Saturday 24 August 2019

Poor planning has 'created postcode lottery' for basic health services

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Eilish O'Regan

Eilish O'Regan

Access to basic community health services, such as GPs, home help, nursing home care and physiotherapy, is a postcode lottery with the Dublin commuter belt areas and the south-east faring worst, a new report reveals today.

The divide means that where you live can define your chance of securing these services, according to the first study of its kind by the ESRI.

Kildare, Meath, Wicklow, Kilkenny, Waterford and Clare are losing out most in the supports which are predominantly provided by the HSE.

Generally, counties in the west and south did better.

The report examined 10 community services adjusting for need, which takes into account age and rates of death and chronic illness.

The list included GPs, community nurses, physiotherapists, occupational therapists, speech and language therapists, podiatrists, counsellors and psychologists, social workers, nursing home beds and home care hours.

It found three counties in the west - Galway, Sligo and Leitrim - did well, while Cork, Westmeath and Tipperary South are relatively better served.

In the capital, the supply of services in Dublin north and south is similar to the national average.

Dublin north has a relatively low supply of GPs, counsellors and psychologists as well as long-term residential care.

Dublin south needs more counsellors, psychologists and publicly funded home care hours.

In Mayo, the supply of community and public health nurses, GPs, and speech and language therapists is above the national average - but it is lagging behind in other services.

In Sligo and Kerry, the supply of physiotherapists is below the national average when local needs are analysed.

"It shows large inequalities in the supply of health and social care across counties in Ireland," the report said.

"In general, healthcare supply was not allocated according to population need."

At the heart of the ad hoc allocation of resources in different counties is the failure to base funding on detailed population need - such as the number of pensioners, medical card holders and people with chronic illness in a given region.

The areas with the highest proportions of those aged 65 and older include Mayo, Leitrim, Roscommon, Kerry and Sligo.

Meath and Kildare have a lower rate of over-65s, but they have a low rate of GPs.

"Given that Ireland has not introduced a system of resource allocation based on population need in the years since 2014, such inequalities are likely to persist," the report said.

It warns the findings suggest that without suitable allocation mechanisms, inequalities in supply could impede progress in implementing Sláintecare, the blueprint for the future of the health service which aims to provide more care outside hospital.

This report said the findings show the importance of accurate and timely collection of health and social care data, adding: "As the population will grow and age at different rates across counties, policies are required to allocate supply according to need."

A spokeswoman for Health Minister Simon Harris said: "The aim of Sláintecare is to break down the barriers in accessing services.

"The Government has taken a number of steps in recent months to address the issues identified by the ESRI."

She said that the "€210m investment in general practice will see additional funding for GPs in both rural areas and areas of urban deprivation to help address inequality of access. This has been accepted by 90pc of GPs".

Irish Independent

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