Engagement eases hospital changes in South

Reconfiguration of hospital services in the south of the country was smoother than in other regions largely because people’s views were taken on board, a study has found.

More meaningful engagement with stakeholders in Cork and Kerry meant while protests did take place, opposition to the reconfiguration of acute hospital services and emergency services was not as acute as in the Midwest or Northeast.

The study found the southern region, where reconfiguration was headed up by obstetrician/gynaecologist Professor John Higgins, engaged in a more inclusive engagement process “with a broad range of stakeholders apparently involved in designing the final reconfiguration plan”.

While protests did take place in the South, “there did not appear to be the same degree of animosity” as in the Northeast and Midwest. Researchers found that in the Northeast and Midwest, engagement was “typically characterised as little more than information- sharing” and “opposition among the public and other external stakeholders was a notable feature”.

In the Northeast, hospital campaigners and GPs generally rejected the case for change, questioning the evidence provided and motivations behind the plan.

In the Midwest, GPs expressed concern at the loss of access to services at several hospitals. “There wasn’t consultation, it was decided that ‘we’re doing this and that’s it’ and the level of consultation, that’s a very important thing. Consultation means ‘evacuate your bases in Crimea, we’re moving in’, that’s consultation from the HSE,” one GP said.

The authors concluded that the need to develop “effective public engagement strategies is particularly pressing in the ‘post-truth’ world, where authority and expertise are coming under increasing public scrutiny” and that wheeling out expert opinion is not enough to convince the public.

The study, by Foley C et al, ‘Understanding Perspectives on Major System Change: A comparative case study of public engagement and the implementation of urgent and emergency care system reconfiguration’, has been published in Elsevier’s online science journal.