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Understanding the legacies of shocks on health system performance: Exploring Ireland's management of recent crises and its implications for policy

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  • Farsaci, Liz
  • Fleming, Padraic
  • Almirall-Sanchez, Arianna
  • O'Donoghue, Catherine
  • Thomas, Steve

Abstract

This paper contrasts the Irish experience of the 2008 economic crisis and the Covid-19 pandemic, and the health system responses to these shocks, from the perspective of health system leaders working across both time periods. Based on semi-structured interviews with seven senior national and international officials, the research presented here forms the qualitative component of RESTORE, a five-year research project examining health system resilience and reform, funded through the Health Research Board's Research Leader Award in Ireland. Findings indicate that the financial crisis deeply impacted the Irish health system in relation to infrastructure and capacity, service delivery and workforce. Due to these legacy issues, Ireland's health system was in a relatively weak position when faced with the Covid-19 pandemic but the system proved adaptive and innovative during this time. Furthermore, the pandemic proved to be a catalyst for positive change, providing opportunities for long-term reform, alongside an immediate response to the crisis. This was facilitated by increased funding, a devolution in decision-making structures and a political commitment to the health system. Exploring lessons from the Irish response to these crises provides a case study for developing appropriate policy responses around financing and resource allocation, fostering support for healthcare among political leaders and policy makers, and preparing for future shocks. Furthermore, examining these experiences facilitates understanding around the impact of each crisis on the health system, exploring options for addressing legacy issues and considering practical steps to improve health system performance.

Suggested Citation

  • Farsaci, Liz & Fleming, Padraic & Almirall-Sanchez, Arianna & O'Donoghue, Catherine & Thomas, Steve, 2024. "Understanding the legacies of shocks on health system performance: Exploring Ireland's management of recent crises and its implications for policy," Health Policy, Elsevier, vol. 143(C).
    • Handle: RePEc:eee:hepoli:v:143:y:2024:i:c:s0168851024000733
    DOI: 10.1016/j.healthpol.2024.105063
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    References listed on IDEAS

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    1. Wren, Maev-Ann & Connolly, Sheelah, 2019. "A European late starter: lessons from the history of reform in Irish health care," Health Economics, Policy and Law, Cambridge University Press, vol. 14(3), pages 355-373, July.
    2. Fleming, Pádraic & O'Donoghue, Catherine & Almirall-Sanchez, Arianna & Mockler, David & Keegan, Conor & Cylus, Jon & Sagan, Anna & Thomas, Steve, 2022. "Metrics and indicators used to assess health system resilience in response to shocks to health systems in high income countries—A systematic review," Health Policy, Elsevier, vol. 126(12), pages 1195-1205.
    3. Sumit Mazumdar, 2020. "Now More Than Ever: Considering Health System Reforms in the Post-COVID 19 Scenario," The Indian Journal of Labour Economics, Springer;The Indian Society of Labour Economics (ISLE), vol. 63(1), pages 157-162, October.
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