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Dr. Sara Burke
Associate Professor, Public Health & Primary Care


Prof Sara Burke is an Associate Professor and the Director of the Centre for Health Policy and Management, which is part of the Discipline of Public Health and Primary Care in the School of Medicine, Trinity College Dublin. She is also a co-Director of the national SPHeRE PhD programme She is the Principal Investigator of a research project entitled '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'. This is a HRB Applied Partnership Award which runs until 2024 thanks to successfully getting a HEA COVID-extension fund in 2021. This APA project started with its focus on the implementation of the regions but changed direction in 2020 in order to harness learnings from the COVID-19 health system response to inform the implementation. Prof Burke leads the team reporting on Ireland for the European Observatory Health Systems COVID-19 response monitor) ( Previously, she coordinated 'Mapping the pathways to universal healthcare'. In the first five months of 2017, Sara and a team from the Centre, led by Prof Steve Thomas 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 Policy and Management and teaches health policy to 4th year medical students and for the Global Brain Health Institute fellows. Sara has worked for more than 25 years as a researcher in and of health systems and policy. Her book entitled Irish Apartheid, Healthcare Inequality in Ireland was published in 2009. She writes on occasionally 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

Parker Sarah, Siersbaek Rikke, Mac Conghail Luisn, Burke Sara, Public Health Responses to Homelessness During COVID-19 in Ireland: Implications for Health Reform, International Journal for Equity in Health, 22, (1), 2023, p36-52- Journal Article, 2023 URL DOI

Rina Maoz Breuer, Ruth Waitzberg, Adin Breuer, Peter Cram, Lucie Bryndova, Gemma A Williams, Kaija Kasekamp, Ilmo Keskimaki, Liina-Kaisa Tynkkynen, Verena van Ginneken, Eszter Kovács, Sara Burke, Domhnall McGlacken-Byrne, Carol Norton, Barbara Whiston, Daiga Behmane, Ieva Grike, Ronald Batenburg, Tit Albreht, Rade Pribakovic, Enrique Bernal-Delgado, Francisco Estupiñan-Romero, Ester Angulo-Pueyo, Adam J Rose, Work like a Doc: A comparison of regulations on residents' working hours in 14 high-income countries, Health Policy, 130, 2023, p104753 Journal Article, 2023 DOI TARA - Full Text

Parker, Sarah and Mac Conghail, Luisne and Siersbaek, Rikke and Burke, Sara, How to not revert to type: Complexity-informed learnings from the pandemic response for health system reform and universal access to integrated care, Frontiers in Public Health, 11, 2023 Journal Article, 2023 DOI

Ellen Cosgrave, Aishling Sheridan, Edward Murphy, Martina Blake, Rikke Siersbaek, Sarah Parker, Sara Burke, Frank Doyle, Paul Kavanagh, Public attitudes to implementing financial incentives in stopsmoking services in Ireland, Tobacco Prevention & Cessation, 9, (9), 2023 Journal Article, 2023 TARA - Full Text DOI

Siersbaek Rikke, Ford John, Ní­ Cheallaigh Cliona, Thomas Steve, Burke Sara, How do health system factors (funding and performance) impact on access to healthcare for populations experiencing homelessness: a realist evaluation, International Journal for Equity in Health, 22, (1), 2023, p218- Journal Article, 2023 DOI URL

Thomas, S, O'Donoghue, C, McCarthy, N, Almirall-Sanchez, A, Burke, S, Keegan, C, Dempsey, G, Barry, S, Fleming, P, The PRESTO report. Sustainability and Resilience in the Irish Health System, Trinity College Dublin/London School of Economics/Partnership for Health System Sustainability & re, March 2023, 2023 Report, 2023 URL TARA - Full Text

Siersbaek, R and O'Donnell, C and Parker, S and Ford, J and Burke, S and Ní Cheallaigh, C, Social exclusion and its impact on health over the life course: A realist review protocol [version 1; peer review: 2 approved with reservations], HRB Open Research, 6, (34), 2023 Journal Article, 2023 DOI

Rikke Siersbaek, Sarah Parker, Paul M Kavanagh, John Ford, Sara Burke, How and why do financial incentives contribute to helping people stop smoking? A realist review protocol, BMJ Open., 12, 2022 Journal Article, 2022 TARA - Full Text DOI

McAuliffe U., Whelton H., Harding M., Burke S., 'Toothless - the absence of political priority for oral health: a case study of Ireland 1994"2021, BMC Oral Health, 22, (1), 2022 Journal Article, 2022 TARA - Full Text DOI

Fleming Padraic, Thomas Steve, Williams Des, Kennedy Jack, Burke Sara, Implications for health system reform, workforce recovery and rebuilding in the context of the Great Recession and COVID-19: a case study of workforce trends in Ireland 2008â€"2021, Human Resources for Health, 20, (1), 2022, p48- Journal Article, 2022 URL DOI

Padraic Fleming, Louise Caffrey, Sara Van Belle, Sarah Barry, Sara Burke, Jacki Conway, Rikke Siersbaek, David Mockler, Stephen Thomas, How International Health System Austerity Responses to the 2008 Financial Crisis Impacted Health System and Workforce Resilience " A Realist Review, International Journal of Health Policy and Management, 12, 2022 Journal Article, 2022 URL

Siersbaek Rikke, Ford John Alexander, Burke Sara, Ní­ Cheallaigh Clí­ona, Thomas Steve, Contexts and mechanisms that promote access to healthcare for populations experiencing homelessness: a realist review , BMJ-Open, 11 , (4 ), 2021, pe043091 - Journal Article, 2021 DOI URL TARA - Full Text

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, 2021, p70 Journal Article, 2021 DOI

Barry, S, Ní Fhallúin, M, Thomas, S, Harnett, PJ, Burke, S. , Implementing Integrated Care in Practice - Learning from MDTs Driving the Integrated Care Programme for Older Persons in Ireland, International Journal of Integrated Care , 21(1):15, ((1) ), 2021, p1 - 11 Journal Article, 2021 URL

Nolan Ann, Burke Sara, Burke Emma, Darker Catherine, Barry Joe, O'Connell Nicola, Zgaga Lina, Mather Luke, Nicolson Gail, Dempster Martin, Graham Christopher, Crowley Philip, O'Connor Cliodhna, Tobin Katy, Scally Gabriel, Obstacles to Public Health that even Pandemics cannot Overcome: The , Irish Studies in International Affairs , 32 , (2 ), 2021, p225 - 246 Journal Article, 2021 URL DOI

Siersbaek, R; Ford, J; Ní Cheallaigh, C;Burke, S;Thomas, S., Making healthcare accessible for single adults with complex needs experiencing long-term homelessness: A realist evaluation protocol [version 2; peer review: 2 approved]., HRB Open Research , 2021, p1-17 Journal Article, 2021 DOI

Unruh L, Allin, S, Marchildon, Burke, S, Barry, S, Siersbaek, Thomas, S, Selina, R, Andriy, K, Alexander, M, Merkur, S, Webb, E,Williams, GA., A comparison of health policy responses to the COVID-19 pandemicin Canada, Ireland, the United Kingdom and the United States of America , Health Policy, online 1 July, 2021 Journal Article, 2021 URL

Snell, M, Nicksica, N, Panteli, D, Burke, S, Eissenberga,T, Fattored, G, Gaucie,C, Koprivnikarf, H, Murauskieneg, L, Reinaph, M, Barnes, A., Emerging electronic cigarette policies in European member states, Canada, and the United States, Health Policy, 2021 Journal Article, 2021 URL

Thomas,S, Johnston, J, Barry, S, Siersbaek, R, Burke, S., Sláintecare implementation status in 2020: Limited progress with entitlement expansion, Health Policy, 2021 Journal Article, 2021 URL

Burke, Sara; Parker, Sarah; Fleming, Padraic; Barry, Sarah, Thomas, Steve, Building health system resilience through policy development in response to COVID-19 in Ireland: From shock to reform, The Lancet Regional Health - Europe, 10, (100223), 2021 Journal Article, 2021 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

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

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 URL DOI

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

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

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

Murphy, Seán Joseph; Lee, Mandy; Burke, Sara., Integrating Care On A Cross-Border Basis: Priorities Of Key Actors In The Irish Context, International Journal of Integrated Care, 17, (5), 2017, p482 - 482 Journal Article, 2017 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

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

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

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 DOI TARA - Full Text

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

Sara Burke, Irish Apartheid. Healthcare inequality in Ireland, 1st, Dublin, Ireland, New Island, 2009 Book, 2009

Research Expertise


  • Title
    • 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
  • Summary
    • All over the world, health systems are responding to the major shock of the COVID-19 pandemic. The virus is causing urgent and fast-paced change in the delivery of health and social care as well as highlighting pre-existing deficiencies and inequalities in the health system and broader society. In Ireland, COVID-19 is occurring during the second full year of Sláintecare's implementation - Ireland's 10-year plan for health reform to deliver universal access to timely, integrated care. This research will coproduce a Living Implementation Framework with Evaluation (LIFE) linking evidence, policy and practice that feeds into real-world Sláintecare implementation. In partnership with senior leadership in the Sláintecare Programme Implementation Office, the Department of Health and the HSE, the researchers will scope, document, measure and analyse the Sláintecare relevant COVID-19 responses using qualitative and quantitative methods. The LIFE will initially take the form of a live spreadsheet which contains the COVID-19 responses most relevant to Sláintecare. For each response, 3-4 indicators will be collected which enables monitoring overtime. The spreadsheet will be accompanied by a series of rapid reviews, narrative descriptions of multiple case studies, research papers, stakeholder engagement and formative feedback. These collectively make up the 'LIFE', informing dialogue with the project partners, which is happening in real time (living), influencing health policy and system decision-making and implementation as the project progresses. The LIFE will inform health system reform in Ireland in the months and years after the emergence of COVID-19 as well as contributing to international health systems and policy research.
  • Funding Agency
    • Health Research Board
  • Date From
    • 01-09-2019
  • Date To
    • 30-05-2022
  • 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 piece for the Irish Times entitled 'Whatever happened to Sláintecare?' in the aftermath of the publication of a report into negligent care provided by the South Kerry Child and Adolescent Mental Health Team. 03/02/2022

I acted as special rapporteur at the health session of the Irish Government's 2021 National Economic Dialogue, this session was co-chaired with the health minister Stephen Donnelly and I. More 23-06-2021

Opinion published in Irish Times 22-092021

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

In 2016/17, I coordinated the research team (with prof Steve Thomas as PI) which won a tender to provide technical support to the Oireachtas Committee on the Future of Healthcare. This work resulted in the publication of the 2017 Sláintecare Report 30-05-2017