Sláintecare chiefs urged implementation of regional health structures

Regional structures ‘critical enabler’ of reforms, Magahy and Keane told Donnelly


The key figures in the Sláintecare reform programme who resigned last week wrote directly to Minister for Health Stephen Donnelly last April to stress the importance of pressing ahead with plans to introduce new regional structures in the health service.

Laura Magahy, the executive director of the programme, and Prof Tom Keane said in the letter on April 22nd that the introduction of the new regional health areas was "a critical enabler for Sláintecare reform".

In the letter, which followed meetings of the Sláintecare Implementation Advisory Council in December 2020 and March 2021 which considered the areas of most importance and of most risk to the overall reform programme.

Ms Magahy and Prof Keane also said a key risk for the programme related to the recruitment of large numbers of health and social care staff, particularly in areas of global shortage such as nursing.

Mr Donnelly met Ms Magahy on Tuesday but his spokesman did not comment on the proceedings. Neither Ms Magahy nor Prof Keane have spoken publicly since their resignations last week.

The departures are believed to be linked to unhappiness at a perceived slow pace of reform, particularly in relation to new regional structures for the operation of the health service, which formed a key part of the originally cross-party Sláintecare blueprint. Proposals for the regional structures were subsequently put forward by former minister for health Simon Harris more than two years ago.

Mr Donnelly is understood to have accepted arguments put forward by the Health Service Executive that now was not the correct time for major structural reform given the pressures the health service was facing as a result of the pandemic.

Advisory council

The Minister was to have met other members of the Sláintecare Implementation Advisory Council on Thursday but this meeting was postponed. The members had submitted a series of written questions to Mr Donnelly about the background to the resignations.

Patient advocate Róisín Molloy, who is a member of the council, said on Wednesday: “I need to know how the people that convinced me to stay, through expressing so much conviction and belief in the delivery of Sláintecare, could somehow, in a short space of time, walk away. What obstacles led them to this position?”

She said Sláintecare needed to be delivered in accordance with the original cross-party plan “and not in a diluted version”.

Meanwhile, Mr Donnelly said the Sláintecare unit in the Department of Health was working on the selection of a preferred model of "regionalisation" for the health service which would then be submitted to the Government for decision.

He said the "model" would include intended governance structures and relationships between the planned new regional health areas, the HSE centre and the department.

HSE chief executive Paul Reid is expected to use an appearance at the Public Accounts Committee on Thursday to push back against suggestions that have arisen since the high-profile resignations from the Sláintecare figures that his organisation was resistant to change.

“There has been some commentary that Covid-19 masked an underlying resistance to change in the health service. On the contrary, I believe that it brought out the best in all our teams in terms of flexibility, agility and adapting to change at a rapid pace.”

Martin Wall

Martin Wall

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

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times

Cormac McQuinn

Cormac McQuinn

Cormac McQuinn is a Political Correspondent at The Irish Times