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Comment by monk_e_boy | Hacker News Reader

Doctors are also important. And nurses. And the admin team. And the cleaners....

I didn't say they weren't important. But, what a waste, when the doctor saves the life via an operation, the nurse administers care, and the patient dies from an infection acquired due to a dirty ward, when it could be so easily avoided, by respecting the important role of the cleaner, starting with actually making them employees, paying them well, proper training, materials and care, and finally, giving them respect, so they feel proud, as they save the life just as much as the doctor or the nurse.

What a waste, when a patient dies in a shining, clean ward because no doctor was there. ;-)

But I agree, cleaners should be more respected.

And now that we've stated both boundary conditions, we can have a productive discussion - is the pay allocation in a hospital arranged optimally in terms of lifes saved and if not, then how can we shift the arrangement (i.e. who should be paid more, and who less) to maximize the effectiveness of that hospital in saving lives?

Doctors are harder to train, as such they are a rarer resource, and more expensive. We can freely pay cleaners less, and purchase more doctors. Isn't that how it works?

Yes, but hiring more doctors is counterproductive if their work is regularly being undone because of bad sanitation. In such a case, a dollar invested in cleaners buys a greater fraction of lives than same dollar invested in doctors.

> a dollar invested in cleaners buys a greater fraction of lives than same dollar invested in doctors

the dollar equation is relative, i.e. "in such a case". The balance point still ends up with doctors being payed more, and cleaners significantly less.

Plus, who guarantees that dollar cleaning improvement? Maybe all you'll be doing is setting a precedent for higher pay - you need more to correlate with better cleaning. Maybe regular (independent) inspections & testing?

Do you have any reason to believe it's suboptimal? It doesn't seem particularly implausible that the current allocation is close to optimal, and presumably hospital administrators and the like look at the numbers and allocate resources where they think they will most effectively lead to saved lives, no?

Not saying that isn't important, but at some point, the cleaning only takes a certain level of skill.

Having a trashy ward - is much more likely a failure of the management / admin team in training & superversion than it is on the cleaner specifically.

Not saying you should treat cleaners poorly, but it does explain the wage level.

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