State faces existential crisis in healthcare, says HSE chief

Any reform plan without cross-party support is doomed to fail, claims Tony O’Brien

Without reforms, the country will face an existential crisis in its capacity to provide healthcare for the population in the years ahead, the head of the HSE Tony O’Brien has said.

Speaking at the annual conference of the Irish Medical Organisation (IMO) in Killarney on Thursday he said the Sláintecare reform programme represented a once-in a generation opportunity to implement changes.

The Sláintecare report was drawn up last year by an Oireachtas committee and proposes a multi-billion euro transformation of the health service providing a greater shift of emphasis towards primary care. It also proposes the elimination of private practice in public hospitals.

Mr O’Brien said without the type of cross-party consensus which the Sláintecare blueprint enjoyed in the Oireachtas, any plan for changing the operation of the health service would almost certainly be doomed to failure as it would fall in the next electoral cycle.

Mr O’Brien said: “If we do nothing, based on what we know about the problems of the healthcare system that we have today and the increasing demand for healthcare that our current population and its future needs will represent, together with workforce issues we face, in the absence of determined action, an existential crisis in our capacity to provide the healthcare that our population needs.”

He said in the past there had been many efforts to reform and improve the health service that had been started but never completed. He said one of the reasons for this was electoral cycle which often reversed one policy before it was completed and replaced it with another that would not be finalised either.

Mr O’Brien said it was very possible to take issue with some of the raw material, sequencing or aspirations set out in the Sláintecare report but what it did offer was a once-in-a-generation opportunity as it had the backing of all political parties in the Oireachtas.

He said it had the potential to transcend the electoral cycle and survive from one government to the next.

Mr O’Brien said the criticism that the report did not in itself provide a precise implementation framework or in itself provide the funding was holding it to a standard that it was never expected to meet.

He said the next step was for the Government to produce an implementation plan, to bring forward multi-year funding to finance the transitional fund which the report recommends and to move the project forward.

The chairman of the Oireachtas health committee Dr Michael Harty said he believed the Sláintecare report had some substance.

He said the report proposed a whole-of-service reform from the bottom to the top.

"It is not an à la carte list of disconnected recommendations that can be implemented independently, one from the other."

He said it would demand a level of sophistication not seen before in health service planning.

But Kilkenny GP Tadhg Crowley said the report represented "blue sky thinking without blue sky funding".

Martin Wall

Martin Wall

Martin Wall is Washington Correspondent of The Irish Times. He was previously industry correspondent