Ireland’s health service is close to “total systems failure,” according to the doctor who reformed the State’s cancer services.
The way healthcare is delivered has to change before this tipping point is reached to forestall a "profoundly negative" impact on people dependent on the public system, Dr Tom Keane, former director of the National Cancer Control Programme, has warned.
Dr Keane, who has chaired a new expert report on the future of the health service convened by the Royal College of Physicians of Ireland, says previous reports that pointed to the direction of reform have not been implemented.
“This failure to implement radical reforms is sustaining the current crisis-ridden system that is struggling to meet the demands of those requiring healthcare and frustrating and potentially harming patients in a way that is utterly unacceptable.”
The Oireachtas has to hold the health system to account for making the changes required by centring services on the needs of patients, he says.
“My own experience in working to implement a radical redesign of cancer services in Ireland a decade ago is instructive. Cancer outcomes and quality have improved significantly. The reasons are many, but those most prominent are a well-designed evidence-based plan, strong clinical leadership, excellent communication and perhaps most important of all strong and sustained political support.”
The Towards 2026 report says only strong leadership can overcome the lack of trust in the system and bring about change. "It must be recognised there is a crisis in leadership at all levels, and there has been a lack of support for leadership development."
It advocates greater accountability, clarity on funding, and more action to keep people well and therefore out of hospital.
“Our existing system has pockets of excellence, but until we address the many systemic problems caused by a lack of process and transparency, we will remain anchored in the past,” according to Dr Keane.”This process is less about ‘fixing’ existing hospitals as it is about imagining a different way.”
Dr Keane said if any other country had the kind of problems found in the Irish health service “the Government would not survive”. It was “astonishing” that people were not marching for better health services in the same numbers as they had on the issue of water charges, he told RTÉ Radio.
Implementing change in the health service required the creation of an independent commission separate from the HSE or the Department of Health, he said, and unless this happened, “we’re looking at an apocalyptic scenario down the road”.
Dr Keane said “untoward outcomes” for patient were inevitable given the level of delays in the system, adding: “If you have to wait more than 12 months for an appointment you may as well not have that appointment”.
