1. LIFE IN THE ACUTE HOSPITAL SECTOR
Prof.Orla Hardiman
Dept.Neurology
Beaumont Hospital

2. Population health triangle5%
15%
80%
Undiagnosed disease
Healthy population with risk factors
Disease Severity

3. THE PATIENT JOURNEY Inefficient Poorly Coordinated
Bad geographic access
Reactive funding

4. Use of hospitals

5. THE NEED FOR REFORM We tried everything, but it still wont work! IRISH
We all the usual methods but it still wont work!
We tried everything, but it still wont work!

6. CHALLENGES TO REFORM
Power struggles
Weak governance

7. Power Struggles Department and HSE Sections within HSE
Managers and clinicians
Who is in charge?
Who should be in charge?
Clinical judgement and standardized care
Who is accountable?

8. Weak Governance Hospital management Clinical work practices
HSE Structure
Process v outcomes?

9. SOLUTIONS Good governance Accountability
New debate over public and private

10. Good governance

11. Accountability

12. Public and private
Co-location?
Cui bono?

13. HOW TO GET THERE..
START THE DEBATE
The time is now…