The Oireachtas Health Committee has been told that it will be very hard or impossible to realise the Sláintecare health care plan with piecemeal reform.
Dr Sarah Burke, Associate Professor and Director of the Centre for Health Policy and Management at TCD School of Medicine, said that delivering the changes in full, will require years more of high political priority, resource allocation and skilled leadership, as well as meaningful engagement with all stakeholders.
She told the committee that research shows that the planned new six Regional Health Areas design is a very top-down process not inclusive for example of GPs, voluntary organisations and citizens.
She said that work the centre is doing leads it to question if there ever has been a right governance architecture for Sláintecare.
Dr Burke said that while there are significantly many more staff in the health system, Ireland is still making the mistakes of the past and putting them in acute hospitals.
She said that while more hospital capacity is needed, ultimately for Sláintecare to succeed, many more staff are needed in the primary, community and social care settings.
She told the committee that early progress on Sláintecare has been slow and the Covid-19 pandemic delayed things too with staff redeployed.
Dr Burke said that the Sláintecare Action Plan for 2023 has not been published.
She said that on the plus side, the 2023 Budget detailed measures which are very much aligned with Sláintecare, for example the abolition of hospital fees.
Also attending the committee from the centre were Professor Steve Thomas and Dr Bridget Johnson.
Dr Burke said that she would score progress on Sláintecare as four out of ten, given it was "really slow".
In relation to the new Regional Health Areas, she said that the existing people who have power need to devolve it to make the RHAs work.
