Sláintecare advisory group to be restructured following resignations

The Sláintecare Implementation Advisory Council is to be restructured following a series of recent resignations, Minister for Health Stephen Donnelly has said.

The Sláintecare process has been thrown into turmoil with the resignation of the two officials leading the reforms, prof Tom Keane and Laura Magahy, and, on Thursday, prof Anthony O’Connor.

In his resignation letter prof O’Connor predicts the plan is “doomed to fail” and that the promised devolution of powers to regions and communities “will not happen”.

The remaining members of the SIAC met on Friday night to consider their future course of action, amid signs of internal differences. Some members of the council believed it should seek an early meeting with the leaders of the three Government parties.

A letter to the Taoiseach was drafted on Friday, saying the council “continues to have serious misgivings” about the implementation of Sláintecare arising from “the very stark difference in perspective which exists at this time” but ultimately decided not to send it. The SIAC will meet again on Monday.

The Sláintecare reforms are not just about establishing new regional administrative systems. The plan involves fundamentally changing budgetary arrangements. Under the proposed reforms, budgets in the regional bodies would be allocated on the basis of demographics, health needs, levels of deprivation and specific geographic issues.

In a letter on Saturday night to the remaining members of the SIAC Mr Donnelly said recent events have “cast a shadow over the real progress that has been made”.

Mr Donnelly said as the Council was due to expire this month (on the 24th), he now plans to create a new group to advise his department on Regional Health Areas which are due to be established under the Sláintecare plan.

He said while considerable work has been done in drafting proposals on regional health areas “I believe we need a new group that can advise and test what is being proposed”.

The new group will comprise some of the remaining members of the SIAC, and frontline workers including nurses and doctors and allied health professionals.

The sites of three elective hospitals in Dublin, Cork and Galway – a key recommendation in the original Sláintecare report – are set to be announced next week.

In his letter Mr Donnelly said: “A number of members of the Sláintecare Implementation Advisory Council have kindly agreed to join this new group and I am hugely grateful.”

Mr Donnelly and his secretary general Robert Watt are set to appear before the Oireachtas health committee next Wednesday.

The Minister also said he was aware that “many are concerned about our waiting lists” and said a new taskforce would be set up to address the issue of almost 900,000 waiting for medical care.

“Our waiting lists were bad before the pandemic hit but have worsened.” Mr Donnelly said he would be announcing details in the budget.

He added: “Recent events have cast a shadow over the real progress that has been made in terms of increasing capacity. We have delivered record annual increases in staff and bed numbers, and increased our critical care capacity by 25 per cent since the beginning of 2020.”

Surgeon Prof Paddy Broe says parts of the Sláintecare programme are being “cherry-picked” because overall progress in reforming the health service is slow.

Writing in Saturday’s Irish Times Prof Broe argues that the private hospital sector will need to help public hospitals reduce waiting lists, and suggests a public-private collaboration similar to that operated during the pandemic to improve access to procedures for uninsured patients.

In relation to the public-only Sláintecare consultant contract, he says: “Now is not the time to impose a contract on our young consultants such as surgeons, gastroenterologists, cardiologists and anaesthetists that will keep them ‘locked in’ to the public hospital.”

Prof Broe was one of a number of doctors on the council who resigned earlier in the year, after details of the draft consultant contract emerged.

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