The Irish healthcare system is a mess, the director of the Adelaide Hospital Society said last night; and while shelves were "groaning" with reports on how to improve it, little action was being taken.
Dr Fergus O'Ferrall said it was time to confront the crisis: "We need to think differently about our overall approach to healthcare. We need to develop new thinking around the principle of people centredness."
He was speaking at an Irish Times/Academy of Medicine lecture in Dublin on the topic "People Centredness: the Contribution of Community and Voluntary Organisations to Healthcare."
Dr O'Ferrall said the principle of people centredness was incorporated into the national health strategy published in November 2001, but so far it had not engaged the public or the health system to any significant degree.
The health strategy's new vision was "already being pushed to one side" in the context of budgetary restraints, and there was a danger the strategy would become "a paper monument to a revolutionary cultural shift" that was planned but never occurred.
"We need to develop a people-based healthcare culture which will free our citizens to take responsibility for the health status and health outcomes of their own areas and communities," he said.
This would require existing systems and structures to let go of some of the power and authority they had been used to and "accept its redistribution into networks in which they are one, but not necessarily the dominant, player".
Describing the voluntary healthcare sector as "the sleeping giant in Irish healthcare", he said a high price would be paid for disengaging from them and community organisations.
Dr O'Ferrall said there had to be an effective "interface" between voluntary organisations and formal service agencies of the State. "Despite the assertions in the health strategy, we do not have an effective interface.
"I believe that the many hundreds of community and voluntary healthcare organisations represent a key reservoir for the new people-centred healthcare service of the future," he added.
If these groups were engaged in the change process we would, he predicted, become "a healthy society in contrast to the current unhealthy society which we inhabit".