Sláintecare: Three new elective hospitals and plan to tackle waiting lists set to be announced

The Government is planning several high-profile announcements this month designed to restore confidence in Sláintecare reforms for the health service following a series of resignations among those leading the process.

The sites of three elective hospitals in Dublin, Cork and Galway – a key recommendation in the original Sláintecare report – are set to be announced next week.

The following week, the budget is expected to include a plan specifically aimed at reversing the effects of the Covid-19 pandemic on waiting lists. Later, a broader, five-year plan for the elimination of waiting lists will be published.

The Sláintecare process has been thrown into turmoil with the resignation of the two officials leading the reforms, Prof Tom Keane and Laura Magahy, and, on Thursday, Prof Anthony O'Connor, a member of the Sláintecare Implementation Advisory Council.

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The remaining members of the council met last night to consider their future course of action, amid signs of internal differences.

Some members of the council believed it should seek an early meeting with the leaders of the three Government parties. A letter to the Taoiseach was drafted on Friday, saying the council “continues to have serious misgivings” about the implementation of Sláintecare arising from “the very stark difference in perspective which exists at this time”.

However, other members suggested holding off holding off until Minister for Health Stephen Donnelly and his secretary general Robert Watt appear before the Oireachtas health committee next Wednesday. The council decided last night not to send the letter but will meet again on Monday.

The health committee has invited Ms Magahy, the former Sláintecare executive director, and Prof Keane, the chairman, to appear before it the following week but they have yet to respond.

Council member Róisín Molloy said on Friday the process was in crisis and she was not reassured that there was a commitment to implementing Sláintecare. "A modified plan, taking pieces out of it, is not Sláintecare," she told RTÉ radio.

Well-placed sources described the in-person meeting of five council members with Health Service Executive chief executive Paul Reid and Mr Watt this week as a "disaster" and a "car crash", with much acrimony around the public responses to the high-profile resignations of recent weeks.

‘Window dressing’

Meanwhile, another council member, who resigned in the summer, has described its role as “just window dressing”

Surgeon Prof Paddy Broe says parts of the Sláintecare programme are being "cherry-picked" because overall progress in reforming the health service is slow.

Prof Broe, writing in Saturday’s Irish Times, argues that the private hospital sector will need to help public hospitals reduce waiting lists, and suggests a public-private collaboration similar to that operated during the pandemic to improve access to procedures for uninsured patients.

In relation to the public-only Sláintecare consultant contract, he says: “Now is not the time to impose a contract on our young consultants such as surgeons, gastroenterologists, cardiologists and anaesthetists that will keep them ‘locked in’ to the public hospital.”

Prof Broe was one of a number of doctors on the council who resigned earlier in the year, after details of the draft consultant contract emerged.

Another council member, emergency medicine consultant Dr Emily O’Conor, resigned when the contract was not tabled for discussion at a meeting. “What transpired [in the draft contract], with clauses limiting advocacy and a failure to incentivise intense and antisocial working, is particularly ill-advised,” she said in her resignation letter.

Taoiseach Micheál Martin, who has spoken to Prof Keane and Ms Magahy in recent days, said on Friday the Government was committed to delivering on the key principles of Sláintecare and would address their concerns.