State needs to invest more in primary health care, health expert urges – The Irish Times


The government needs to invest more money in primary and community care to ease the pressure on the hospital system, including emergency rooms and general wards, a leading health research expert has urged.

dr Sara Burke, research assistant professor of health policy at Trinity College Dublin, said the reform proposed in Sláintecare, which includes a transition to primary and community-based care, is the right approach, but more resources are needed to properly implement the transition.

dr Burke said at the Dublin Economics Workshop in Wexford that while investment in the hospital sector was scaled back around 2013 due to austerity measures, the hospital system still received more funding than primary care.

“Yes, we don’t have enough consultants and specialist nurses in hospitals, but to solve the hospital crisis, we really need to move forward with primary and community care to ease the pressure on hospitals and make that shift away from hospitals,” says she said.

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dr Burke, lead researcher on a research team at TCD studying implementation of Sláintecare, said there was initially little progress in implementing the politically agreed package of reforms in 2016-2017 due to a number of external factors.

This included a focus by the Fine Gael-led minority government of 2016 on repealing the Eighth Amendment in 2018, but ironically the emergence of Covid 19 in 2020 meant that many of the proposals contained in Sláintecare were introduced almost by default, she said.

dr Burke said that in February 2020 there was a particular focus in healthcare on managing Covid 19 and when it became clear that Covid 19 would not be a short lived episode there was a very rapid roll out of Covid 19 infrastructure such as PPE, test tracing and Establishment of vaccination centers.

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dr Burke, author of Irish Apartheid: Inequality in Irish Healthcare, said what is remarkable about the state’s response to Covid 19 is the universal way in which measures have been introduced, which is one of the founding principles of the Sláintecare programme.

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“What we saw in releasing hospitals for surge capacity was that you were doing Slaintecare almost by default because you had to do critical care in primary care and in community care,” she said.

Another notable feature was that Covid 19 facilitated the introduction of several reforms proposed in Slaintecare, such as:

Since the relaxation of the emergency measures put in place to deal with Covid 19 and the resignation of Sláintecare Director Laura Magahy and Chair Dr. Tom Keane over the past year, however, progress in implementing the reform measures has stalled, said Dr. burke

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“Right about this time last year, Laura Magahy and Tom Keane resigned, and I would interpret their resignations as meaning that they did not feel they had the political or institutional support to implement the reform, or the possibility of reform, that was going to happen.” they intended to deliver.

“A year ago I was a little more optimistic that the crisis would be a catalyst for the rollout of this long haul that is health care reform – what our research is seeing now is the system going back to type, but we will continue to research and monitor implementation progress.” in the coming years.”

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