'I’d give Sláintecare four thus far': Healthcare reforms not happening fast enough
Concerns were also raised around the way reform is being run with the HSE and Department of Health in charge, which one speaker described as expecting turkeys to vote for Christmas.
Healthcare reforms only deserve a four out of 10 score as change is not happening fast enough nor is there enough of it, the Oireachtas Health Committee heard on Wednesday.
Some services have seen noticeable improvements but overall Sláintecare reforms have been “piecemeal”, the committee heard from academics specialising in health at Trinity College Dublin.
Concerns were also raised around the way reform is being run with the HSE and Department of Health in charge, which one speaker described as expecting turkeys to vote for Christmas.
Trinity College Dublin Centre for Health Policy and Management Discipline of Public Health and Primary Care director Professor Sara Burke said reforms needed to be more than individual projects.
“I’d give Sláintecare four thus far because it’s really slow,” she said. “It’s really hard to change, when you talk about healthcare systems it’s like an enormous aircraft carrier, it’s really hard to change direction. We are changing the direction in the right way, but much more is needed.”
She told People Before Profit TD Gino Kenny this is because key building blocks including workforce changes and digital strategies were not in place.
She added: “Continued political leadership and drive, coherence at the top, the department reforming, the HSE reforming, there is lots to be done.”
Her colleague Professor Steve Thomas supported this score. He pointed to the recent removal of hospital fees for patients, saying: “[This] was planned for the first year of Sláintecare, it is now being delivered in year six-seven.”
Prof Burke said the pressures of covid-19 led to a lot of change, citing access to remote appointments and independent health identifier numbers while praising the agile response, particularly in early 2020.
However she highlighted the lack of legislation to support reform with Social Democrats co-leader Róisín Shortall in terms of legal entitlement to healthcare.
“It’s something we feel very strongly is a key pillar of Sláintecare, and it is one of the areas they are slowest to act upon,” she said.
The committee heard five pieces of legislation were needed.
The urgent need to increase access to free public healthcare was highlighted by Dr Bridget Johnston, also of TCD.
“Pre-pandemic, pre-cost-of-living crisis, we found that almost 20% of Irish households couldn’t afford what they spend on healthcare,” she said.
“That it either impoverished them further or pushed them into poverty. Or they were spending more than 40% of their monthly budget on healthcare, that is the direct charges they were paying at the time they accessed it but also paying for their private health insurance premiums.”
She described healthcare access as: “A slow-bubbling crisis for a long time”.
The academics expressed frustration at information flows, saying a regional health area implementation plan due before the end of last year was still not published, neither was the HSE 2023 National Service Plan nor the Sláintecare Action Plan for 2023.
Senator Martin Conway raised questions about leadership, referring to a series of resignations from Sláintecare during 2021.
Prof Burke said: “I’m totally absorbed in this, and I don’t understand who is actually responsible for Sláintecare. The head of the HSE reports to his board, and the head of the Department of Health reports to the minister, so who is actually responsible for this?”
She agreed with Senator Conway the whole service was responsible, but said: “You need somebody to deliver on it, you do need an ultimate point of responsibility.”
