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Review
. 2021 Oct:9:100223.
doi: 10.1016/j.lanepe.2021.100223. Epub 2021 Oct 7.

Building health system resilience through policy development in response to COVID-19 in Ireland: From shock to reform

Sara Burke  1 , Sarah Parker  1 , Padraic Fleming  1 , Sarah Barry  1 , Steve Thomas  2
Affiliations
Review

Building health system resilience through policy development in response to COVID-19 in Ireland: From shock to reform

Sara Burke et al. Lancet Reg Health Eur. 2021 Oct.

Abstract

Health systems worldwide are experiencing profound shocks resulting from the COVID-19 pandemic, with increased attention to health system resilience and researching ways to endure shocks. Pre-COVID-19, Ireland had begun a ten-year programme of reform, Sláintecare, aiming to deliver universal, timely access to integrated care. This study examines whether and how the Irish government's pandemic response contributed to health system reform and increased resilience including delivering universal healthcare. Documentary analysis identified and critiqued relevant government, health system and budgetary documents, published March 2020 - May 2021. Thirteen national policy documents were found, showing increased policy rhetoric and intent to implement reform, demonstrated by increased policy alignment with and budgetary allocation to Sláintecare, alongside implementation of key innovations. Ireland's health system response to COVID-19 offers a unique opportunity to advance understanding of government efforts to reform amidst a global pandemic. It indicated policy intent and funding to manage the Irish COVID-19 crisis, but to also build health system resilience through implementing Sláintecare. This case study has international significance, enabling policy development with potential for long-term health system transformation.

Keywords: COVID-19; Health policy; Health system reform; Ireland; Resilience.

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Conflict of interest statement

Sara Burke: Sara Burke's research positon is funded by an Irish Health Research Board grant APA-2019-012 which requires co-funding from knowledge user organisations. This research is cofunded by the HSE and Dept of Health for €40,000 from each organisation. The research article critiques Irish government, Dept of Health and HSE policy and strategic documents. The funding agencies have in no way influenced the content of this article which is independent academic research. Steve Thomas: Steve Thomas's research is funded by an Irish Health Research Board, Research Leader Award to explore health system resilience, reform and staff engagement. Prof Thomas developed a policy brief with the European Observatory on Health Systems and Policies examining health system resilience and is in an unpaid advisory role around the development of a Health Systems Performance Assessment framework for the Irish Dept of Health. Sarah Parker: Sarah Parker's research position is funded by an Irish Health Research Board grant (APA-2019-012) which requires co-funding from knowledge user organisations, including the HSE and Department of Health. The research article critiques Irish government, Dept of Health and HSE policy and strategic documents. The funding agencies have in no way influenced the content of this article which is independent academic research. Padraic Fleming: Padraic Fleming's research position is funded by the Health Research Board grant RLA-2020-001. The Health Research Board (HRB) is a State Agency under the Department of Health. The research article critiques Irish government, Dept of Health and HSE policy and strategic documents. The funding agency has in no way influenced the content of this article which is independent academic research. Sarah Barry: Sarah Barry is a member of the Performance and Delivery Committee of the HSE Board. The role is one of technical assistance and insight

Figures

Fig 1
Fig. 1
New daily cases per 1000,000 in Ireland from Our World in Data The lines reflect the development of daily new confirmed cases of COVID-19 across Ireland (dark blue), Brazil (orange), India (grey), United Kingdom (yellow) and the United States (turquoise) from March 2020 to June 2021.
Fig 2
Fig. 2
Health budget, Ireland 2021 – Major items (€million) ‘Protection from COVID’ relates to extra funds given to enhance all aspects of healthcare devoted to protecting vulnerable groups, staff and patients from the disease; ‘Additional beds’ relates to 2,600 extra beds in hospital and community settings; ‘Extra community services’ relates to enhanced non-COVID care in primary and community settings; ‘Access to care fund’ relates to a new scheme to reduce waiting lists; and ‘Models of care’ relates to new care delivery pathways. The blue bars represent the budgeted amounts allocated to each category in the 2021 Irish Health Budget.
See this image and copyright information in PMC

Comment in

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