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Sláintecare Council opposes Donnelly’s halt on regionalisation

The Sláintecare Implementation Advisory Council (SIAC) strongly disagreed with Minister for Health Stephen Donnelly’s view that progressing the new regional health areas (RHAs) should be postponed as a result of the Covid-19 pandemic, the Medical Independent (MI) can report.

Minister Donnelly informed the Council of his decision concerning the RHAs during a meeting of the SIAC in September 2020. “The Minister believes the health systems need to be stabilised in order to get through Covid-19,” according to meeting minutes.

“We require to progress with Sláintecare and innovations as far as possible and then look at a reorganisation in due course, but he would not be adding this reorganisation risk to the system at the moment.”

However, significant opposition to the Minister’s standpoint was expressed at the subsequent SIAC meeting in December. Council members said “regionalisation is essential to Sláintecare service redesign and hospitals cannot engage in progressing in this direction until progress is made with the RHAs”, according to minutes. The Minister was not in attendance at the December meeting.

“Sláintecare requires integrated care and the RHAs are the key structures to enable this. The Council should seek to have Government re-engage on regionalisation restructuring, which has been parked during the pandemic.”

SIAC members noted that a “vacuum or uncertainty during a reform programme is unproductive”.

“There will always be problems within the health system, whether it be the pandemic or other crises. Therefore, the regionalisation programme should not be parked, but rather it should be accelerated.”

Furthermore, Council members said they did “not agree with the view of not progressing with the RHAs during a crisis”, with many members “concurring that it is actually the most appropriate time to move to drive change”.

At the meeting in December, it was noted there “were no dissenting views to the importance and critical need” for the RHAs to progress. The SIAC said “this strong message” should be conveyed to the Minister. The Council’s view “that the regions are essential and should proceed” should be impressed upon him, according to minutes. SIAC Chair Dr Tom Keane summed up the discussion saying “there is a very strong and clear message from the Council on the importance of progressing” the RHAs.

The SIAC, which comprises 21 members including a number of doctors, provides advice to the Sláintecare programme implementation office in the Department of Health. In July 2019, the Government approved the creation of six new RHAs as part of reforming the health service. A Department spokesperson told MI work on the RHAs “had understandably been put on hold during the height of the pandemic… but has resumed in recent months”.

“The rationale for developing the regional health areas is to improve clinical governance, corporate governance, and accountability; to enable a population-based approach to service planning; and to better integrate community and acute services.”

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