Healthcare Reform as the Pandemic Recedes

As the Minister for Finance acknowledged in his Budget speech, the past 19 months has been a period of major challenge for the healthcare system with staff, facilities and patients put under enormous strain.

However, the successful delivery of the Covid-19 vaccination programme illustrates the ability of that system to respond in a coordinated way, adapt as challenges emerge and successfully implement a complex programme across the state.

While recognising the significant additional resources provided in response to the Covid-19 pandemic, understandably, the pandemic has meant that many of the developments and reforms planned for healthcare were delayed. However, as the scale of the pandemic’s impact on the health system slowly recedes, the period ahead is one where there is a unique opportunity to implement significant reform of Ireland’s healthcare system.

As we outline in our annual Socio Economic Review, Social Justice Matters, healthcare has been approached for some time in an unsustainable way that requires comprehensive reform of health policy. The model of healthcare used in Ireland contributes to these issues, including an overemphasis on hospitals and acute care rather than primary and social care being more central. International experience demonstrates that countries with a strong primary care sector have demonstrably better health outcomes, lower mortality rates, and lower overall costs of healthcare.

Underpinning Social Justice Ireland’s approach to healthcare policy is a core policy object ‘to provide an adequate healthcare service focused on enabling people to attain the World Health Organisation’s definition of health as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’.

However, reform will not happen without a commitment to multi-annual investment. Reflecting this, we believe that Government must now prioritise two key areas:

• Ensuring that the c.€4bn additional resources committed for the development of the healthcare system in 2021 are retained and now fully rolled out in 2022 to implement Sláintecare; and
• Enabling the rollout of the major strategic initiatives that must be addressed to move the system towards an effective one-tier healthcare system.

The latter requires the prioritisation of five key strategic areas:

• Enhanced Community Care including the funding and provision of Community Health Networks, Community Specialist Teams and Home Support Services;
• addressing and reducing waiting lists and waiting times for acute hospital, OPD, inpatient and day cases (scheduled care);
• addressing the recurring problems of hospital capacity and the problem of trollies in Emergency departments (unscheduled care);
• prioritising early interventions and improved access to person centred mental health services; and
• resourcing the implementation of a suite of disability supports given Ireland’s signing of the UN convention on the rights of people with disabilities.

Budget 2022 rightly acknowledged the huge contribution of the healthcare sector over the past year and a half. However, it should have done more to facilitate the reforms needed in healthcare in the years to come.