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Dr. Sara Burke
Research Assistant Professor, Public Health & Primary Care


Dr Sara Burke is Research Assistant Professor of Health Policy in the Centre for Health Policy and Management, in the School of Medicine, Trinity College Dublin. She is the Principal Investigator of project entitled 'Health system foundations for effective Regional Integrated Care Areas (RICAs) - co-producing evidence to inform the design of regional organisations to support integrated care in Ireland'. This is a HRB Applied Partnership Award which runs til August 2021. Prior to this, she coordinated 'Mapping the pathways to universal healthcare' - In the first five months of 2017, Sara and her team worked with the Oireachtas Committee on the Future of Healthcare, who had a remit to develop a ten year plan for healthcare reform in Ireland - Prior to the Pathways research project Sara was a post-doc researcher on the Resilience of the Irish health system during the economic crisis. Sara is the lead on the health policy module on the SPHERE programme and the Centre's MSc in Health Services Management Sara has worked for 20 years as a researcher in and of health policy. Her book entitled Irish Apartheid, Healthcare Inequality in Ireland was published in 2009. She writes regularly on health system for the national newspapers and for seven years from 2008 to 2015 had a weekly health slot on RTE Radio 1's Drivetime programme.

Publications and Further Research Outputs

Peer-Reviewed Publications

Rikke Siersbaek; John Ford; Clíona Ní Cheallaigh;Sara Burke; Steve Thomas, How accessible is healthcare for single adults experiencing long-term homelessness and complex needs? A realist evaluation protocol, HRB Open Research , 2020 Journal Article, 2020 DOI

Burke, Sara, Thomas, Steve, Stach, Malgorzata, Kavanagh, Paul, Magahy, Laura, Johnston, Bridget, Barry, Sarah, Health system foundations for Sláintecare implementation in 2020 and beyond " co-producing a Sláintecare Living Implementation Framework with Evaluation: Learning from the Irish health system"s response to COVID-19. A mixed-methods study protocol, HRB Open Research, 3, 2020, p70 Journal Article, 2020 DOI

Burke Sar, McGettrick Grainn, Foley Kare, Manikandan Manjul, Barry Sarah, The 2019 neuro-rehabilitation implementation framework in Ireland: Challenges for implementation and the implications for people with brain injuries, Health Policy, 2020 Journal Article, 2020 DOI URL

Embracing and Disentangling from Private Finance: The Irish System in, editor(s)Colleen Flood and Bryan Thomas , Is two-tier health care the future?, Ottawa, University of Ottawa Press, 2020, pp291 - 314, [Stephen Thomas, Sarah Barry, Bridget Johnston, Rikke Siersbaek and Sara Burke ] Book Chapter, 2020 URL

Johnston, B, Thomas, S, Burke, S., Can people afford to pay for health care? New evidence on financial protection in Ireland, 1st Edition, WHO Europe, WHO Europe, 2020, p1 - 118 Report, 2020 URL

Johnston BM, Burke S, Barry S, Normand C, Ní Fhallúin M, Thomas S., Private health expenditure in Ireland: Assessing the affordability of private financing of health care. , Health policy (Amsterdam, Netherlands), 2019 Journal Article, 2019 DOI

Burke, S, Brugha, R, Thomas, S, The National Treatment Purchase Fund - A success for some patients yet a public policy failure? , Administration. Journal of the Institute of Public Administration of Ireland , 67, (2), 2019, p47 - 69 Journal Article, 2019 URL URL TARA - Full Text

Barry. S., Harnett, P.J., Burke, S., Thomas, S., Evaluating the Implementation of Integrated Care for Older Persons as a path to Universal Health Care, International Journal of Integrated Care, 18th International Conference for Integrated Care, Utrecht, Holland, 23-25 May 2018, edited by Robin Miller & Viktoria Stein , 19, (00), International Federation for Integrated Care, 2018, pp00 - 00 Conference Paper, 2018

Sara Burke∗, Sarah Barry, Rikke Siersbaek, Bridget Johnston, Maebh Ní Fhallúin,Steve Thomas, Sláintecare - A ten-year plan to achieve universal healthcare inIreland, Health Policy, 2018 Journal Article, 2018

Steve Thomas, Sarah Barry, Bridget Johnston, Sara Burke, Ireland's health care system and the crisis: a case study in the struggle for a capable welfare state, Anais do Instituto de Medicina Tropical , 17 (Supplement), (1), 2018, p27 - 36 Journal Article, 2018 URL

Burke, S, Brugha, R, Thomas S., It's the economy, stupid! When economics and politics override health policy goals - the case of tax reliefs to build private hospitals in Ireland in the early 2000s, HRB Open Research, 1, (1), 2018 Journal Article, 2018 Handle DOI

Barry. S., Burke, S., Boyce., M., Eustace-Cook, J., Normand, C., Thomas, S., Implementing Universal Healthcare implies Integrated Care Design - findings from a systematic review of the organisational challenges of implementing UHC policy, International Journal of Integrated Care, 17th International Conference for Integrated Care, Dublin, Ireland, 8-10 May 2017, edited by Robin Miller & Viktoria Stein , 17, (5), International Foundation for Integrated Care, 2017, ppA477 - A477 Conference Paper, 2017 DOI

Sarah Barry, Sara Burke, Ella Tyrrell, Steve Thomas,, 'Is someone going to saw off the plank behind me?' - Healthcare managers priorities, challenges and expectations for service delivery and transformation during economic crisis., Health Systems, Policy and Research, 4, (1:39), 2017, p1 - 7 Journal Article, 2017 TARA - Full Text URL

Burke S, Normand C, Barry S and Thomas S, From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis., Health Policy, 120, (3), 2016, p235 - 240 Journal Article, 2016 URL URL

Reform of the Irish Healthcare System: What Reform? in, editor(s)Murphy, M and Dukelow F. , The Irish Welfare State in the Twenty-First Century, Challenges and Change, Basingtoke, Palgrave Macmillan, 2016, pp167 - 193, [Burke, Sara] Book Chapter, 2016

The impact of the financial crisis on the health system and health in Ireland in, editor(s)Maresso A, Mladovsky P, Thomson S, Sagan A, Karanikolos M, Richardson E, Cylus J, Evetovits T, Jowett M, Figueras J and Kluge H , Economic crisis, health systems and health in Europe: country experience, Copenhagen, Denmark, : WHO/ European Observatory on Health Systems and Policies, 2015, [Anne Nolan, Sarah Barry, Sara Burke, Steve Thomas] Book Chapter, 2015 URL TARA - Full Text

Burke S, Thomas S, Barry S, Keegan C, Indicators of health system coverage and activity in Ireland during the economic crisis 2008-2014 - From 'more with less' to 'less with less'., Health policy (Amsterdam, Netherlands), 117, (3), 2014, p275-8 Journal Article, 2014 TARA - Full Text DOI

Steve Thomas, Sara Burke, Sarah Barry, The Irish health-care system and austerity: sharing the pain, The Lancet, 383, (9928), 2014, p1545 - 1546 Journal Article, 2014 DOI

The impact of the financial crisis on the health system and health in Ireland in, editor(s)Maresso A, Mladovsky P, Thomson S, Sagan A, Karanikolos M, Richardson E, Cylus J, Evetovits T, Jowett M, Figueras J and Kluge H, eds , Economic crisis, health systems and health in Europe: country experience,, Copenhagen, World Health Organization - European Observatory on Health Systems and Policies, 2014, pp1 - 42, [Nolan, Anne, Barry Sarah, Burke, Sara, Thomas, Steve] Book Chapter, 2014

Lessons from the European Union. Case Study 1: The Economic Crisis and the Irish Health System: Assessing Resilience. in, editor(s)X Hou, E Velenyi, AS Yazbeck, RF Iunes, O Smith , Learning from Economic Downturns, How to Better Assess, Track and Mitigate the Impact on the Health Sector, Washington, The World Bank, 2013, pp155 - 161, [Burke S, Nolan A, Thomas, S, Barry, S] Book Chapter, 2013 TARA - Full Text

Steve Thomas. Sara Burke, Coping with Austerity in the Irish Health System, Eurohealth, 18, (1), 2012, p7 - 9 Journal Article, 2012

Burke, Sara., Boom to bust: its impact on Irish health policy and services., Irish Journal of Public Policy. , 2, (2), 2010 Journal Article, 2010

Non-Peer-Reviewed Publications

Sara Burke, Universal Health care in Ireland in the context of the proposal of Universal Basic Services , A Just Transition, How do we tackle heat, greed and need? , Maynooth University , 28022020, 2020, Department of Sociology, Maynooth Invited Talk, 2020

Sara Burke, The Irish health system - what sort of system do we have and why - tracing Irish health policy developments , RCSI HSE Executive Skills Development Programme plenary , RCSI, 22/1/2020, 2020, RCSI Invited Talk, 2020

Research Expertise


  • Title
    • Health system foundations for effective Regional Integrated Care Areas (RICAs) - co-producing evidence to inform the design of regional areas to support integrated care in Ireland
  • Summary
    • Ireland has a poor track record of introducing organisational change in the health system, often causing great turmoil to the staff without improving access or quality of care for the people who use the service. We also have a health system that is overly-dependent on hospitals, difficult to access and fragmented in nature. The Sláintecare Implementation Strategy outlines how Regional Integrated Care Areas (RICAs) will be the mechanism to fund and provide integrated care locally. It is imperative that these new structures are designed and implemented so that they result in universal access to more responsive care, which better meets the needs of individuals and communities. Through analysing, synthesising and translating international and national theory, evidence and experience, this research will feed into the real-time RICA development process. Using methods including rapid reviews, mapping exercises, documentary analysis, key informant interviews, participant observation, secondary analysis of data and co-design techniques, findings will be instrumental to designing a Living Implementation Framework with Evaluation (LIFE), which is expected to be utilised beyond the timeframe of this project. Central to this project will be identifying the best data sources to measure impact of RICOs on integrated care and ensuring evidence-informed decision-making. This research will be carried out by the Trinity team, whose technical advice formed the basis of the Sláintecare Report, in partnership with the most senior leadership in the Department of Health, the Sláintecare Implementation Office, the HSE and the European Observatory on Health Systems and Policy. The real-time, iterative, nature of this research means it will impact as the project progresses, continuously learning and refining with the aim of developing an evidence-informed Regional Integrated Care Organisation (RICO) Living Implementation Framework with Evaluation (LIFE), which facilitates bounded regional autonomy within national policy, that is person-centred, empowers staff and communities, is effective and efficient.
  • Funding Agency
    • Health Research Board
  • Date From
    • 01-09-2019
  • Date To
    • 31-08-2021
  • Title
    • Mapping the Pathways to Universal Healthcare in Ireland
  • Summary
    • Ireland is unique among its European counterparts in that, unlike them, we have no universal access to healthcare. Since 2011, both Programmes for Government have committed to the goal of universal healthcare. Building on our prior work for the Resilience project, the Pathways project is mapping a potential pathway or pathways to universal healthcare through the three components of the research project: - Assessing the gap between current Irish health system performance and universal healthcare, using and adapting World Health Organisation concepts; - Evaluating the strengths and weaknesses of different models of universal healthcare and assessing their feasibility of implementation within the current context according to key criteria such as affordability, human resources and complexity of design; - Assessing the organisational challenges of moving to universal healthcare by reviewing the experience of other countries and exploring the current capacity and constraints facing decision makers throughout the system.
  • Funding Agency
    • Health Research Board
  • Date From
    • 01/10/2014
  • Date To
    • 01/10/2018
  • Title
    • Resilience of the Irish Health System: Surviving and utilising the economic contraction
  • Summary
    • A new government came to power in Ireland in March 2011. Included in the Programme for Government were the most radical proposals for health policy reform since the foundation of the State in 1921. The new government promised to undo the unequal, unfair two tier system of healthcare, specifically committing to 'access to medical care based on medical need, not income'. It specified over 80 health policy commitments including free GP care for all by 2016 and the introduction of Universal Health Insurance during a second term in office. All this was pledged during the most severe economic crisis experienced by Ireland since the 1930s which led to significant budget cuts including cuts to the health system. The Resilience project 2011-2014 gathered a range of indicators to monitor how the health system coped during the crisis, as well as, carrying out qualitative interviews with key policy makers, politicians and health service leaders. A specific website was set up to disseminate information and findings from the project.
  • Funding Agency
    • Health Research Board
  • Date From
    • 01/01/2011
  • Date To
    • 01/01/2014


Health Care Policy; Health Care Reform; Health Planning/Policy; Health policy; Health policy analysis; Health system reform; Healthcare Policy Implications; POLICY ANALYSIS; Public Policy; Public Policy Systems Analysis; RESEARCH POLICY IMPLICATIONS



Publication of an opinion article in the Irish Times entitled Election 2020: How are parties going to implement Sláintecare? 04-02-2020