Much of the health service responded effectively to the Covid-19 pandemic, despite an unpromising start, according to an evaluation by researchers at Trinity College Dublin.
Opinion polls show the public and health service staff thought the Government “got its response largely right”, the collaboration between TCD’s centre for health policy and international researchers asserts.
While Covid-19 provided a “profound stress test” for the health service, with time “decision-making became much more agile and evidence-informed, with a reasonably fast response to the pandemic, appropriate stringency and general compliance with public health advice”.
Extra resources were provided, there was significant innovation, and linkage with the private sector was developed quickly. “Nevertheless, decisions made around private nursing homes, shutting transport links and occasionally ignoring public health advice had profound consequences.”
The report, which seeks to assess the resilience and sustainability of the system through its performance during the pandemic, says it is clear “imperfect” decisions were made, such as the slow expansion of testing capacity, the failure to block travel from heavily infected regions earlier and differing responses on either side of the Border.
“The timeliness and appropriateness of decision-making in relation to service-delivery mitigation measures was subsequently called into question, as was the top-down, non-participatory approach,” for instance when private hospital capacity was taken over in 2020.
“While some decisions may have been made quickly in relation to private healthcare provision and how best to utilise these resources, other areas of the privatised healthcare ecosystem suffered from delayed decision-making, such as the failure to integrate and support private nursing homes at the beginning of the pandemic.”
“A key question,” the report says, “is to what extent mistakes are inevitable or even acceptable.” It quotes one unnamed “commentator” saying, “Once the emergency is over, the people who made an awful lot of right decisions will end up getting kicked up and down the street for the few they got wrong.”
“By and large, the Government delivered a sufficiently clear, strong and flexible response to the pandemic which was typically viewed as appropriate by the public and viewed positively by health sector staff, translating into comparatively low excess mortality rates.”
The report also describes the gap between current practice and what is required to achieve environmental sustainability in health care as enormous, with demand increasing and huge gaps in decarbonising activities.
While Ireland invested heavily in health during the pandemic, “questions remain concerning whether such high levels of investment can be maintained and put to good use”. About €2 billion of spending on Covid-related care could be available post-pandemic to meet backlogs and invest in healthcare priorities, the report says.