they are outnumbered by the old there will be an environment of resistance to change... which would probably end up doing more damage than good... i suspect...

daffyThreads: 40 Posts: 2,118 Joined: Feb 5, 07	May 7, 07, 11:48 / #
Quoting: BubbaWoo who would be setting bench marks and targets... and who would be monitoring if these were being met, or not? the government, it can appoint 'watchdogs' equivical to 'inspectors' a three way lock as it where. the contracters, the government, the watchdog. a cyclical 'inspectorate' works here i think i know what your suggesting - but who bench marks and targets for hthe civil service? so that wouldnt change as much i think

daffyThreads: 40 Posts: 2,118 Joined: Feb 5, 07	May 7, 07, 11:44 / #
Quoting: BubbaWoo yeah... but how long do you think it would take until the new members are in a position to make effective end worthwhile changes...? i think immediately, we're talking just pay vs efficiency at the start. As to getting things done. the tasks of the job must be realistically set. if the goals are not being met - then re-evaluation to the private firm. if that doesnt work, out to tender again. I suppose it depends on what we classify as worthwhile changes. to me, removing the civil service (or rather, civil, we help you when we want service and no further) is the first big step. Once that is done - and it will take time - it is easier to move a contracted private company yo change than a civil service. i think so anyway

BubbaWooThreads: 46 Posts: 4,438 Joined: Sep 26, 06	May 7, 07, 11:46 / #
who would be setting bench marks and targets... and who would be monitoring if these were being met, or not?

BubbaWooThreads: 46 Posts: 4,438 Joined: Sep 26, 06	May 7, 07, 11:50 / #
i am with you in what you say daff... but the synic in me wonders if it would really work... and could we then apply the same model to education etc...?

daffyThreads: 40 Posts: 2,118 Joined: Feb 5, 07	May 7, 07, 11:52 / #
Quoting: BubbaWoo but the synic in me wonders if it would really work... the synic in me looks at the civil service and asks the same XD Quoting: BubbaWoo nd could we then apply the same model to education etc...? possibly - teacher related performance - but i havent looked into that as i have with health. id have to get back to you on reflection

BubbaWooThreads: 46 Posts: 4,438 Joined: Sep 26, 06	May 7, 07, 11:55 / #
im the opposite... most of my thoughts have been in the area of education... but havent really given it much thought for awhile..