The HRB have funded Dr Stephen Thomas to undertake a three year research project entitled 'Resilience of the Irish Health System: Surviving and utilising the economic contraction'.

The national and international economic crisis has had a direct impact on the health system as a result of reduced health sector funding. The Resilience project is monitoring and assessing the impact of the economic crisis on the Irish health system. The final Resilience seminar is taking place on 31 March 2014, in the Trinity Hub.

The project team is also currently writing the Irish page for the WHO's European Observatory 'Health Systems and Policy Monitor' which provides a detailed description of health systems and provides up to date information on reforms and changes that are particularly policy relevant across 20 OECD countries.

The Resileince research has gathered a range of quantitative indicators monitoring the impact of the crisis on the health system and is carrying out qualitative interviews with senior health policy and health service personnel to assess their expereince of the economic crisis. The aim of this research is to develop guidelines on how the Irish health system might both withstand and, if possible, benefit from the current economic crisis and to provide strategies to strengthen the Irish health system in anticipation of future crises.

In particular, this innovative research draws lessons from other countries' experiences with managing health systems during recessions and analyse Ireland's current health system experience in terms of protecting health funding, pursuing efficiencies and promoting reform.

A useful concept is that of resilience, defined as 'the capacity of a system to absorb disturbance and reorganise while undergoing change so as to still retain essentially the same function, structure, identity and feedbacks'.

There are primarily three areas of concern in understanding the resilience of a health system:

  • Financial resilience - the impact of the economic contraction on the size of the funds available for health care;
  • Adaptive resilience - the ability of government and providers to manage the system with fewer resources while not sacrificing key priorities
  • Transformatory resilience - the ability of government to design and implement desirable and realistic reform when the current organisation, structures and strategies are no longer feasible.

In 2012, Dr Thomas received further funding from the HRB through the Knowledge Exchange and Transfer Scheme. This funding is intended to improve health system decision-making by increasing the flow of effectively communicated, high quality research and analysis on the performance of the Irish health system during the recession.

In June 2013, the Centre for Health Policy and Management in Trinity cohosted a conference with the Economic and Social Research Institute entitled 'Health Systems in the Era of Austerity'. At this conference, international and national findings on how health systems have been affected by the financial crisis were presented. High level Irish policy makers were exposed to thinking from other health systems on how best to manage the crisis. This is to allow public debate but also more open reflection to learn lessons.