Health services on offshore islands need range of improvements

HSE review finds that islanders find the services fragmented and unpredictable

Tory Island, Co Donegal. The HSE  focuses on the provision of health services to nearly 3,000 people living on 18 islands off the coast of Ireland that are not connected by a land causeway with the mainland. Photograph: Fáilte Ireland
Tory Island, Co Donegal. The HSE focuses on the provision of health services to nearly 3,000 people living on 18 islands off the coast of Ireland that are not connected by a land causeway with the mainland. Photograph: Fáilte Ireland

Health services on the Republic’s offshore islands vary between different islands and need improvement in many areas, according to a HSE review.

The services currently available are regarded by islanders as fragmented and unpredictable, though it is recognised staff work extremely hard to provide a high-quality service with inadequate resources, it says.

And while there are challenges in providing an equitable, cost-effective and high-quality primary care service to the islands, many of these challenges are also shared by communities living in remote rural Ireland.

“Not every service can be delivered on the islands but we should aspire toward the delivery of a quality service working to defined standards and aiming to reduce the need to travel,” the Primary Care Island Services Review states.

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The review was completed in April 2017 but only launched in Galway last week. It focuses on the provision of health services to nearly 3,000 people living on 18 islands off the coast of Ireland that are not connected by a land causeway with the mainland.

The review calls for Government policy to be “island proofed” so that policies take into account the impact on their residents.

A national forum should be set up to implement the recommendation of the review and the HSE’s annual service plan should contain specific objectives on the delivery of services to the islands.

Transport links

Currently, people living on islands have significant distances to travel to access services, the review points out. However, improved transport links, and the use of technology to minimise the burden of travel, are options that need further exploration.

The recruitment and retention of healthcare staff, as well as pay, also pose a challenge. GPs need to be provided with adequate locum support so they can take leave and go for training, while the maintenance of skills of island nurses “requires review”.

The review says primary care should be available in Irish for those who require them and lists of people who can speak Irish should be drawn up in health centres on Gaeltacht islands.

Emergencies

For emergencies, every island should have a medical evacuation policy kept up to date for air evacuations of patients. There should be a major accident plan specific to each island with regular practices scenarios held for relevant groups.

This review was commissioned by the HSE’s primary care division with a view to developing a sustainable, cost-effective quality and fair primary care service that meets the everyday needs of the Irish island populations.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.