This is my second column in Punt magazine. See other posts for info on Punt and Rude Health I.
Why does Irish health system incentivise sickness rather than well-being? (more…)
THE HEALTH Service Executive (HSE) has been severely criticised for its failure to manage its own public dental service that provides free dental care for children, people with disabilities and older people in care. The criticisms are contained in a new report on the service. The Public Dental Service (PDS) has a budget of €60 million for 2009 and services are provided by 200 dentists, working as HSE employees.
The Department of Health appointed Dr Paul Batchelor, a London-based oral care consultant to write an Analysis and Evaluation of the Public Dental Service of the Health Service Executive , a copy of which has been seen by The Irish Times .
The evaluation report found “little evidence among senior levels of the HSE of a serious engagement to understand the operation of the PDS with a view to actively managing that part of the organisation, providing encouragement and knowledgeable direction. This lack of leadership at a national level is having a demoralising effect on the providers of the service.” It also found that “the most important factor inhibiting the introduction of improvement is the lack of clinical [dental] leadership in the PDS”.
I had the honor of hearing Margaret Whitehead, professor of public health in Liverpool, speaking at a confernce in Belfast on 2 October. Whitehead is synonymous with strategies to reduce health inequalities and improve the health of the poorest. She wrote the follow up to the seminal Black Report in England which was the first official government report in the developed world to document the extent of health inequalities that existed between rich and poor. This work also made clear the social gradient that exists in health, ie the more income you earn and the higher you are up the social scale, the better your health. Whitehead’s book ‘The Health Divide’ which also included the Black Report was a classic Penguin best seller and sold well over 100,000 copies – a very unusual achievement in public health literature. Here are some of the interesting points she made in Belfast and some quick thoughts of mine on strategies (or lack of them) to reduce health inequalities in Ireland, North and South. (more…)