Transcript Navigating the Political Maze of Healthcare

Navigating the
Political
Maze of
Healthcare
Eilish McAuliffe, Senior Lecturer/Director, Health Policy and
Management, Trinity College Dublin.
Frank Ahern, Former Assistant Secretary, Department of Health &
Children
Part-time lecturer, Health Policy and Management, Trinity College Dublin.
Fergus O Ferrall, Director, Adelaide Society & Part-time lecturer, Health
Policy and Management, Trinity College Dublin
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The Book
Contributors:
Michael Kelly, Chairman of the Higher Education Authority and Former Secretary
General,
Department of Health and Children
John Owens, Chairman of the Mental Health Commission and Consultant
Psychiatrist
Ruth Barrington, Former Chief Executive, Health Research Board
Fenton Howell, Public Health Specialist, HSE North East and Shane Allwright,
Associate
Professor, Department of Public Health and Primary Care, Trinity College
Frank Ahern, Former Assistant Secretary, Department of Health and Children
Matt Merrigan, National Industrial Secretary, SIPTU
Anne Scott, Head of the School of Nursing and Deputy President of Dublin City
University
Aileen O Meara, Independent journalist and media consultant, formerly RTE’s Chief
health
correspondent
Fergus O Ferrall, Chairman of the Adelaide Society
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Content of workshop
• The critical elements of health service reform
– The practice of reforming in a politicized environment
• Story of reforming from the inside out - Frank Ahern
• Story of reforming from the outside in – Fergus O Ferrall
• Navigating the political maze
– Common characteristics of successful navigators
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Critical elements of reform
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timing
financial viability
political will and leadership
strategic alliances
public support
well-managed process
technical infrastructure and capacity.
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Saltman & Figueras (1997: 259)
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Timing
• New mood for strategic thinking
• Led to several national strategies and policy
documents
• National Health Strategy (2001)
• DoHC move away from operational
management – Health Services Executive (2005)
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Timing
• Busy period of policy formulation in healthcare
– Long-term perspective
• Policy implementation
– short-term
– Influenced by political cycle
– Eg. Priority of health strategy diminished with
changing Minister
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Financial viability
• National Health Strategy funding
– Not supported by Dept of Finance
• De-institutionalisation of mental health patients
– Without additional finances
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Strategic alliances
• Smoking Ban
– Strategic alliances to counter the anti-ban alcohol
industry
• Development of Nursing Profession
– Strategic alliances needed to transfer to university
environment
• Health Services National Partnership
– Reduction in strike action
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Public support
• Unwillingness to engage with the public has led to
difficulties implementing hospital reconfiguration
• Democratic deficit has had many negative effects on
the nature and progress of healthcare reform
• Poor relationships with media have led to focus on
“bad news” stories creating ever-widening divide
between the public and the healthcare system
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The practice of reforming in a
politicized environment
– Story of reforming from the inside out Frank Ahern
– Story of reforming from the outside in –
Fergus O Ferrall
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