A health research expert has urged that the government needs to invest more money in primary and community care in order to relieve pressure on the hospital system including emergency departments and general wards.
Dr Sarah Burke, associate research professor of health policy at Trinity College Dublin, said the proposed reform in Sláintecare that includes moving toward primary and community care was the right approach, but more funding was needed to properly implement the transition.
Dr Burke told the Dublin Economic Workshop in Wexford that while investment in the hospital sector was reduced around 2013 due to austerity measures, the hospital system still received more funding for that primary care.
“Yes, we don’t have enough specialist consultants and nurses in hospitals, but in order to solve the hospital crisis, we really need to preload primary and community care to take the pressure off hospitals and make this shift away from hospitals,” he said.
Dr. Burke, who is the principal investigator on a team of researchers at TCD examining how Sláintecare is being implemented, said initially there was little progress in implementing the politically agreed reform package in 2016 and 2017 due to a number of external factors.
This included the focus of the 2016 minority government led by Fine Gael on repealing the Eighth Amendment in 2018, but somewhat ironically, the emergence of Covid 19 in 2020 led to many of the proposals included in Sláintecare being made almost by default, she said.
Dr Burke said that in February 2020, there was a singular focus in Health on dealing with Covid 19 and once he realized that Covid 19 was not going to be a short-lived episode, there was a very rapid spread of Covid 19 infrastructure such as personal protective equipment, tracing of tests and setting up of vaccination centers .
Dr Burke, author of Irish Apartheid: Inequality in Irish Healthcare, said what was notable in the country’s response to Covid 19 was the global way in which the measures were implemented, which was in line with one of the core tenets of the Sláintecare programme.
“What we saw with the liberalization of hospitals in order to increase capacity is that, almost by default, you were making Sláintecare happen because you had to provide critical care in primary and community care settings,” she said.
Another notable feature is that Covid 19 has facilitated the introduction of many of the proposed reforms in Sláintecare such as the introduction of electronic prescriptions, which health reformers have been searching for for decades without success but delivered within days of the pandemic.
However, since the relaxation of emergency measures introduced to deal with Covid 19 and the resignation of Sláintecare Director Laura Magahi and Chairman Dr Tom Keen last year, progress towards implementing reform measures has stalled, Dr Burke said.
“It was exactly this time last year when Laura Magahi and Tom Kane resigned and my view was in their resignations that they did not feel that they had the political or institutional support to implement the reform or the potential for reform that they were supposed to be.
“A year ago, I was a little more optimistic that the crisis would be a catalyst for the introduction of that long-term health reform – what our research now sees is that the system is back in kind, but we will continue to research and monitor progress in implementation in the coming years.”