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The suggestion that Newry, the border area and Daisy Hill Hospital in particular is greatly disadvantaged with the lack of an island wide health service was brought up by the Chairperson of the Daisy Hill Future Group, Dr Conor Patterson at the launch of a new report on an Irish National Health Service.
Ireland's Future have released the report entitled 'An Opportunity for a World Class, All Island National Health Service - An Irish National Health Service' which sets out the current state of play and how an all island service could work. Ireland's Future advocate for, and promote, debate and discussion about Ireland’s future, including the possibility and viability of new constitutional arrangements on the Island.
Chairperson of the Daisy Hill Future Group, Dr Conor Patterson, acted as moderator and explained how sharing resources in both jurisdictions is not a pipe dream but a necessity.
Dr Patterson said "I chair the Daisy Hill Future Group which emerged out of a shared concern about how healthcare was being delivered to people in south Armagh, mid and south Down and Newry City. I'd experienced the effects of a health crisis that's affecting us all personally and that's what drew me into this cross party, cross sector effort to secure change for the better.
He continued "In the last year as someone from outside the health service, as a consumer and as a taxpayer I have learned a huge amount and I've concluded that health service managers are not part of a grand conspiracy to diminish healthcare and dupe citizens. They want to do well but they are constrained by lack of resources and I think the real issue also is that they are having to confine their work and the parameters of the options which they can evaluate to a space which is a very small geography. Tied to working within the confines of that small space and its very small population of professionals, they've had very little opportunity to reconfigure systems as business would and in fact has done in a broader geographical context, to secure economies of scale."
Speaking on Daisy Hill and how it has been hugely disadvantaged due to its location Dr Patterson added "If you take Daisy Hill Hospital in Newry as an example. It has always been measured in terms of the numbers of patients and operations that it can deliver against half of what is its hinterland in actual geographical terms. The half to the north of the hospital and the half to the south has been ignored and the un-met health needs of populations residing there, and the mirror of that has happened in Dundalk and Monaghan and right along the border. Large towns and a city whose location in terms of political geography has disadvantaged them hugely."
He concluded "At a time of workforce shortages, and exponentially increasing demand across the island I believe we need to look towards much greater sharing of resources between these two systems on this small island. That's why I have become part of the debate which Ireland's Future is seeking to promote, not as a pipe dream, but as a necessity to improve the lives of people of all cultures, religions and orientations living in this small island in the Atlantic."
Potential Solutions
Speaking on how a health budget could be spent in a new and united Ireland he report states that both jurisdictions spend similar amounts per citizen on healthcare *
There are currently significant differences in finance routes within the two healthcare systems. One of the key principles of healthcare as experienced by citizens in the North is that services are free at the point of use, whereas in the south citizens pay for GP visits, emergency department attendances and prescriptions.
The South is an outlier among EU countries in terms of charging for GP access, and this would need to be reviewed regardless of work towards a shared system.
Resolving this single issue is likely to remove a key barrier in terms of the perceptions of citizens in the North about the Southern system.
More widely, the North operates a straightforward taxation based model, whereas the Southern system is a mix of public and insurance funding.
A higher proportion of residents in the south have health insurance but the report states that many in north also have but that many also pay for consultations because of long waiting lists.
The report concludes that every area of healthcare would be improved with an all island approach.
An all island approach to healthcare is a medical imperative.
For too long both the HSE and the NHS have operated sub-optimally on the island of Ireland. When the two systems work together they can work well. The example of the congenital heart disease network is a clear example and this was built on a Swedish model. What else can we learn from similar sized countries?
The patients and the medical professionals in Ireland have so much in common. It makes no sense to continue doing things separately. Every area of healthcare would be improved if there was an all island approach.
Waiting lists would undoubtedly shorten but the waiting list system itself, is a system that is designed to fail. A new Irish National Health Service provides an opportunity for significant root and branch reform, in a way that would be necessary given the current state of healthcare.
Check out the report at An Irish National Health Service
