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Healthcare policy must prioritise Primary Care Teams, community supports and social care infrastructure

Ending the ongoing spiral of healthcare crises in Ireland requires that Primary Care Teams (PCTs) and the linked community supports and social care infrastructure must be put at the centre of healthcare policy and resourced adequately according to Social Justice Ireland’s latest Policy Briefing. This approach would enable communities to look after their own people locally with their families and friends where they want to be according to Social Justice Ireland.  

Healthcare is a social right that every person should enjoy. People should be assured that care in their times of vulnerability is guaranteed.  This is patently not the case at present. Major change is required.

Social Justice Ireland's Policy Briefing on Healthcare states that if everyone in Ireland is to be sure they can access healthcare in the most appropriate manner when needed then Primary Care Teams (PCTs) must be in place in all parts of the country.  It also requires that these PCTs be fully operational and working in an integrated manner and that they be adequately funded.
A Primary Care Team (PCT) is a team of health and social care professionals (catering for a population of 7,000-10,000 people) who work closely together to meet the needs of people living in a community. These professionals include GPs and their Practice Nurses, Community Nursing i.e. Public Health Nurses and Community Registered General Nurses, physiotherapists, occupational therapists and home care service staff. These provide the first point of contact when individuals need to access the health system. 518 PCTs would be needed to cover the whole country.
In practice this approach requires that Primary Care Teams be closely linked to community supports such as home care packages, home helps, sheltered housing, meals on wheels and day care centres. It also requires that social care infrastructure and services be in place and adequately resourced. In practice these Primary Care Teams should also be linked to services in areas such as local government and education to ensure a joined-up service is delivered in the local community.
Ireland has become over-focused on the acute hospital system. This must change and we need to focus instead on prioritising community-based health and social services.
According to Social Justice Ireland’s Policy Briefing on Healthcare, community-based health and social services must become more:
  • Accessible and acceptable to the community they serve;
  • Responsive to the needs  of the local community and its particular set of requirements;
  • Developed to a position of dominance in relation to acute hospital services and be accepted as theprimary health and social care option to be accessed by the community;
  • Supportive of local people in their efforts to build caring communities.
These goals can be achieved in a reasonably short time period.
For this to happen however, in the overall context of health service delivery, there will be a need to:
  • Integrate the acute hospital care system
  • Integrate the community-based service system
  • Integrate both hospital and community systems to ensure that there is a consistent and seamless approach to service delivery where the person is at the centre of the service.
  • Develop and enhance a social care model of service focused on supporting local communities in improving the overall health and wellbeing of the population.

The standard of care provided is dependent, among other things, on the resources made available which in turn is dependent on the expectations of the society.

For years Ireland has struggled to deliver a fair and equitable healthcare system in which people could have trust. Social Justice Ireland welcomes the new Government’s commitment to produce a one-tier healthcare system. Budget 2012 is a good opportunity to move in this direction.

The full text of Social Justice Ireland's Policy Briefing on Healthcare may be accessed here.