Everybody knows there are profound problems of passive management, demoralised staff and institutional sclerosis. But, for honourable reasons, nobody wants to say this too openly for fear of talking down the system or betraying their colleagues.
Most people who go into the system really want to do a good job. They start out with idealism and commitment. As they learn the ropes, they see how things could be done better, more efficiently and more humanely. They think they can make these changes happen. And then they’re buried under the inertia of the other three kinds of people.
What anyone who works in the system will tell you is that there is no penalty for cynicism. If you’re a low-level worker who can’t be bothered, your colleagues and supervisors just have to find a way to take up the slack. They have no confidence that their superiors will support them if they cause “trouble”. So the whole system is less about working than working around. The good people – and they are the large majority at every level – work around the bad practices.One is that the hospital system was built on an alliance of religious orders and consultants. The first group has a direct line to God, the secondGod.
finally some sense from o'toole, few and far between over last few years...
It is recognised that in the institutional setting a bad outcome resulting from no decision being made is less likely to be punished than when a decision is made that results in the same outcome.
Perhaps we could learn from management that are doing the right things in the right way? . DonnellyStephen RTENewsAtOne drivetimerte
Ah, yes, Fintan, a centralised patient system would be best. But people would object. The contrarians wouldn’t want to hand over their medical information to the government. They would think it would be used against them somehow.