The Irish Times view on Sláintecare: vital questions must be answered

Internal rows between parts of the health service bureaucracy cannot be permitted to get in the way of dealing with problems in the system

It is now more than two weeks since the sudden resignation of two key figures associated with the Sláintecare health reform programme, Prof Tom Keane and Laura Magahy. The departures cast a shadow over the future of the entire programme, which has all- party support and is the blueprint on how the health service should evolve.

Members of the Sláintecare Implementation Advisory Council, which Prof Keane chaired, have warned that the programme is facing a grave crisis and have asked the Government to extend their term of office until the end of the year to address the problems. The Government, for its part, insists it is fully committed to Sláintecare.

There are still significant questions that need to be answered, however. Magahy, in her letter of resignation to Minister for Health Stephen Donnelly, cited “slow progress” in “three key areas requiring dedicated, focused reform effort” .These were proposed new regional structures for the health service, ehealth – or using technology to enhance services – and tackling waiting lists.

Prof Keane said in his letter that “fundamental failures of governance, accountability and commitment continue to make any chance of success impossible”. Neither has spoken publicly and it is now important that they should do so – perhaps to the Oireachtas health committee – at the earliest opportunity. Prof Keane should elaborate on what precisely were these fundamental failures of governance, accountability and commitment.


There have been various, so far unsubstantiated, charges suggesting that either the HSE, figures in the civil service, politicians or others may have been blocking change. If there is evidence of this, it should be brought forward. It is understandable during a pandemic that structural reforms were not afforded as high a priority as they would in normal times. However, if there have been turf wars or other attempts by one group or another to protect their own patch and slow down change, that would be a serious issue.

The Minister seems likely to go before the Oireachtas committee in early October. He should bring with him all the records surrounding the proposed regional health structures under consideration and let the public see who was in favour, or not, of the different options. Sláintecare is an Oireachtas reform plan. It is not the sole property of the Department of Health.

Similarly he should release all the documents surrounding the alleged dispute over the governance and reporting relationships regarding the Government’s forthcoming waiting-list plan.

There are now about 900,000 people queuing for various forms of public hospital care. Any internal rows between parts of the health service bureaucracy cannot be permitted to get in the way of dealing with this problem or of implementing the reform programme in general.