We need an integrated health system that takes our ageing population into account, says Dr PJ Harnett

PJ Hartnett Mowlam copy

Ireland is not alone in having a fragmented healthcare system, reflecting the piecemeal evolution of such systems over the decades. But, like other countries, it is now endeavouring to integrate all aspects of its health and care services, so that patients can enjoy continuity of care that is more personalised and will ensure better outcomes.

Dr PJ Harnett was recently appointed as Mowlam Healthcare’s head of integrated care. As a previous national programme lead for integrated care for older people with the HSE, he is uniquely placed to deliver on Mowlam Healthcare’s strategy to deliver diverse community-based care services to support the needs of the Irish healthcare system and our ageing population.

Mowlam Healthcare is the largest independent Irish provider of nursing home care in Ireland and operates a “continuum of care model”, whereby, as a person’s care needs change as they age or become unwell, they can be met. Services include respite, rehabilitation, long-term care and palliative care.

Developing integrated care means working in a more planned and collaborative way with the whole health system to ensure better access and continuity, and co-ordination for the service user, leading to outcomes that matter to them. Dr Harnett says the health service has successfully improved outcomes for acute illnesses – heart attacks and strokes, for example – but is less equipped to treat patients’ with care needs over the long term.
However, changes are happening in healthcare internationally that involve “focusing on local populations and seeking to implement integrated care as an approach”, Harnett says, citing trends in the UK, Canada, Singapore and New Zealand as examples.

“The concept of compassionate communities, looking after older people, with the health system working in partnership with others, is taking root in communities all over the world,” he adds.

Ireland’s health service is much-maligned, with issues from long waiting lists to bed shortages attracting criticism. Yet Harnett says there are many positives to Ireland’s health service that will be invaluable as it begins the shift to integrated care.

“The prevailing narrative about the health system not working is not entirely accurate because in Ireland we have the longest life expectancy in Europe,” he explains. “We have fantastic pathways for cancer and heart disease now and they have been very successful.”

The fact that Ireland has a unified health and social care system – which is not the case in all jurisdictions – is another advantage, Harnett adds. We also direct substantial investment towards enhancing community care.

But Ireland, in common with many other countries, is also grappling with a rapidly ageing population; gains in life expectancy bring new expectations and a need for a different approach. These changing demographics are also making care more complex.

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