Policy Impact
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Timeframe: March 2025
CHPM members: Ph.D. Scholar Paul Leavy
The project in 20 words: An open letter published in the Irish Times calling on HSE and the Government to address dental waiting lists
Project policy impact and/or engagement:
Oral health system advocacy
Winston Churchill purportedly said, “Never let a good crisis go to waste”. While the recent high-profile case of an autistic child potentially having to endure a long wait for dental care under general anaesthesia will no doubt have caused considerable distress and uncertainty for that family, it presented an opportunity to highlight persistent inadequacies in state funded oral healthcare in Ireland and to call for action.
Publishing in The Irish Times opinion section (‘Dental waiting lists’, 3 March 2025), Dr Paul Leavy who is a dentist and PhD scholar at the TCD Centre for Health Policy and Management used the opportunity to call on the Irish Government and HSE to redouble efforts and ensure that appropriately funded and resourced care pathways are made available. Paul highlighted the need for health system strengthening in this regard against the backdrop of the National Oral Health Policy (2019) implementation and the need to support primary care dentists, with the ultimate goal of ensuring timely access to care for patients, including the vulnerable.
Timeframe: February 2025
CHPM members: Assistant Professor Mandy Lee
External collaborators or stakeholders: European Hong Kong Diaspora Alliance (EHKDA), Irish Uyghur Cultural Association (IUCA) and Stand With Hong Kong (SWHK)
Publication link: https://www.irishtimes.com/politics/2025/02/17/government-urged-to-raise-uyghurs-with-visiting-chinese-foreign-minister/
The project in 20 words: Joint Open Letter to the Irish Prime Minister Micheal Martin, and the Irish Foreign Minister Simon Harris, on the Chinese Foreign Minister’s visit to Dublin in February 2025.
Project policy impact and/or engagement:
Assistant Professor Mandy Lee co-authored a Joint Open Letter to the Irish Prime Minister, Micheál Martin and the Irish Foreign Minister Simon Harris on the Chinese Foreign Minister’s visit to Dublin in February 2025.
As a member of the European Hong Kong Diaspora Alliance (EHKDA), working in close partnership with the Irish Uyghur Cultural Association (IUCA) and Stand With Hong Kong (SWHK), Mandy Lee co-authored a Joint Open Letter to warn the leaders of the Irish Government of the phenomenon of transnational repression (TNR) perpetrated by the Chinese regime that poses serious threats to minoritised ethnic communities in Ireland and across Europe, where marginalised communities live in fear of foreign regime surveillance and harassment, with members being prevented from exercising full democratic and cultural rights despite living in the EU and far outside of China’s jurisdiction.
This letter was the first-ever public cross-community action between the Uyghur and Hongkonger communities in Ireland. The letter was published by the Irish Times on the day of the Chinese Foreign Minister's arrival in Dublin (see link above), with substantive quotes reported.
Timeframe: December 2024 to September 2025
CHPM members: Professor Sara Burke
External collaborators or stakeholders: HIQA, HSE, ESRI, patient organisations
Publication link: HIQA publishes its Review to inform decision-making on the design and delivery of urgent and emergency healthcare services in HSE Mid West | HIQA
The project in 20 words: Publication of HIQA Review of design and delivery of urgent and emergency healthcare services in the HSE Mid-West
Project policy impact and/or engagement:
Dr Sara Burke was a member of the Expert Advisory Group which supported the work of the Health Information and Quality Authority (HIQA) which on 30 September 2025, published an independent Review to guide decision-making on urgent and emergency healthcare services in Ireland’s HSE Mid-West region. Prompted by serious patient safety concerns, the Review offers advice to the Minister for Health, supported by stakeholder input and data analysis. HIQA identified a critical inpatient bed capacity deficit at University Hospital Limerick (UHL), exacerbated by rising demand and projected population growth through 2040, as outlined by the ESRI.
To address this, HIQA proposed three options: expanding UHL’s current site (Option A), developing a nearby second campus under shared governance (Option B), or establishing a new Model 3 hospital with a second emergency department (Option C). Options A and B offer faster relief for immediate safety risks, while Option C may better meet long-term needs but involves longer lead times.
The HIQA Mid-West Review also incorporated international evidence, policy analysis, regulatory inspections, and public consultation. HIQA recommends a strategic plan focused on safety, demographic trends, and ongoing public engagement. Continuous monitoring of demand versus ESRI projections is essential to ensure responsive and flexible service planning.
Timeframe: December 2023 – April 2024
CHPM members: Dr Katharine Schulmann
External collaborators or stakeholders: Department of Health, the HSE, and the Department of Children, Equality, Disability, Integration and Youth (D/CEDIY) as well as HIQA and NTPF. Key stakeholders from the non-governmental sector, including Family Carers Ireland and Nursing Homes Ireland, among others.
Publication link: State of Long-term Care in Ireland
The project in 20 words: A system-level technical assessment of Long-term Care in Ireland
Project policy impact and/or engagement:
Dr Katharine Schulmann contributed country expertise to a report by the WHO Regional Office for Europe titled ‘State of Long-term Care in Ireland’ published in November 2024. The report applies the WHO’s new State of Long-term Care Toolkit, a practical, innovative resource intended to support policymakers at regional, national and local levels in reshaping long-term care (LTC) systems to be more equitable, responsive and sustainable.
The report is the culmination of a system-level technical assessment carried out between December 2023 and April 2024, which involved direct engagement with and support from relevant government agencies, including notably the Department of Health, the HSE, and the D/CEDIY as well as HIQA and NTPF, and key stakeholders from the non-governmental sector including Family Carers Ireland and Nursing Homes Ireland, among others. A policy dialogue involving key stakeholders took place in March 2024 to disseminate findings and to enable a forum for constructive dialogue and exchange.
The report identified 4 key areas of policy action for promoting sustainable change in
in Ireland’s LTC system:
- Integrating care to ensure coherent pathways across care settings,
- Increasing public expenditure and reorganising financing to allow for needs-driven allocation decisions,
- Protect, support and invest in the care workforce, both formal and informal,
- Strengthen data infrastructure and improve capacity to generate timely evidence for policy and planning.
Timeframe: March 2023 to June 2025
CHPM members: Professor Sara Burke, Dr Sarah Parker, Dr Carlos Bruen, Dr Katharine Schulmann, Dr Rikke Siersbaek, Luisne Mac Conghail – all members of the HRB-funded Applied Partnership Award entitled ‘Health system foundations for Sláintecare implementation in 2020 and beyond’.
External collaborators or stakeholders: Department of Health, HSE, patient organisations
Publication link: Health system reform in the context of COVID-19: a policy brief outlining lessons from Ireland’s journey towards the goal of universal healthcare
The project in 20 words: This project sought to co-produce evidence to inform the new health regions, it pivoted during COVID-19 to harness the lessons from the COVID-19 health system response.
Project policy impact and/or engagement:
This HRB, Department of Health and HSE funded project ran for five years due to extended funded from the HEA COVID-extension fund. Examples of policy and impact and engagement are:
June 2025 Guest on inaugural HRB evidence for policy podcast HRB podcast and chosen as one of four Irish academics giving expert tips to influence policy as part of HRB campaign
May 2025 Interview on RTE Radio 1’s Today with Claire Byrne on new Sláintecare policy
March 2025 Guest on two USA podcasts entitled Code WACK on Irish healthcare reform
March 2025 Keynote speaker at European Parliament Spring Talks series giving a public lecture on Health Policy and Implementation
February 2025 Keynote speaker at Business Post National Health Summit on the new health regions – getting the governance right?
May 2024: Irish Times opinion piece on the accountability of the new health regions being implemented by the HSE
February 2024: Featured on Ireland’s Edge podcast discussing healthcare system overload and Sláintecare implementation
March 2023: Presented to the Oireachtas Health Committee on Sláintecare, with coverage on RTE and in Irish Times and Irish Examiner. Oireachtas Committee hearing and transcript, March 2023. The full committee hearing can be viewed here Joint Committee on Health debate - Wednesday, 1 Mar 2023 (oireachtas.ie). The transcript is here Joint Committee on Health debate - Wednesday, 1 Mar 2023 (oireachtas.ie)
Timeframe: December 2022 – Nov 2024
CHPM members: Co-P.I. Dr Bridget Johnston and Dr Padriac Flemming, in collaboration with Dr Charlotte Myers, Veronica Segerström, and Ali McDonnell
Publication link: Surgery Medical Workforce in Ireland 2024 - 2038 and Dual Training Specialties of Medicine Medical Workforce in Ireland 2024 - 2038. Further publications expected in 2025-2026.
The project in 20 words: A medical workforce planning project in collaboration with the HSE National Doctors Training and Planning (NDTP) unit
Project policy impact and/or engagement:
This research was commissioned by the HSE to estimate the required number of medical and surgical consultants needed in the Irish health system in 2038, and to subsequently identify the number of training places necessary to train this workforce, with a long-term goal of being self-sufficient in graduates across all medical and surgical specialties in Ireland.
The research aligns with Sláintecare, the Irish Government’s national health policy, which advocates for universal access to healthcare services. A key deliverable of Sláintecare is to increase and orient the health and social care workforce to meet the demand of Ireland's future population. Sláintecare implementation plans, specifically Reform programme 2, workstream 6, call for medical workforce planning (MWP) to be conducted across all clinical roles. The consultant workforce was selected as a starting point, with several other MWP projects in progress, such as clinical nurses and staff mix in residential care settings.
Timeframe: 2021 - 2023
CHPM members: Professor Steve Thomas
External collaborators or stakeholders: Department of Health
Publication link: Health System Performance Assessment (HSPA) Platform).
The project in 20 words: Advisory to the Department of Health on the development and implementation of the Health System Performance Assessment framework for Ireland
Project policy impact and/or engagement:
As part of the international advisory panel for developing and implementing the Health System Performance Assessment framework for Ireland, Professor Steve Thomas was involved in assessing, critiquing and guiding draft frameworks from 2021; launching the HSPA framework with the Department of Health (the only speaker at the event from outside Government), and helping give feedback on the HSPA platform and its presentation of data for its launch in 2023.
Timeframe: 2021-2022
CHPM members: Assistant Professor Dr Bridget M Johnston & Assistant Professor Dr Carlos Bruen
External collaborators or stakeholders: Department of Health
Publication link: Review of the Implementation of the 2001 Report of the National Advisory Committee on Palliative Care as it relates to Adult Palliative Care
The project in 20 words: A review of the implementation of the 2001 “Report of the National Advisory Committee on Palliative Care” to inform the new policy as it relates to adult palliative care
Project policy impact and/or engagement:
In 2001, the Irish government published the Report of the National Advisory Committee on Palliative Care, positioning Ireland as a world leader in the provision of high-quality palliative care. Twenty years later, the Department of Health set out to update the National Adult Palliative Care Policy and commissioned a team at the CHPM to conduct a review of the implementation of the 2001 Report, informing the new policy as it relates to adult palliative care. Published in 2022, the report mapped and assessed progress on the 2001 recommendations, synthesising this with stakeholder interviews and a comparative analysis of other countries' palliative care models to identify key issues the new policy should address. Report lead author Dr Bridget Johnston was later seconded to the Department of Health as part of the team responsible for developing the new National Adult Palliative Care Policy, published and approved by the government in late 2024. The Review of the Implementation of the 2001 Report was one of three evidence reviews used to inform the new national adult palliative care policy.
Timeframe: June 2021
CHPM members: Professor Steve Thomas
External collaborators or stakeholders: Swedish National Board of Health and Welfare and the European Observatory
The project in 20 words: A dialogue to understand international experiences of challenges related to VHI (Voluntary Health Insurance) and dual practice.
Project policy impact and/or engagement:
On 16 June 2021, the Swedish National Board of Health and Welfare and the European Observatory held a policy dialogue entitled: “Managing a growing VHI market in Sweden: lessons from other countries”. The purpose of this policy dialogue was to understand the experiences of countries that have faced similar challenges related to VHI (Voluntary Health Insurance) and dual practice, and to consider possible options for addressing unintended consequences of VHI growth in Sweden. Professor Steve Thomas was invited to provide an expert view on lessons learned from Ireland. Professor Thomas outlined various policy options available to Sweden based on Ireland’s troubled history with VHI.
Timeframe: June 2020
CHPM members: Professor Steve Thomas
External collaborators or stakeholders: WHO European Observatory on Health Systems and Policies
Publication link: Strengthening health systems resilience: key concepts and strategies
The project in 20 words: A Policy Brief on Strengthening Health System Resilience
Project policy impact and/or engagement:
Professor Steve Thomas and colleagues published (18 June 2020) a policy brief for the WHO European Observatory on Health Systems and Policies exploring health systems resilience during shocks like COVID-19 and economic downturns. It is important reading for anyone interested in how health systems can prepare for, recover from, and learn from crises.
Key findings include the following strategies for enhancing health system resilience:
- Governance: effective and participatory leadership with strong vision and communication; coordination of activities across government and key stakeholders; an organisational learning culture that is responsive to crises; effective information systems and flows; and surveillance enabling timely detection of shocks and their impact.
- Financing: ensuring sufficient monetary resources in the system and flexibility to reallocate and inject extra funds; ensuring stability of health system funding through countercyclical health financing mechanisms and reserves; purchasing flexibility and reallocation of funding to meet changing needs; and comprehensive health coverage.
- Resources: appropriate level and distribution of human and physical resources; ability to increase capacity to cope with a sudden surge in demand; and motivated and well-supported workforce.
- Service delivery: alternative and flexible approaches to deliver care.
In 2015, the Irish government introduced free GP care for under six year olds and over seventy year olds. This followed the 2011 Programme for Government commitment to free GP care for all.
Between May and September 2013, Prof Steve Thomas provided advice and costed a strategy for Minister of State for Primary Care, Alex White, on the design and implementation of roll-out of free GP care. Previously, between October 2011 and February 2012, Prof Thomas led a TCD team to develop a workforce planning model for the Department of Health to support the roll-out of free GP care and presented the work to minister of State for Primary Care, Roisin Shortall.
The 2016 Programme for Government committed to the introduction of free GP care for all under 18 year olds.
The Resilience Project was a four year research programme (2011-2015) assessing the resilience of the Irish health system during the economic crisis. Funded by the Health Research Board, PI, Professor Steve Thomas and resear +chers Dr Sara Burke, Dr Sarah Barry and Conor Keegan provided ground breaking research demonstrating the catastrophic impact of austerity on people who use health services and the health system itself.
With numerous peer reviewed publications and conference and seminar presentations, the project is credited with making the case for the reversal of cuts to the health budget in 2015 and the reduction of some of the increased healthcare costs to families and individuals introduced during the economic crisis.
The team collaborated with the European Observatory for Health Systems and Policies, the WHO Barcelona Office for Health Systems Strengthening, the World Bank and the Countries in Crisis network (Portugal, Greece and Spain) comparing the resilience of systems across countries.
The Centre’s Pathways to Universal Healthcare research team led by Prof Steve Thomas provided technical assistance to the Oireachtas Committee on the Future of Healthcare which drafted the Sláintecare report.
A key recommendation of the Report is the removal of private practice from public hospitals during the first seven years of the plan: ‘the phased elimination of private care from public hospitals. Everyone will have entitlement to access public care in public hospitals – those who have private health insurance will still be able to purchase care from private healthcare providers. The Committee also recommends an independent impact analysis of the separation of private practice from the public system in order to identify any adverse and unintended consequences on the public system’. An Independent review group examining the removal of private practice from public hospitals was established by Minister Harris in December 2017 and made a public call for submissions.
Centre researchers led by Dr Sara Burke subsequently produced a submission (link to PDF of Pathways submission) to the Review Group providing evidence and findings from research projects Resilience of the Irish Health System and Pathways to Universal Healthcare to inform their work. Dr Sara Burke and Prof Steve Thomas also wrote an op ed on this topic published on 26 February 2018 in the Irish Times.
From November 2016 to May 2017, a team of researchers - Prof Steve Thomas, Dr Sara Burke, Dr Sarah Barry, Dr Bridget Johnston, and Rikke Siersbaek - from the Centre provided technical support for the Oireachtas Committee on the Future of Healthcare. Initially, the team hosted three workshops with the Committee and then assisted the Committee with its remit ‘to devise cross-party agreement on a single long-term vision for health care and direction of health policy in Ireland’.
On the 30 May 2017, the Committee published its final report. According to the Committee’s chairperson, Roisin Shortall TD, ‘the formation of the Oireachtas Committee on the Future of Healthcare provided a unique and historic opportunity for TDs from across the political spectrum to come together to develop consensus on a long-term policy direction for Ireland’s healthcare system. Our task has been to consider how best to ensure that, in future, everyone has access to an affordable, universal, single-tier healthcare system, in which patients are treated promptly on the basis of need, rather than ability to pay’.
An overview of the Committee’s work process and the report’s recommendations can be found in the Oireachtas News press release. View full video of report launch here.