Will a new model for public health become a reality?

In our last editorial, the question was posed as to whether the pandemic would result in a better resourced and funded health service. In response to Covid-19, the healthcare allocation was substantially increased in Budget 2021. Recently, the HSE published its National Service Plan detailing how this additional funding, which is €3.5 billion greater than the figure received last year, will be spent.

Within the extra allocation, some €1.68 billion relates to Covid-19. A total of €1.1 billion of this additional investment is reserved for “permanent and enduring improvements in healthcare” arising from Sláintecare.

According to the plan, the remaining €0.7 billion of this underlying increase is to cover “the increased costs of providing existing levels of service, which have increased due to demographic changes and various cost increases”.

Among the different spending areas outlined, the plan states that €12 million will be allocated to public health. It says that a new model for the delivery of public health medicine based on international evidence and best practice will be designed and established.

This new model will have accompanying workforce and change management plans. Such a new model is to take account of the “Covid-19 environment” in which we all find ourselves. Elsewhere, the plan highlights the importance of ensuring end-to-end Covid-19 testing and contact tracing. It also stated a case and incident management system for health protection was needed to support more efficient and robust reporting and management of infectious disease cases, outbreaks, and incidents.

In this issue of the Medical Independent, we publish a feature on how ‘Stone Age’ IT systems have hampered the ability of public health to respond to the pandemic. The lack of investment in IT, as well as the failure to recruit public health doctors and grant the group consultant status, is especially glaring at a time of a global pandemic.

We also recently reported that the HSE’s updated corporate risk register acknowledges that there is a risk to the ongoing management of Covid-19 crisis due to “inadequate and sustained resourcing of public health teams”.

Recognising an issue is the first step towards solving it, and the hope is that the aspirations within the Service Plan on the new model for public health will be realised. Whether the resources outlined in the plan are sufficient to fill the glaring gaps in service remains to be seen.

Public health doctors have heard a lot of promises in recent times, but have not seen much in the way of action. If the past year has not underlined the value of public health as a specialty, one wonders what it will take for the Government and health management to finally provide these specialists with the recognition and support they need and deserve.