Plans to reduce hospital waiting lists under the Sláintecare plan have been hit by a “significant challenge”, a new report has said.
It comes as members of the Sláintecare Implementation Advisory Council (SIAC) expressed “shock, regret and concern” at the decision of two senior officials to leave the programme, which aims to end the country's two-tier health service.
The Sláintecare progress report for January to July 2021 highlighted three areas of delivery facing a “significant challenge”, 25 that were progressed but with a “minor challenge” and 84 that were “on track”.
The report said a plan to reduce Ireland’s hospital waiting lists, which now stand at more than 900,000, was not agreed.
An objective to “agree actions to deliver a multi-annual plan on reducing waiting lists and assign ownership” was cited as a significant challenge.
The report said that while “actions to deliver the multi-annual plan have been drafted”, the “ownership of actions and implementation oversight is still under consideration”.
Another area cited as a “significant challenge” was the Sláintecare recommendation to devolve the Health Service Executive (HSE) into six regional health authorities (RHA).
“Revisions are continuing in light of feedback from DoH (Department of Health) stakeholders,” the report said.
“However, engagement with the HSE, clinicians, and patient representatives has been delayed due to competing cyberattack and pandemic priorities.”
Efforts to further the rollout of community eHealth initiatives were also “significantly impacted by the cyberattack”.
The Sláintecare programme aims to end the State's two-tier health system of both public and private care, and deliver a universal system where access is not determined by ability to pay.
But the project has been rocked by the resignations of executive director Laura Magahy, and Dr Tom Keane, the chair of the SIAC.
In a strongly worded statement on Friday, 11 members of the SIAC called for clarity from the health minister on the issues that led to their resignations.
It said: “News of their resignations is a cause of shock, regret and concern to us and we are actively seeking answers from the Department of Health and the minister regarding the events that led up to and resulted in their resignation.
“In light of these developments, as members of SIAC, we urge the Government to ensure the Slaintecare programme of reforms is implemented in word, deed and spirit.”
Minister for Health Stephen Donnelly praised the departing officials for the “fantastic job” they had done on Sláintecare to date, and said reducing waiting lists remains a “top, top priority” for the Government.
He said: “Before Covid arrived here we had some of the longest waiting lists in Europe, they were too long, they were unacceptable then.
“They are a lot longer now, because of Covid, because of the cyberattack, and they are unacceptable now.
“We’re putting an awful lot of resources into bringing those waiting lists down. That has been and will continue to be a top priority.”
The Minister accepted that the programme had been hit by delays, with eHealth in particular described as a “mixed bag”.
“I would say that some of the planning in terms of the larger infrastructure of reform … hasn’t happened at the pace we would like, partly because of Covid, partly because of the cyberattack,” he said.
“At the same time, we’ve actually seen huge advances through necessity in things like telemedicine and other areas.”
He said: “What we’ve got to do is continue with the mission, which is universal healthcare.
“We have a two-tier system of healthcare in this country, which is completely unacceptable. And we need radical policies to deal with that.”