2014-04-22 - Socio Economic Review 2014 - Full text and cover - FINAL

access to social care services, for example, be universal as well as access to GP services?
For the strategies outlined to be implemented there is a clear need for an increase in
the proportion of the total healthcare budget being allocated to primary care and a
more comprehensive and integrated approach to social care services to support people
living at home. Instead, a net reduction of €87 million (3.5%) in Community
(demand-led) primary care schemes is provided for in the HSE Service Plan, 2014.
primary care teams and primary care networks
Ireland’s healthcare system has struggled to provide an effective and efficient
response to the health needs of its population. Despite a huge increase in investment
in recent years great problems persist. The development of primary care teams
(PCTs) across the country could have a substantial positive impact on reducing these
problems.
Developing PCTs and primary care networks is intended as the basic building block
of local public health care provision. The Primary Care Team (PCT) is intended to
be a team of health professionals that includes GPs and Practice Nurses, community
nurses (i.e. public health nurses and community RGNs), physiotherapists,
occupational therapists and home-care staff. PCTs are expected to link in with other
community-based disciplines to ensure that health and social needs are addressed.
These include speech and language therapists, dieticians, area medical officers,
community welfare officers, addiction counsellors, community mental health
nurses, consultant psychiatrists and others.
It was envisaged that 530 Primary Care Teams supported by 134 Health and Social
Care Networks would cover the country by 2011. According to the HSE, there were
486 PCTs in place by the end of 2012 (Department of Health, 2012). The work done
on existing teams is very welcome but much more is needed to ensure they
command the confidence and trust of local communities and there is a need for
greater transparency in relation to their roll-out.
The Government’s introduction of a new system of seven Directorates to run the
health system is of concern because this approach is likely to obstruct the delivery
of an integrated healthcare system for service users at local level. There are real
concerns that the new approach will increase rather than reduce costs and
bureaucracy. Instead of an integrated system based on primary care teams at local
level, seven ‘silos’ could emerge, competing for resources and producing a splintered
system that is not effective, sustainable or viable in the long term.
Social Justice Ireland believes that reform of the healthcare system is necessary but is
seriously concerned that the proposed new structure will see each Directorate
establish its own bureaucracy at national, regional and local levels.
8. Healthcare 179