Sláintecare crisis


Sir – Sláintecare is the most important healthcare reform in the history of the State. It’s not a structure. It’s an idea – a mechanism to take politics out of healthcare so we the people can collectively decide and deliver the best possible healthcare system, locally and regionally.

It isn’t perfect. But it is designed to become increasingly so – by regional, autonomous, and accountable care – not to politicians, vested interests or multiple organisations, but to the people, through one integrated system, owned, managed and responsive locally, based on regional population need.

Right care, right place, right time. An end to silos. Putting the needs of patients first – not the needs of organisations.

Its mission provides the people with the care they need, close to home, given by those who know them best (GPs, nurses, consultants) in a community that works together. One budget, one system, one plan.

One centralised HSE structure has not worked.

A devolved structure is required with local co-design, eHealth enablers and collective implementation. Each regional health area being integrated, population-focused and accountable.

Laura Magahy and Tom Keane had that vision and purpose. They each had a track record of success in complex transformations. Their loss is a major crisis for Sláintecare.

We on the Sláintecare Implementation Advisory Council (SIAC) trusted them. Not once did we doubt their integrity, wisdom or determination – even when we disagreed on aspects. They were not quitters – but they were realists.

If the Sláintecare project can’t succeed because the political and administrative support required for transformation through early regional devolution, is not forthcoming, then let’s name that.

Regional health areas are central to Sláintecare’s success. Without these we will flounder in perpetual indecision, and politics, vested interests and centralisation will continue to dictate the ne plus ultra of our healthcare reform.

The 900,000 patients on waiting lists to see specialists in a population of five million is an indictment to a failed system of centralised care.

To move forward from this crisis, we must re-commit to Sláintecare implementation with urgency – devolve and deliver the regions, hold them accountable to the higher purpose: right care, right place, right time – but begin now. 

– Yours, etc,


Member SIAC,

Castle Gardens Medical