Document Type

Conference Paper


Available under a Creative Commons Attribution Non-Commercial Share Alike 4.0 International Licence


Health policy and services, public administration, Organisation Theory

Publication Details

Political Studies Association of Ireland Annual Conference October 2010, Technological University Dublin, Dublin. Issues in Comparative Public Administration Session.


The complexity of the health care environment necessitates that health policy, legislative objectives, resource allocation models, and management structures be aligned to plan and deliver healthcare services strategically. Policy in the Irish health care system is guided by the National Health Strategy of 2001; in that there should be equitable distribution of health services focused on the need of the citizen-client. Though the Strategy uses the words ‘evidence based’, ‘population health’, ‘equity’, ‘people-centred’ and ‘health and social gain’, there is little evidence that these concepts have gained purchase in the present implementation of policy and planning in Irish health care (Byers 2009). Health policy in the last five years, in terms of the statements made and the actions taken by the Minister for Health and Children, runs counter to the national strategy; in terms of advocating increased provision of private health care facilities in the acute care sector and their subsidisation by the state as well as through the increased centralisation of health care structures with reduced transparency.

This paper reports on a study of policy and planning in the health care sector. It considers the ambiguity of a health care strategy crafted to underpin such planning in service delivery and espousing the principles of ‘people centredness’ and ‘equity’, and policy implementation on the ground. The paper also draws on the Canadian experience as a comparator, where the pursuit of citizen-centred policy, has stimulated innovative approaches to the organizational design of governments’ service delivery systems (Flumian, Coe & Kernaghan 2007).