Doing less with less - The Resilience Project

The final seminar of a three year Health Research Board funded research project by academics in the Centre for Health Policy in Trinity College Dublin which took place on March 31 2014 has revealed a transferring of cost from the State on to people, for example, prescription charges, hospital charges this affects the oldest and sickest most.

The Resilience Project is a three year research programme (2012-2014) assessing the resilience of the Irish health system during the economic crisis.

The research has also found that increased efficiencies in the health system between 2008 and 2012. According to the research, the health system that now has to do less with less.

Dr Steve Thomas, Associate Professor, Centre for Health Policy and Management in Trinity who led the Resilience Project spoke about the economic context within which this study was conducted. He said, “A new government came to power in March 2011 with the most radical proposals for health system reform in the history of the Irish state, including improving access to healthcare, free GP care for all by 2015 and the introduction of Universal Health Insurance after 2016. All this was to be achieved amidst the most severe economic crisis experienced by Ireland since the 1930s, resulting in severe cuts to the health budget.”

The research showed a system that managed ‘to do more with less’ from 2008 to 2012 using increased efficiencies such as clinical care programmes, agreements between health service management and unions which allowed for increased flexibility and productivity; reduced professional fees and drug cost savings. They also found that some of the efficiencies were achieved by transferring the cost of care onto people and through significant resource cuts.

Key Figures about the Irish Health System:

· Approximately €2.7 billion has been cut from the Irish health system since 2009.

· There are over 12,000 fewer Health Service Executive (HSE) staff in December 2013 than there were at the height of public health sector employment in 2007.

· By December 2013 there were 1,890,465 with medical cards, the highest number in the history of the state, (over 600,000 more now than in pre crisis 2007) reflecting lower incomes and higher levels of unemployment.