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

2. The Irish Border region

3. Cross-border research Jamison et.al. 2001 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. 2001 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.

4. CAWT Cross-border Region

5. 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

6. PROJECT NAMESouth IR£ North £ Child Accident Prevention Programme 228866 280739 Cross Border Flexi Workers 3750037500 CAWT Resource Unit* 345339 365953 Protecting Children with a Disability 5550055500 Parenting Initiatives69625 69500 Primary Care Phase 702159 598903 Drug Awareness133333 0 Improving Health in Border Areas 324912340833 Ambulance Training177000 167000 Community Youth219000 0 Cognitive Therapy59245 82472 Melvin Mental Health235393 212571 CAWTAS28089 25000 AGH/ Letterkenny Feasability Study34832 31000 Letterkenny Cancer Services 52434595300 TOTALS3175138 2362271 EU Investment

7. 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.

8. 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?

9. 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

10. 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

11. 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

12. Recent progress 5 ministerial meetings February 2000 - June 2002 Programme of work Joint training, staff development, staff exchanges Exchanges of information and research Feasibility studies Operational issues Strategic reviews

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

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

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

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

17. Further details Centre for Cross Border Studies www.crossborder.ie