Health service reform must be driven by ‘judicious, evidence-based approach’


Reform of the health service must be driven by a “judicious, evidence-based approach” to patient care, the president of the Royal College of Surgeons in Ireland has urged.

Kenneth Mealy told an RCSI conference that Ireland’s health service regularly exceeds its budget.

“Without a serious look at how and why our health service spends the money it does, we run the risk of building something that is, in the long term, unaffordable and unsustainable,” he said.

While an appropriate budget was crucial, money should not be thrown at a broken system underpinned by broken practices.

“We need to review the full care journey we provide for patients so that we are not spending or allocating resources in an inefficient and ineffective manner,” he said.

“For example, individual doctors and surgeons often use drugs, treatments, and implants that are three or four times more expensive than the available alternatives.”

Mr Mealy said the situation is leading to the squandering of limited resources that could be better spent or utilised elsewhere.

Overprescribing of antibiotics by GPs is depleting stocks of valuable medicine and, ultimately, leading to antibiotic resistance.

Whatever form the next Irish government takes, it is crucial that its Sláintecare implementation programme is guided by rules governing best practice and driven by a judicious, evidence-based approach to patient treatment.

Evidence-based medicine is the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients.

“Wasteful practices and inefficiencies, such as unnecessary procedures or the use of more expensive medicines despite the availability of cheaper and equally effective alternatives, drive up costs,” said Mr Mealy.

Sláintecare, produced by a cross-party committee of TDs in May 2017, recommends a greatly expanded public health service, underpinned by long-term funding commitments.

The 10-year-plan plan promises increased efficiency but admits that the reforms will cost significantly more money.

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