Wicklow People (West Edition) - - FRONT PAGE - RE­PORTS EIMEAR DODD

A new re­port has high­lighted the rel­a­tive lack of health­care ser­vices in County Wick­low com­pared to the avail­abil­ity of these ser­vices na­tion­wide.

A ge­o­graphic pro­file car­ried out by the Eco­nomic and So­cial Re­search In­sti­tute (ESRI) looked at the dis­tri­bu­tion across the coun­try of ten pri­mary, com­mu­nity and long-term health­care ser­vices.

It found that eight out of the ten health­care ser­vices in Wick­low were 10 per cent lower than the na­tional av­er­age. Ser­vices in Coun­ties Meath, Kil­dare and Wex­ford were also found to be below the na­tional av­er­age.

While the data used for the anal­y­sis is from 2014, the re­port’s au­thors sug­gest that in­equal­i­ties in the sup­ply of ser­vices may still per­sist. They point to ‘a his­tor­i­cal fail­ure to in­vest in health in­for­ma­tion and data sys­tems’ sug­gest­ing this has ‘se­verely hin­dered the abil­ity to draw a com­pre­hen­sive pic­ture of health and so­cial care in Ire­land.’

They also warn that a lack of re­forms could ‘im­pede the progress’ to­wards the Gov­ern­ment’s planned health­care re­forms in­clud­ing Slain­te­care.

The re­port ti­tled Ge­o­graphic Pro­file of Health­care Needs and Non-Acute Health­care Sup­ply in Ire­land ex­am­ined the sup­ply of ten health­care ser­vices in 2014. They found there were con­sid­er­able vari­a­tions in sup­ply across the coun­try though the anal­y­sis did not look at the ad­e­quacy of these ser­vices.

The re­port found that 36.7 per cent of the pop­u­la­tion of County Wick­low had a med­i­cal card in 2014, com­pared to a na­tional av­er­age of 38.2 per cent. The per­cent­age of the county’s res­i­dents with a GP visit card in 2014 was also lower than the na­tional av­er­age of 3.3 per cent at 3 per cent.

The re­port iden­ti­fied that there were 5.6 GPs per 10,000 in Wick­low in 2014 which was al­most equal to the na­tional av­er­age of 5.7 GPs per 10,000. How­ever, a de­cline in the sup­ply of GPs in the county was noted over a ten-year pe­riod drop­ping from 6.1 GPs per 10,000 in 2004 to 5.6 GPs per 10,000 in 2014. The anal­y­sis es­ti­mated that there 2,868 GPs prac­tic­ing na­tion­wide in 2014 as there is no na­tional reg­is­ter of GPs prac­tis­ing. The study found there were a to­tal 40 GP prac­tices and 86 GPs prac­tis­ing in the county in that year.

Wick­low was found to be 10.7 per cent below the na­tional av­er­age in terms of com­mu­nity nurses with 63.3 work­ing in the county. The num­bers of phys­io­ther­a­pists, oc­cu­pa­tional ther­a­pists, speech and lan­guage ther­a­pists, so­cial work­ers, chi­ropodists and po­di­a­trists, coun­sel­lors and psy­chol­o­gists were all found to be below the na­tional av­er­age. In the case of phys­io­ther­a­pists, an­other 15.4 would have to em­ployed on a full-time ba­sis within the county to reach the na­tional level.

Wick­low was also below the na­tional av­er­age for the num­ber of home help hours on of­fer in 2014. A to­tal of 357 home care pack­ages were pro­vided that year, giv­ing an av­er­age of 20.3 hours for the county’s pop­u­la­tion over 65 years of age. In com­par­i­son, the na­tional av­er­age was 24.1 hours.

The only area where Wick­low scored above the na­tional av­er­age was in the avail­abil­ity of long-term res­i­den­tial care cen­tres and long-term res­i­den­tial care beds. The county had 57 beds per 1,000 pop­u­la­tion aged 65 or older com­pared with the na­tional av­er­age of 49.8 beds per 1,000 pop­u­la­tion.

Over­all, the find­ings noted ‘sig­nif­i­cant in­equal­i­ties’ be­tween coun­ties in the avail­able sup­ply of non-acute health­care ser­vices in re­la­tion to the needs for care. The re­port’s au­thors sug­gest that to re­duce the sub­stan­tial vari­a­tions be­tween the coun­ties, ‘con­sid­er­able in­creases in the sup­ply of non-acute care would be re­quired in many coun­ties.’

The re­search high­lighted that there is no na­tional datasets of the num­ber, lo­ca­tion and catch­ment pop­u­la­tion of non-acute health­care ser­vices. In­stead, re­searchers had to draw on a range of data sources from the Cen­tral Sta­tis­tics Of­fice, the Health Ser­vice Ex­ec­u­tive, the De­part­ment of Health and other health reg­u­la­tory bod­ies.

A num­ber of lo­cal TDS re­acted to the re­port.

Sinn Féin TD John Brady said the re­port ‘lays bare the in­equal­i­ties in non-acute and pri­mary care ser­vices county by county.

‘The re­port it­self un­der­lines the in­equal­i­ties in the sup­ply of health ser­vices and so­cial care in Wick­low and high­lights the need for tar­geted in­vest­ment in our county’s pri­mary and com­mu­nity care

‘The re­port is very clear that health­care sup­ply has not been al­lo­cated ac­cord­ing to pop­u­la­tion need and this has led to in­equal­i­ties across the pri­mary care and other non-acute ser­vices they ex­am­ined across the State, es­pe­cially in Wick­low.

‘This re­port un­der­lines the need for tar­geted in­vest­ment in pri­mary and com­mu­nity care to ad­dress the in­equal­i­ties we have in health­care sup­ply and also to have any hope in im­ple­ment­ing Sláin­te­care.’

Fianna Fáil Spokesper­son on Health, Stephen Don­nelly TD, has said ‘in­equal­ity can­not be tol­er­ated in health­care. Through Slain­te­care we are at­tempt­ing to move to­wards uni­ver­sal health­care which means that every­one, re­gard­less of whether they have money or not, can ac­cess high stan­dard health­care. We need to see the same ac­cess in com­mu­nity health­care.

‘We know that cen­tral to this in­equal­ity is the fact that we have no data on pop­u­la­tion need. In fact, a sys­tem of re­source al­lo­ca­tion based on pop­u­la­tion need has not been in place since 2014 so it’s very rea­son­able to as­sume that this in­equal­ity will con­tinue long into the fu­ture un­til we al­lo­cate on the ba­sis of need.

‘Com­mu­nity and so­cial health­care fa­cil­i­tate dis­charges from the acute hos­pi­tal sec­tor and pre­vents ad­mis­sions in the first place. The ad hoc al­lo­ca­tion of re­sources is un­doubt­edly heap­ing pres­sure on the acute net­work.

‘It shouldn’t be the case that a child in Wick­low has to wait over a year for an ini­tial ap­point­ment for speech ther­apy while a child on the other side of the coun­try gets more im­me­di­ate ac­cess.

A spokes­woman for Min­is­ter for Health Si­mon Har­ris said: ‘The Gov­ern­ment has taken a num­ber of steps in re­cent months to ad­dress the is­sues iden­ti­fied by the ESRI. The €210 mil­lion 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 90 per cent of GPs in an IMO con­sul­ta­tion bal­lot.

‘The an­nounce­ment of six new health re­gions will also as­sist. Each re­gion will have their own bud­get, based on its pop­u­la­tion and their lo­cal needs.’

Source: ESRI/Ge­o­graphic Pro­file of Health­care Needs and Non-Acute Health­care Sup­ply in Ire­land.

Deputy John Brady.

Deputy Stephen Don­nelly.

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