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Public patients wait four months longer for scans

Posted on October 24, 2019 by Miriam Ahern

People who are unable to afford private medical insurance are disadvantaged when they need to have tests to diagnose serious conditions, according to a new report.

Ireland’s two-tier health service means patients are less likely to get an early diagnosis for a serious illness, such as a brain tumour, if they cannot pay for private diagnostics, the report by  the TASC think-tank highlighted.

The average wait for a brain MRI through the public system is 126 days – over  four months – , the report points out, while private patients wait just six days or about one week.

The situation would be even worse without the involvement of civil society organisations – charities and support groups – which play a significant role in reducing health inequalities in Ireland, it says.

The TASC report examined access to diagnosis for three different conditions: (1) a common cancer such as lung cancer; (2) a rare one such as a brain tumour; and (3) autism spectrum disorder, a complex condition, across three countries with different health systems.

The three countries are Ireland, which does not have universal healthcare and where access is based on residency and, often, means; Germany, which operates a social insurance system; and Spain, which has a national health service.

In Spain and Germany, where healthcare is almost universal, the study notes there were geographical  or regional inequalities in access to lung cancer and brain tumour diagnostics, rather than inequalities based on socioeconomic background.

Move to review laws on non-disclosure deals at work

Posted on June 8, 2019 by Miriam Ahern

THE British government has announced a review of legislation on the use of non-disclosure agreements (NDAs) in the workplace. These ‘gagging agreements’ have often been use to cover-up or hide unacceptable behaviour or harassment by senior managers or business owners.
These legal mechanisms – usually in return for enhanced payments – are becoming increasingly common in Irish workplaces as firms try to limit reputational damage by insisting on confidential clauses related to unacceptable behaviour.

Ben Willmott, head of public policy for the CIPD, said:“We welcome the government’s plans to tackle the minority of cases where NDAs are used unethically to potentially prevent victims of alleged harassment or discrimination from speaking out about their experience.
“We particularly welcome plans to make clear the limitations of a confidentiality clause so individuals signing them fully understand their rights. Proposals to ensure that individuals signing NDAs will get independent legal advice on the limitations of a confidentiality clause are also a positive step,” he added.

“However, changes to the law alone will not help to prevent harassment and discrimination from occurring in the first place. There needs to be far greater recognition in some organisations that their culture has to change. This change starts with leaders and managers role-modelling the right behaviours and a greater focus on boosting diversity and inclusion.”

Ten do’s and don’ts for Irish managers – Sunday Business Post

Posted on January 27, 2014 by Gerald Flynn

Ten Do’s and Don’ts of People Management

[Published in Sunday Business Post’s ‘Your Business’ magazine – 26 January 2014]

By Gerald Flynn

1.       Do take all problems very seriously

People problems always arise in the workplace and may call for corrective action, performance reviews or disciplinary action. These are fraught with procedural hazards a bit like the years of legal loopholes used to get around drink-driving legislation.

Take time to think about how serious this problem actually is. It is a matter of time-keeping, personal/health issues, misbehaviour, inter-personal grievances, or under-performance? Then plan your response and intervention by being very careful to document clearly each step you are taking.

Never accuse anybody of wrong-doing unless you have clear evidence and not just an anonymous or vague complaint. Try a mediating approach first before invoking any formal disciplinary hearing and ensure that your behaviour is reasonable because, if you don’t, the Employment Appeals Tribunal or a Right Commissioner may very well do so some months later.

2.       Do tell people when they’re doing a good job

We are all inclined to take consistent, trouble-free behaviour for granted. Good people managers, as a rule of thumb, should be giving praise or encouragement on a ratio of five to one for every criticism or short-comings they might raise.

The old adage: ‘You’ll catch more flies with honey than with vinegar’, applies very much in a work environment.

3.       Do remember that change cannot be achieved without communication

This is a big organisational problem. The boss or the senior team have a ‘bright idea’ which they expect will boost profits/slash costs/ increase market share/ develop new products. They then come down from the boardroom mountain, like Moses, and announce their great ideas which will take shape from next month.

Communication is a two-way street and as many people likely to be affected should be included in consultation.  Share information and evidence so that ownership of the change spreads to many more people.

There is supposed to be consultation over collective job redundancies or transfers of undertakings, but it rarely happens. Managers just go through the legal motions rather than really asking people for their views and inviting them to raise any concerns or possible alternatives. Then they wonder: ‘Why do we have so many change blockers around here?’ and dismiss them as ‘Luddites’.

4.       Don’t slash training spend to zero

It is very tempting to cut all training and development spending as a first reaction to a downturn. In the short-term it seems much better and fairer than cutting jobs or wages. This was the immediate reaction of many private and public sector organisations after the asset bubble burst in 2008.

A bit like putting off painting your house or cleaning your gutters; you’ll get away with it for a while but the remedial costs after a few years will be much higher with structural problems due to water-seepage and rot.

Better to review learning and select key people for up-skilling and,if money is very tight, persuade them to undertake e-learning initiatives and to do some of it in the evenings or over weekends as ‘self-managed learning’. Ensure that it is job-relevant and tailored to the participants’ educational standards.

 5.       Do prepare thoroughly for an interview

Isn’t that what the applicants or candidates are supposed to do? Well, yes.  They have all read about reviewing your web-site, knowing about your products and services and wearing well-polished shoes.

The person conducting the interview needs to do much more work. Know the job-spec well and have read the CV of each short-listed interviewee noting follow-up questions.  Then plan how to sequence questions and consider where open or probing questions are more appropriate. Be sure that someone on your side of the table is taking notes of times and responses covered as you may need to show them to a third-party should any disappointed candidate take further action.

And, of course, do not ask if they are planning to have children or how old they are – I know you wouldn’t but a surprising number of managers actually do.

6.        Don’t allow a blame culture to take hold

Sadly, this has been a serious handicap in much of the HSE since its establishment ten years ago. It can kill initiative and responsibility in any workplace. The best weapon against it is ‘employee engagement’ so that mistakes are acknowledged, people have input into addressing problems and everyone is encouraged to learn from their mistakes.

This is reinforced by sharing information, having self-managing teams, and clearly including everyone is setting their own targets, goals and performance standards at regular performance conversations.

Delegating tasks and projects, while being there for back-up but not looking over their shoulders, is a great way to boost confidence and encourage initiative.

7.       Do examine underperformance in detail

During the First World War the French military generals were rather keen on shooting their own troops at dawn for underperformance at the front. They called is cowardice but later studies found that many of the conscripts, who spoke southern dialects, had not understood what they were being told to do.

If you feel the someone fails to measure-up, ask yourself is it because they just don’t know how to do it and lack the ability; or have not been trained and so do not have the required skills; or are they unwilling to do it due to poor attitude or motivation; or, finally, like the unfortunate French soldiers, have they not fully understood what they are supposed to do.

Often poor performance is just a reflection of inadequate management of the situation rather than employees trying to make sure you lose the war

8.       Don’t believe that bonuses and pay rises can cure problems

At its most basic employees trade their time and skills for a monthly, electronic cash transfer.  So the more money on offer, often as a performance bonus, should provide even greater motivation and success, or so the crude theory goes.

The reality is somewhat different unless, perhaps, you are a really greedy, senior finance sector executive who can persuade gullible directors that you have “created shareholder value”.  Sure a bonus cheque feels good but occupational psychologists have found that being valued as a professional and being recognised and respected by your manager is a more powerful and longer-term stimulus.

9.       Don’t always think you are captain of  your team

Good people managers are more co-ordinators than captains.  Even in football the manager does not run around the pitch. Instead managers watch individual and collective performance and adjust, where necessary, with repositions and using substitutes when extra support is needed or team players need a break.

Ask how well is this team working together; do we prioritise collectively; if there is disagreement on the tactics, are they openly discussed and considered;  and do we regularly review our team performance.

10.   Do really know yourself and your capacities

The aphorism ‘Know Thyself’ is most often associated with the Greek thinker Socrates and he, apparently, saw it inscribed at the Temple of Apollo at Delphi. He was considered the wisest person in downtown Athens around 400BCE because he openly acknowledged how little he really knew.

We all spend so much time and effort presenting an image that we sometimes believe our own propaganda. Nobody is asking you to change your personality or have a ‘head transplant’ but know your own strengths and weaknesses and try to balance your behaviour to smooth these out.  Be open about what you prefer and respect that the workplace is made up of all sorts of personalities. Understanding yourself is the first step in understanding others.

There is nothing as sad as seeing ambitious, younger managers trying to become clones of their boss.

Gerald Flynn is an employment specialist with Align Management Solutions in Dublin and a former adviser to the CIPD.  E-mail: gflynn@alignmanagement.net