The publication of the first Sláintecare action plan, listing the key areas of focus for 2019, is welcome. It signals progress is being made on the 10-year plan to deliver a health and social care service that meets the needs of our population.
Published in 2017, the Sláintecare report was the work of the cross-party Oireachtas committee. At its core is a vision to achieve a universal single-tier health and social care system where everyone has equitable access to services based on need, not ability to pay.
The action plan has a clear timeline, though much of its detail is (perhaps necessarily at this point) at a macro level. As a result there is little in the plan to assuage the concerns of those waiting three years for cataract surgery or those struggling to find a GP today.
Sláintecare Implementation Advisory Council chair Dr Tom Keane, reflecting on his time as the national cancer Czar, notes that implementation does not happen overnight.
However, he says he is confident that “we have identified and sequenced the first essential steps needed to create the foundations for an Irish health and social care service that, in due course, will provide the right service, in the right place, at the right time.”
The health service has endured a workforce recruitment and retention crisis for a number of years. What does the action plan promise in order to address this in primary care? “Expand capacity in general practice and community nursing to manage chronic disease” is scheduled to occur across the whole year.
The second half of 2019 promises to bring implementation of “new contractual arrangements with GPS and nurses”. However, the document is vague on the practicalities of delivery.
Almost two years after the publication of the original costed Sláintecare plan, the failure to include a budget in this action plan is regrettable. The 2020 action plan will need to be a more specifically costed document for the public to maintain any enthusiasm and confidence in Sláintecare.