Press release
Minister for Health announces implementation of fundamentally reformed Consultant-led Public Health Model in Ireland
From Department of Health
Published on
Last updated on
From Department of Health
Published on
Last updated on
The Minister for Health is today announcing that agreement has been reached with the Irish Medical Organisation (IMO) on a reformed public health model in Ireland. It is understood that the IMO will recommend the Agreement to their members who will ballot on it in the coming weeks.
Minister Donnelly said:
"The government has recognised that major reform of the Public Health function is necessary and through the COVID-19 Path Ahead Plan we have committed to investing in, and resourcing of public health and the delivery of a strengthened and reformed consultant-delivered public health model. The past year has highlighted the critical national importance of a public health workforce with the capability to provide a robust and resilient health protection response. I welcome that an agreement has been reached with the Irish Medical Organisation that will support the implementation of a fundamentally reformed public health model at a national and regional level which is aligned with international best practice. I want to acknowledge the support from Minister McGrath and his commitment to this critical public health reform which has enabled us to reach this agreement."
The enhanced service delivery model radically changes the governance and operating structure within Public Health, introducing a more fit-for-purpose National and Regional management structure across each of the pillars of Public Health – a consultant led ‘hub-and-spoke’ structure as envisaged by the Crowe Horwath Report.
The Minister is pleased that implementation of the new model will be progressed on a phased basis and will include the establishment of the grade of Consultant in Public Health Medicine to provide the strategic leadership for this reformed Public Health Model.
As Ireland emerges from the current set of protective measures and seeks to prevent, minimise and delay any future escalation in cases, a fast, dynamic and agile, integrated and intelligence-led public health response, organised at a local level, will be critical to preventing or minimising a further resurgence in cases in the medium and long-term. As a result, the Phase 1 priority posts for recruitment through open competitive processes will be in the Health Protection pillar.
Acting Chief Medical Officer, Dr. Ronan Glynn, said:
"The past year has highlighted the critical importance of a robust, comprehensive, public health-led multidisciplinary response to the management of infectious disease threats in our communities. As we hopefully emerge from this pandemic, the other components of public health medicine including the promotion of public health and wellbeing, the ongoing evaluation and improvement of our health services and the use of health data and intelligence to inform those developments, should provide a fundamental underpinning to the necessary transformation that will be required in our approach to the improvement of the public’s health in the years to come. Today’s announcement recognises the critical role that consultants in public health medicine can play in this transformation, acknowledges the importance of prevention as well as cure, and provides a basis for the development of a new and reformed model of public health medicine in Ireland."
Chief Clinical Officer of the HSE, Dr. Colm Henry, added:
"We have long known the value of our Public Health teams and the role they play in the individual and collective health of our people. The past year has highlighted the global threat to population health posed by novel infectious agents and the critical national importance of a public health workforce sufficient to provide a robust, resilient, and responsive health protection response to those threats. The HSE’s Public Health teams have been at the forefront of our COVID-19 pandemic response, demonstrating considerable leadership, commitment, and professionalism in protecting our communities. I look forward to working with our Public Health colleagues to bring the service to the next level and ensure that Ireland emerges from the pandemic with a public health service and workforce aligned with international best practice."
A considerable amount of work has been completed in the design of the new model and the department and the HSE are excited to continue to work with our public health physicians to now implement the new model. The next step will involve the HSE commencing an open recruitment process for Consultants in Public Health Medicine to fill the prioritised posts.
In 2017, the Department of Health commissioned Crowe Horwath to undertake a review of the current and future role, training, and career structures of public health physicians in Ireland. The report published in December 2018 recommended that a new Service Delivery Model for the Public Health function in the HSE should be created and that it should be led by Consultants in Public Health Medicine.
The new model introduces a strong Public Health Function strategically aligned within the HSE to protect and promote the health of the Irish population, to contribute effectively to major service design and policy implementation, to address health inequalities, and ensure a population needs based approach to integrated healthcare delivery. The model seeks to rebalance capacity to deliver effectively across all four domains of public health practice (Health Protection, Health Intelligence, Health Service Improvement and Health and Wellbeing) and optimise the contribution of consultant expertise to deliver greater impact across an expanded remit of service provision. Under the new model, Consultants in Public Health Medicine (CPHM) will lead appropriately resourced multidisciplinary teams, that include surveillance scientists/epidemiologists, senior medical officers, trained contact tracers, administrative and, crucially, robust operations and management support.
Consultants in Public Health Medicine (CPHM) are the medical experts, with substantial and direct involvement in the assessment, delivery of care (with a focus on proactive, preventive and integrated care) and overall leadership for ensuring the protection and improvement of health of the population.
The Department of Health, HSE and the Irish Medical Organisation have been engaged in discussions about the new model and the future of the specialty of Public Health Medicine over the past number of months and are agreed on the implementation of the new model and the immediate introduction of the grade of Consultant in Public Health Medicine for the first time in Ireland.
A Consultant-led model will enable recruitment and retention of Public Health Doctors with the capability, autonomy, authority, accountability and multidisciplinary teams to deliver an agile, dynamic, intelligence-led public health medicine service to protect the population from health threats, promote health, improve health services and tackle inequalities in health.
The parties have agreed that a Consultant-delivered Public Health Model will be implemented by December 2023, with the establishment of 34 consultant posts in the first year and a total of 84 Consultant in Public Health Medicine posts by end December 2023. The phased nature of the implementation will facilitate the completion of a review process to ensure reform is embedded in this Public Health Model throughout the implementation process.