Sláintecare is ‘light at end of the tunnel’ for health system, Harris says

Minister says Government committed to reform plan despite failure to set budget or timeline

Minister for Health Simon Harris and Laura Magahy, executive director of the Sláintecare Programme Office. Photograph: Nick Bradshaw/The Irish Times.

Minister for Health Simon Harris and Laura Magahy, executive director of the Sláintecare Programme Office. Photograph: Nick Bradshaw/The Irish Times.


The Government’s has unveiled its 10-year plan to reform the health service but has failed to provide a definitive timeline for the Sláintecare initiative or to allocate a budget for it.

Minister for Health Simon Harris insisted the Government was committed to the implementation of the 106 actions contained in the Sláintecare implementation plan and will provide the necessary funding.

A final cost could not be determined at this time, he said, as there were “significant contractual negotiations with many stakeholders in the health service” to be undertaken.

Mr Harris said ministers had over the years kept “chopping and changing plans” but this is the plan that has the support of all political parties and would not change.

“This is the vision. If you are working in the health service today, if you are a nurse or a doctor or a healthcare assistant, if you are working in our primary care or caring for the elderly and you are working bloody hard and you are wondering if there is light at the end of the tunnel,” he said.

“This is that. This is how we are going to get there. We are not going to get there overnight. We are going to work with you, we are going to engage with you.”

The National Association of General Practitioners claimed this was empty rhetoric by the Minister and warned that its members would be advised to work to contract if there is no funding for GP-led primary care and Sláintecare.

The plan contains commitments to expand on community care by establishing more primary care centres and to increasing capacity across the health service. It sets out an ambitious target of waiting lists being no longer than 12 weeks and to developing legislation to underpin those guarantees. Figures compiled by Fianna Fáil this week show the number of people on waiting lists for various medical procedures has reached almost one million.


Speaking at a news conference, Mr Harris said: “If you are an Irish person waiting for a hip operation, a knee operation, or a cataract operation – how long should you have to wait? How can we guarantee that it will be delivered? We are going to look at underpinning that with legislation.”

The Sláintecare report, produced by an all-party committee and published over a year ago, has been hailed by its supporters as a blueprint for the future of the health service. It recommends a series of reforms throughout the health service, including the complete separation of the public and private systems of healthcare which currently overlap in many instances.

The action plan published on Wednesday does not address the issue of private care in public hospitals as the findings of an expert group asked to examine the matter are being awaited. The Minister said private health insurance generated significant income for the public health system but stressed that access to healthcare cannot be based on ability to pay.

Mr Harris said he did not accept that doctors should be compensated if private practice is disentangled from public hospitals, but added that there would be a requirement for contract negotiations.

“I don’t accept this is beyond us. I mean, why are we happy to be outliers on this? This is not normal,” he said. “I sometimes think we have convinced ourselves in this country that this is the norm...It is not going to be straightforward or easy but it is certainly right that Slaintecare asks us tease it out, report on it and publish it.”

The 10-year plan will be funded through a multi-annual fund and overruns in the Health Service Executive will not effect the funding of Slánintecare, the Minister said.

The implementation plan, which is based on the Oireachtas committee’s report, does not examine mental health or disability services. It also does not include some elements of primary care or the ambulance service.

While accepting many health service workers have reform fatigue, the Minister urged them to have faith in this plan.