Regional health areas cannot be ‘mini HSEs’

The six new regional health areas (RHAs) should not be “six mini HSEs”, Ms Yvonne Goff, HSE National Director for Change and Innovation, told the 19th National Health Summit.

At the meeting, which was held in Croke Park on 8 February, Ms Goff said the implementation plan for the RHAs would be completed in “early 2023”.

“We are currently going through one of the biggest reform programmes in decades in the HSE,” she told attendees. “We are looking to devolve responsibility, authority, and decision-making. It is a very large reform programme.”

“What we don’t want to do, because we have very large entities here, we don’t want to create six mini HSEs. It’s very important that we focus on the ground up and make sure that we are organising ourselves within an RHA that can deliver on integrated care.”

Kilkenny GP Dr Ronan Fawsitt, who is a member of the RHA advisory group, also spoke at the Summit. He told the Medical Independent (MI) that GPs have a crucial role to play in the new structures.

“At the moment [doctors] are not really aware of it; it’s not on their radar,” Dr Fawsitt said.

“We have had so many promises and false starts with primary care plans, different reports, Hospital Groups, CHOs and now we have RHAs. So they are thinking ‘are we moving the deckchairs on the Titanic?’. But we’re not. This is a fundamental reform and change and general practice needs to be at the heart of it.”

He told MI that GPs need to “develop a local voice at every acute hospital in Ireland”.

Dr Fawsitt cited GP engagement with St Luke’s General Hospital, Kilkenny, and Tallaght University Hospital, Dublin, as good examples to follow.

“GPs engage with consultants and can actually influence care pathways in and out of the hospital, front door and back door. I also think that general practice needs to be at the heart of the regional health areas, there needs to be representation on the RHAs in each of the six regions.

“I think there is no way you can move care out of the hospitals into general practice without involving GPs in its design and delivery. It will not happen. I think the earlier we are involved in that the better.”