Tony O’Brien: Our health system needs delegated authority and local integration

With Sláintecare hanging in the balance, the proposal to decentralise HSE structures remains a battleground issue but delaying change will only make things worse

How to structure the governance and delivery of the Irish health service and balance central planning with local delivery has been the dominant question for the last 20 years. Picture: Getty

One of the key decisions now facing health policymakers is the extent to which the Sláintecare proposal to decentralise health service structures is (or, more pointedly, is not) to be implemented.

Lack of planning, progress, or even clarity on this question was cited as one of the main issues leading to the recent resignations of several senior personnel from the Sláintecare implementation team. Since those resignations, leadership figures have sent mixed signals, clearly indicating that ...