Dear Ministers, here is a couple of ways to make Irish health better for the Irish people
Health does not have to be an unsolvable crisis for the Irish people? There are small changes that can make a big difference.
There’s a huge amount of services provided by our hospitals at massive cost that could be provided by GPs at a fraction of that. For example, there’s no reason why minor surgical procedures should not be provided by the local doctor
It’s hard not to feel sick at the thoughts of our health service. Since the new year began, we’ve heard nothing except there’s almost 600 sick people on trolleys in A&E waiting for admission and do bear in mind you no longer get admitted to an Irish hospital unless you are extremely unwell. The INMO have called for all elective procedures to be cancelled for the first half of January, to ease the pressure, and nurses are serving strike notices at Beaumont hospital. Health is a mess.
On the other hand, the country is doing well, we’re told. We’re going to grow at the fastest rate of any economy in Europe this year. Unemployment is down and we took €1.2bn more into the coffers than was expected. Now, I may just be a simple GP, but Ministers Noonan and Varadkar, may I make two humble suggestions to you?
Firstly – we’ve approximately 800 elderly patients in hospital, waiting on long-term beds in the community. They don’t need to be in hospital but they can’t go home. Long-term beds aren’t cheap. They cost an average of €1,000 per week. But the reason those patients are in hospital isn’t because there are no long-term beds – it’s because there’s no funding for those beds.
They aren’t moved out of those hospitals because HSE managers know that the minute they are, those acute hospital beds will be refilled immediately, by those poor souls on trolleys in A&E. And then the HSE will be paying for two beds where they are currently only paying for one. It’s called bed blocking – are you still with me?
So here’s a radical thought. Do just that. Fund those long-term beds. Those 800 people at €1,000 per week will cost us about €40m per year. Do that and free up 800 acute beds for the seriously ill. In effect, it’s the equivalent of providing and running – in bed terms – a whole new hospital at a minimal cost to the State.
Also, do bear in mind, that because these long-term beds will be provided in the private nursing home sector, which – unlike the HSE – will put on additional staff to cope with additional patients, there will be an increased tax take, which will go some way to offset that €40m.
Secondly, there’s a huge amount of services provided by our hospitals at massive cost that could be provided by GPs at a fraction of that cost. I’m thinking minor surgery, chronic disease management, or mental health services.
Transfer funding from secondary care to primary care and get these services provided faster, cheaper and nearer to patients. This is actually already a stealth policy of the HSE, but they are hoping to transfer these services without any funding – which means the already over-stretched GP service is unable to actually provide them. Pointless. Transfer with funding and new GPs practice nurses and physios etc. can be hired – and the patients benefit hugely.
This could actually be budget neutral as the funding to secondary care could be cut (by no longer hiring hugely expensive agency staff) by the same amount as primary care is increased. To illustrate: if it costs €300 for a surgeon in St Vincent’s to remove your mole, your local GP could remove four people’s moles for that money – without waiting lists, and down the road from you. What a GP can’t do is remove them for free, Ministers. Incidentally, it also frees up the surgeon for proper surgery – we GPs can’t do everything.
So there’s a thought for the unsolvable problem that is health. For the princely sum of €40m (out of the €1.2bn perhaps?), free up 800 acute beds; put elderly patients back into their local communities where relatives can visit them more easily; and provide faster, cheaper, more efficient health services through primary care. Happy New Year, Ministers. You’re welcome.
95% compliance rate for Local Property Tax in 2014 says Revenue
The amount of money collected by Revenue last year was up in a number of categories, more than €450m was collected through the Local Property Tax last year, according to the Revenue Commissioners, with 95% of liable households paying the charge.
The LPT was introduced in the middle of 2013 and recorded a compliance rate of 91% during its first six months, with €242m raised during the period.
Revenue said the figures showed a “strong compliance culture among our customers”, adding that it had received €39m in payments for this year’s charge.
Revenue’s headline results for 2014 confirm the Exchequer’s receipt of almost €41.3bn over the course of the year.
There was a 4.5% increase in the number of PAYE employees during the year to 2.4m – though this includes people with multiple employments and those in receipt of occupational pensions.
Those registered for self-assessed tax returns was up 3.5% to 639,487, while the number of companies registered for corporation tax was 4.2% higher at 167,783.
The agency also collected €610.4m through audits and compliance checks, compared to €551.9m in 2013.
A further €222.7m was received through collections enforcement, up slightly on the previous year, while €88.5m was gained from settlements with tax defaulters.
There was a sharp rise in the value of seizures during 2014, which stood at €122.1m last year compared to €44.3m in 2013.
Seizures of cocaine and heroin accounted for the largest portion of this, representing €73.4m of the total amount, while cigarette and tobacco detections accounted for almost €30m.
Revenue said it received more than 2.2m calls to its telephone services during the year, with more than 660,000 relating to the Local Property Tax.
Customers made contact online more than 5.7m times, while 2.3m letters were received in the year.
In addition to a high compliance rate for the Local Property Tax, Revenue said compliance was also strong amongst most businesses.
In 2014, large companies with a tax liability above €500,000 had a compliance rate of 99%, while firms with a tax liability of €75,000 to €500,000 had a rate of 97%.
Other cases, which would include companies with smaller returns, had a lower rate of compliance, however, at 83%.
Enterprise Ireland creates record number of net jobs in 2014
Agency revealed its client companies recorded lowest level of job losses since 2000.
Minister for Jobs Enterprise and Innovation Richard Bruton, and Enterprise Ireland chief executive Julie Sinnamon, pictured at the Enterprise Ireland end of year review.
Enterprise Ireland backed companies created almost 20,000 new jobs last year, resulting in the highest net jobs gain in the history of the state agency – a total of 8,476.
In its end of year statement, the agency said software and services sector accounted for the strongest net jobs growth, adding 2,092 jobs.
The agency said client companies last year recorded the lowest level of job losses since 2000, with more than 180,000 people (almost 10 per cent of the workforce) now employed in Enterprise Ireland supported companies.
Figures from the IDA Ireland, released last week, also revealed a record year for jobs growth in 2014, with multinationals creating 15,012 jobs and a net increase in employment of 7,131.
Minister for Jobs, Enterprise and Innovation Richard Bruton said the positive figures did not happen by accident, adding that they were the result of extra resources and trade missions.
“We have put in place a raft of measures to deliver on this, including doubling the number of trade missions, recruiting extra staff in overseas markets, and delivering new funding supports for Irish exporting companies,” he said.
Mr Bruton said the Government’s Action Plan for Jobs was creating a powerful engine of Irish enterprise, alongside the strong multinational sector, and that Ireland has the capacity to create full employment by the end of 2018.
Enterprise Ireland chief executive Julie Sinnamon said 69% of the net job gains were outside of Dublin, adding that the level of increased employment achieved is “remarkable”.
“We continue to relentlessly focus on ensuring the right supports are available for clients at every stage of growth.
“This focus — coupled with our priority to support entrepreneurship across the regions, and develop strong, export focussed, ambitious Irish companies that can win new business — will mean even more jobs for Ireland over the next 12 months”.
Primary School literacy and numeracy rise for first time since 1980
Despite progress no real reduction in gap between disadvantaged urban schools and others.
A study on literacy and numeracy in primary schools has identified the first ’statistically significant’ rise in standards in over 30 years.
A study on literacy and numeracy in primary schools has identified the first “statistically significant” rise in standards in over 30 years.
The 2014 national assessments of English reading and mathematics showed a major improvement in students’ performance at second and sixth class, compared to the last study in 2009.
However the researchers found that despite an overall progress there has been “no real reduction in the gap” between pupils in disadvantaged urban schools and pupils in other school types.
The Educational Research Centre study cited particular concern over “the large proportion of very low achievers in reading” in the most disadvantaged schools, namely those falling into Deis (Delivering Equality of Opportunity in Schools) band 1.
The agency, which carries out the assessments for the Department of Education at five year intervals, said it was the first time since 1980 that increases in performance had been recorded.
While it cautioned against putting too much store in a single set of results, it pointed to the impact of improved teacher training and professional development, including the use of new methodology, as well as spending more time on literacy and numeracy in class.
Progress in vocabulary and comprehension was found to be well ahead of a target set in 2011 National Literacy and Numeracy Strategy. Progress in algebra and data analysis was also found to be ahead of target but to a lesser degree.
The study showed girls are still better readers than boys but the gap has narrowed since 2009, from 14 points to 7 points among second class pupils, on a 250-point baseline for the tests.
Reading skills among second class pupils in Deis band 1 schools rose by 14 points compared to 2009 but the improvement was greater (27 points) in Deis band 2 schools (these are schools deemed less disadvantaged than band 1). The latter also saw a significant increase in maths scores (up by 29 points) whereas there no significant change in band 1 schools.
The most disadvantaged schools also saw no significant increase in reading at sixth class whereas band 2 schools saw a 14 point increase in scores, deemed as “substantive important”.
In reading, the mean score for Deis band 1 sixth class pupils was 233. This compared to 246 for Deis band 2 schools and 263 for all schools. In maths, the mean score for Deis band 1 was 233 compared to 241 for Deis band 2 and 262 for all schools.
Minister for Education and Skills Jan O’Sullivan welcomed the upward trend overall, acknowledging the work of teachers, parents and students in improving standards.
Cautioning against complacency she said:“The results leave scope for improvements, especially in maths and in Deis schools”. She has asked for a review of the strategy to be brought forward to this year from 2016.
An additional €6 million had been provided for the implementation of the strategy in Budget 2015, bringing the annual budget to €13.8 million and further measures would be considered, she added.
One proposal mooted by her predecessor Ruairí Quinn was for Leaving Cert honours maths to be made a requirement for entry into teacher training. Asked whether or not she would support such a measure, Ms O’Sullivan said she was awaiting advice from the Teaching Council. “We can be generally fairly sure as of now that the qualifications of people going into teaching are very high,” she said.
The primary teachers’ union, the INTO, also welcomed the test results. General secretary Sheila Nunan said they were probably the result of several different factors including supports for disadvantaged schools, changes to teacher education, improvements in learning support allocations to schools and an increased focus on literacy and numeracy.
However she singled out the fact that only qualified teachers were now licensed to teach in primary schools. Research by the organisation a decade ago showed more than 1,400 primary classes were taught by people who had no teaching qualifications.
Easter Island demise revealed? New findings provide intriguing clues
What caused the demise of Easter Island’s population? Researchers may have solved the mystery behind what caused the extinction of the Rapa Nui people of Easter Island.
Recent findings suggest significant changes in land use and dynamics that occurred within the community before the European arrival may have been linked to the people’s demise, the University of Auckland reported.
“The results of our research were really quite surprising to me. Indeed, in the past, we’ve published articles about how there was little evidence for pre-European-contact societal collapse,” said study co-author Thegn Ladefoged of the School of Social Sciences in the Faculty of Arts.
To make their findings, the scientists looked at more than 400 obsidian artifacts from six sites around the island. Obsidian absorbs water after being exposed to air, allowing the team to measure the amount of water in the artifacts and determine how old they were. These findings helped the researchers determine land use and population fluctuations based on the number of tools made during each time period.
Sites on the northwest coast of the island showed an increase in population that occurred between 1220 and 1650 followed by a significant decline. The second site on the northwest coast (which was wetter and less prone to drought but had low soil fertility) saw an increase in use from 1200 to 1480 that sustained itself before declining around 1705. The third site, which was both rainy and fertile, showed an increase in use starting at 1250 and remaining consistent until about 1850.
Europeans are believed to have arrived on the island around the year 1722, but these findings suggest the indigenous was already struggling before this occurred.
“It is clear that people were reacting to regional environmental variation on the island before they were devastated by the introduction of European diseases and other historic processes,” Professor Ladefoged concluded.
In the future the researchers plan to examine individual dwelling on the island in hopes of gaining further insight into the interaction between Easter Island’s aboriginal people and the natural environment.
