Fórsa has welcomed this week’s Cabinet decision to approve the establishment of six HSE regional health areas, which the union says is an essential step towards improved community health services that will ease pressures on acute hospitals.

First announced in 2019, the new structures are designed to devolve HSE decision-making and allow for regional planning, funding, and delivery of integrated health care services.

Fórsa said the Government decision was welcome after recent media reports claimed that the secretary general of the Department of Health was resisting plans for strengthened community health services.

The union’s assistant general secretary, Catherine Keogh, said the development of devolved and high-quality community services was an essential element of the Sláintecare health reform programme, which will ultimately see the establishment of 96 new community healthcare networks across the new regional health areas.

“The current highly centralised approach to health service delivery is not working, and the bureaucratic urge to retain central control over all health operations would inhibit the delivery of universal health care and community health interventions designed to strengthen local services and reduce the burden on our creaking acute hospital system.

“Community services are the bedrock of these ambitious plans for fair, affordable, high-quality health services. That’s why health workers and service-users will welcome today’s Cabinet decision,” she said.

The ten-year Sláintecare plan promised universal quality healthcare, free at the point of delivery, and an end to private practice in public hospitals. Along with free GP and hospital care, it would also herald an end to Ireland’s over-reliance on hospital care through a greater focus on community and primary services.

Catherine said burgeoning hospital queues demonstrated the urgent need to continue to develop community and primary care services.

“Our over-reliance on acute hospitals and their trolleys is a direct result of under-developed regional and community health services. Community and primary care, planned and implemented at regional level, is at the heart of Sláintecare and we need to accelerate the progress that has already been achieved in this area. There’s no alternative to community-led provision if we want to improve access to services and address hospital overcrowding,” she said.

Fórsa also rejected the secretary general’s reported view that the implementation of new Sláintecare structures had led to “endless claims” from unions.

“In our experience, the limited progress on introducing Sláintecare promises so far has not generated union claims. Rather, Fórsa has negotiated constructively in cases where the reforms have demanded additional staffing or new structures and reporting relationships,” said Catherine.

The union pointed out that the Sláintecare report itself recommended increased resources – including staffing – to underpin enhanced community and other services to the public.

Catherine also repeated the union’s call for the Government to implement its longstanding commitment to appoint a specialist health and social care professional (HSCP) advisor in the health department to ensure that physiotherapy, occupational therapy, speech and language therapy, social work, social care and other professional services were placed at the centre of health planning.

“This simple and inexpensive act might help Mr Watt understand and tackle the many challenges of bringing our community health infrastructure up to scratch,” she said.