The Healthcare System cannot afford to stand still

‘The hospital system in Ireland has suffered from under-investment for many years and COVID 19 has highlighted the ongoing shortage in hospital capacity’ says Padraig Duff, Commercial Director at Temperature Controlled Pharmaceuticals Limited

7th January, 2022
The Healthcare System cannot afford to stand still

What's your name and what position do you hold?

Padraig Duff – Commercial Director at Temperature Controlled Pharmaceuticals Limited, trading as TCP Homecare, a clinical homecare company specialising in the provision of patient-centred services including IV Home Infusions across a broad range of conditions including Rare Diseases, Community Infusion and Venesection Clinics, Patient Training & Education Services, Wound Clinic Services and Community Oncology Outreach Services.

What are your day to day responsibilities?

As Commercial Director my objectives are to develop and implement strategies which result in commercial opportunities while also managing the needs of existing customers and ensuring their requirements are met. My day-to-day responsibilities include collaboration and regular engagement with our client companies. Our clients include pharma manufacturers (sponsors of a very large number of Patient Support Programmes delivered by TCP Homecare in the community) and the HSE. We work with the HSE to support the on-going delivery of clinical homecare services and in the identification, development, and implementation of new services. The majority of these services support the treatment of patients outside of the acute hospital setting, in either the patient’s home or in a community-based healthcare facility.

What is your professional background?

A Biochemistry Science graduate of UCD with over 30 years of pharmaceutical industry experience, working as Hospital Sales Manager with Lederle & Wyeth Laboratories where I gained essential experience in antibiotics, biologicals, and oncology. I later served as General Manager of Organon Laboratories in Ireland before becoming a founder member of TCP Homecare and co-developed the first homecare company specialising in a total turnkey solution for hospital care in the home or community clinic setting.

What will the impact of COVID-19 be on health spending? Will health outcomes deteriorate after the virtual shutdown in “elective” procedures, and what are the lessons?

COVID-19 has demonstrated our ability to react to change and how to be flexible and agile in how we respond to every-day challenges in delivering care to our patients. How we spend on healthcare has changed and will continue to change as we move forward into the future. The hospital system in Ireland has suffered from under-investment for many years and COVID 19 has highlighted the ongoing shortage in hospital capacity. As the demand for healthcare continues to grow there will be a requirement to rethink how we can meet healthcare needs while supporting economic recovery. We cannot continue to have so many chronically ill patients continuing to access acute hospital services for relatively routine procedures and treatments, which can be safely and effectively delivered in alternative locations in the community at less cost to the Exchequer.

I expect health outcomes will deteriorate following the shutdown in elective procedures and the reduction in access to screening services for the early detection of several diseases. Unfortunately, these patients will be presenting later, with more advanced disease and requiring more complex and prolonged care in our hospitals. There is no doubt there will be continued strain on capacity and resources within the acute hospital system, just to deal with the backlog, not alone with the associated increase in age related clinical conditions associated with an increasing aged population.

Now is the time to re-focus on the key strategic objectives of Sláintecare and re-evaluate how we can provide healthcare to our patients in alternative settings to that of the hospital with a focus on the development of community healthcare services.

Throughout the COVID-19 pandemic, TCP Homecare has developed and implemented several patient centred services which has seen the transfer of significant numbers of patients from the Hospital Day Ward and from the Oncology Day Infusion Unit, to receiving their treatment at home or in a community based HSE Primary Care Centre. A most recent service development is the roll-out of a Community Oncology Outreach Service which will see TCP Homecare provide a team of Dedicated Oncology Nurses providing a range of services to the Oncology Unit in one of our leading teaching hospitals.

What lessons have we learned for the next crisis?

The Healthcare System cannot afford to stand still, it must continue to embrace change and review how it delivers healthcare based on the challenges and learnings from the last two years. I believe the health service can move forward with confidence, as the past two years has demonstrated that an organisation like the HSE can adjust quite quickly to unforeseen challenges and can implement change in an agile and timely fashion when needed.

In TCP Homecare, we have been completely bowled over by the resilience of our staff, their ability to adopt to change, willingness to look at new ways of working and their commitment to ensuring every patient in our care has received their treatment and support irrespective of the challenges put in front of them by the COVID-19 pandemic. Of course, this has been made easier by the fact that TCP Homecare has invested significantly over the years to ensure our systems and operations are very process driven, supported by a strong internal IT Infrastructure and a committed leadership team.

Therefore, I believe we have the people, the processes, and the infrastructure in place in our organisation to adapt to whatever challenges are put in front of us.

What opportunities will emerge out of the current crisis and eventual recovery for transforming health care?

Over the last number of years, there has been a recognition and acceptance that we cannot continue to deliver healthcare as we have done in the past. The pandemic has highlighted that our healthcare system can’t absorb sudden pressures on the system and cope with an increased surge in demand. It is not possible to continue to rely on our acute hospital system to the extent that we have in Ireland. An opportunity for a new model of healthcare delivery now presents itself which should focus on preventative measures, telehealth services and community-based healthcare delivery. Such new models offer the opportunity to support and manage chronic long-term conditions outside of the acute hospital sector. This in turn will free up hospital capacity, provide greater convenience for patients and support patient centric care.

Sláintecare has presented an alternative approach to how we need to develop an integrated healthcare system that sees greater use of Primary Care and other community healthcare systems. Similarly, the National Cancer Control Programme (NCCP) has now published their guidance document supporting the delivery of Systemic Anti-Cancer Therapy (SACT) and supportive care in the community.

What will the healthcare experience look like by the end of this decade?

There will be more sick patients and these patients will require more complex healthcare services. To support the growing demands on the service there will be a requirement for more integrated healthcare systems and improved technologies with a greater emphasis on data security. Hopefully we will see a healthcare service that provides universal access to care for the entire population, patients will be able to access diagnostics in the community and there will be a significant shift in how treatment is delivered moving from the acute sector to the community setting. Hopefully we will see the expansion of clinical homecare services and the implementation of clinical services located in Primary Care Centres as opposed to patients having to continually return to the acute hospital for treatment.

Finally, the hope is that we will see the Sláintecare vision for a single-tier health service where patients are treated solely on healthcare need, come to life.

Padraig Duff is speaking at the 2022 National Health Summit taking place virtually on Feb 8th. For details and to book visit

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