Liam Doran 'none the wiser' about Sláintecare's future after meeting Health Minister

Liam Doran, a member of the Sláintecare Implementation Advisory Council, said he did not know why two people had resigned. Picture: Sam Boal/Photocall Ireland

A member of the Sláintecare Implementation Advisory Council has said he is "none the wiser" following a meeting with the Health Minister as to why two other members of the Council resigned - or where the Sláintecare plan is going.

Liam Doran, a former general secretary of the INMO, was among the members of SIAC who met with Stephen Donnelly on Friday evening, the first such meeting since the shock resignations last week of the council's chair Professor Tom Keane and executive director Laura Magahy.

The minister said the meeting was "productive" and that he had "outlined the Government’s commitment to the implementation of Sláintecare", with a range of issues around the plan discussed.

'We are not sure who is in charge'

Mr Doran said of the "frank" meeting: "I am none the wiser as to why two people resigned and [have] no sense that the Government is of mind to renew and re-energise their commitment to Sláintecare."

Mr Doran said: "We are not sure who is in charge of Sláintecare at the moment."

Another member of the committee said the minister had expressed regret at the recent resignations, but that there was a lack of clarity over "the direction of travel" for the health reforms.

The terms of the current members of SIAC come to an end in the coming weeks and the group is expected to hold its own meeting next week, but with little sense as to what will happen after that.

It is understood that the minister was pressed at the meeting on the three main issues of contention - regionalisation, e-health and waiting lists.

A spokesperson later said the minister remains committed to decentralisation of the HSE and the development of new regional health areas as outlined in Sláintecare.

While the implementation of this has halted because of the pandemic, the spokesperson stressed that work is still proceeding on developing the strategy around this. However, no commitment was provided to those at the meeting as to when the implementation of this key part of Sláintecare will commence.

The spokesperson said there had been some "roadblocks" including the cyber attack, with regards to e-health, but progress is also being made.

The meeting was told the minister intends to publish plans around tackling waiting lists "in the near future".

Some of the group, including Mr Doran, had called for Sláintecare to be brought under the Department of An Taoiseach, however, the minister does not intend to change this.

Mr Donnelly shared the resignation letters with the group during the meeting which lasted for around an hour and a half. It is understood the minister had asked Ms Magahy to attend the meeting, however, she was unavailable.

In her letter, Ms Magahy said " progress has been slow in three key areas requiring dedicated, focused, reform effort: regional health areas; eHealth, and waiting lists."

Prof Keane had said: “Sadly, I have come to conclude that the requirements for implementing this unprecedented programme for change are seriously lacking.”

A policy expert who advised on the original report has criticised the “real absence of urgency” from Government in responding to the Slaintecare crisis,

Dr Sara Burke, assistant professor of Health Policy at Trinity College Dublin, said the resignations of two senior officials is “clear evidence” that reforms are not felt to be supported politically or by the HSE and department of health.

“There has been a real absence of urgency to Minister Donnelly’s response in terms of what happens next,” she said.

I think the resignation of the two senior people responsible for implementing it has the potential to finish it off. 

 

Dr Burke said from the start everyone supporting having an independent implementation office.

“Its success to date was because there was an implementation office driving the reform, but if the person responsible for that has resigned who is going to drive the reform,” she asked.

HSE chief Paul Reid has expressed concerns the pandemic was not a good time to make change.

Referring to this, she said while a complete overhaul would not have worked initial steps could be taken.

She said: “There is never a good time for change. There is evidence too showing a crisis is a good time to change.” Dr Burke said the way the public accesses health now is “unusual”: 

We are a complete outlier in a European and OECD context that we don’t provide medical care on the basis of need, that you need to have money and practically superhuman powers to access care when you need it. 

Separately the chair of South/SouthWest Hospital Group board Professor Geraldine McCarthy resigned referring to delays in setting up regional health authorities with autonomy.

Dr Burke didn’t wish to comment on this directly, but said: “The indecision on the regions is a factor in the future certainty or absence of it for the hospital groups.”