One small change: A consultant in paediatric intensive care on improving our health system

Prof Suzanne Crowe

(Consultant in paediatric intensive care medicine, president of the Irish Medical Council and a board trustee of the Down Syndrome Centre, Cheshire Ireland and LGBT Ireland)

I would like to see a public forum in which those trying to gain access to health and social services in Ireland have a chance to explain their needs. Often, we only hear from those who have suffered on long waiting lists when it is too late (for example those with chronic pain).

In some ways what I’m asking for is not one small change but a complete shift in the way we design and fund our healthcare services. It is a cultural shift which would help us meet our legislative obligations for timely assessment of needs of children with disabilities – for example while also ensuring that these children get the services identified in the assessments.

Instead of having a healthcare system driven by service developments, we need a healthcare system that listens to the lived experiences of the patient and their healthcare team: a system that actively wraps policy and funding around children and their families, not the other way around.

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So, we need to look at healthcare funding in a completely different way and allocate money to each child and their family for the services they need, rather than fund services which aren’t always tailored to the needs of individual children. Families know what works for them and what doesn’t.

I believe that healthcare professionals often know exactly what individual children need – and when – but because the healthcare system is configured to support itself rather than the patients, these needs can’t always be met as urgently as they should be.

If we start by having a public forum in which patients and their advocates point out how things would work better for them, this could alert clinicians, civil servants, politicians and legislators to new ways to develop policies and allocate funding which genuinely puts the patient first.

And after demonstrating that this forum can deliver real change for children, it could be a model for delivering healthcare to all ages.

As our health system begins to return to normal activity levels following the Covid-19 pandemic, we would like to hear about one change you would like to see in our health system. It can be something simple that annoys you, day in, day out, that is easily fixed, or it can be a small change in practice or attitude that would make life easier for everyone. Email health@irishtimes.com with your suggestion or fill in the form below.