Dr Patricia Clarke Centre for Cross Border Studies, Northern Ireland Improving health in the Irish border region: The lessons from cross-border co-operation

The Irish Border region

Cross-border research Jamison et.al To explore the potential for cross-border co-operation in terms of the practical benefits to patients in both jurisdictions, for health services as a whole, and in terms of economic and other considerations. Clarke et al To evaluate the co-operative progress of the health boards, the extent to which such co-operation has been embedded into mainstream health care and the future content of co-operation.

CAWT Cross-border Region

CAWT working structure Management Board and Director General Executive OfficerFinance Forum SecretariatProject/Finance Manager Health Promotion Human Resources CAWT Resource Unit Public Health Primary Care Acute Services Learning Disability Family/Child Care Information Technology Projects, Training Events, Conferences, Information Exchanges Mental Health Communications Co-ordinator Office Manager

PROJECT NAMESouth IR£ North £ Child Accident Prevention Programme Cross Border Flexi Workers CAWT Resource Unit* Protecting Children with a Disability Parenting Initiatives Primary Care Phase Drug Awareness Improving Health in Border Areas Ambulance Training Community Youth Cognitive Therapy Melvin Mental Health CAWTAS AGH/ Letterkenny Feasability Study Letterkenny Cancer Services TOTALS EU Investment

Cross Border Acute Care Aims and Objectives To develop relationships between institutions, their staff, their patients and their communities. To improve quality of access and reduce inequity in the provision of service. To create employment. To promote cross-border participation as part of everyday life by bringing communities together for the provision of acute hospital services. To share information, expertise, technology and understanding for the benefit of both communities.

Early contributions 1.Improved relationships 2.Inclusive debate 3.Raised the awareness of the health-related problems of the Irish border region at a European level. 4.Developed pool of experience 5.Patient benefits?

CAWT primary objectives Improving population health and well-being Exploiting opportunities for co-operation in planning and providing services Taking up available funding from the EU or from other third parties Involving other public sector bodies in joint initiatives Assisting border areas in overcoming problems arising from isolation Exploiting opportunities for joint working or sharing of resources where these would be of mutual advantage

Political endorsement NORTHERN IRELAND ADMINISTRATION GOVERNMENT OF IRELAND NORTH/SOUTH MINISTERIAL COUNCIL SIX AREAS FOR CO-OPERATION through existing jurisdictional bodies Education Transport Agriculture Health Environment Tourism SIX AREAS FOR ALL-ISLAND CO-OPERATION through IMPLEMENTATION BODIES Inland Trade and Business Food Safety Language Special EU Aquaculture, Waterways Development Promotion Promotion Programmes Lighthouses, Marine Tourism

Areas for co-operation 1.Accident & Emergency services 2.Planning for major emergencies 3.Co-operation on high technology equipment 4.Cancer research 5.Health promotion Cross-cutting mobility study Institute of Public Health and Food Safety Promotion Board

Recent progress 5 ministerial meetings February June 2002 Programme of work Joint training, staff development, staff exchanges Exchanges of information and research Feasibility studies Operational issues Strategic reviews

Constraints/ Barriers Policy and structural differences Funding issues Reciprocation Public acceptance Professional accreditation Insurance Competing pressures Political context

Constraints/ Barriers 2 Political instability and maintaining momentum 2001 Foot and Mouth Disease Defining parameters Phasing development in step with national strategies

Critical factors 1 Identification and definition of the problem 1.Systematic review of border problems 2.Added value of collaboration 3.Clinical-need driven

Critical factors 2 Mechanisms for innovation 1.Institutional structure 2.Resources 3.Removal of obstacles 4.Overall political context

Further details Centre for Cross Border Studies