Health cuts ‘wrong way’ to reform system, Harvard expert says

Cutting spending and employment in healthcare in Ireland is the wrong way to go about reforming the system, a Harvard professor has told the Health Service Executive at a conference in Dublin.

Speaking after delivering the first day of a two-day master class on Value in Healthcare to the HSE, Prof Robert S Kaplan said fundamental change is needed in the way money is paid out in the health service.

He said one step should involve the formation of integrated units for acute care conditions, but also for primary and population-based care.

“So rather than have a general practitioner dealing with the whole range of conditions . . . we have some that are focused on diabetes and others focus on disability and others focused just on . . . keeping healthy adults and healthy children well,” said Prof Kaplan.

'Superior outcomes'
"Then reward and pay those people for delivering superior outcomes; not paying them for being there, but actually make the payments contingent on excellent outcomes and efficient processes."

He said that during the day he had learned of the “tremendous cuts in spending and employment in the system” and how it has struggled to keep doing “quite a good job”.

“Clearly this is the wrong way to go about reforming the system,” he said. “The system needs to be reformed from within and doing it intelligently in ways that enable you to deliver the same or even better quality of care but at lower cost. That is possible.”

Prof Kaplan is the Marvin Bower professor of leadership development at the Harvard business school and an internationally recognised management specialist.