Renewing Health Services Management Research: Redrawing the Citizen-Client in Irish Health Care Policy

Ireland has a history of health policy which is not explicit as to its aims and objectives. In light of this fact, this paper examines the position and direction of the Irish Health Services, five years on from the advent of the setting up of the Health Services Executive (HSE) and the restructuring of the health services. The Irish health system policy is guided by the Health Strategy of 2001; in that there should be equitable distribution of health services focused on the need of the citizen-client, and also by the Primary Care Strategy (2001:7); in that there should be an increase in primary care provision to ‘meet people's health and personal social service needs in the community’. However, health policy in the last five years runs counter to this stated policy; in terms of advocating increased provision of private health care facilities in the acute care sector and their subsidisation by the state and through the increased centralisation of health care structures with reduced transparency. Tritter, Koivusalo, Ollila, and Dorfman, (2010) note that tensions between commercialisation, consumerism and patient and public involvement in healthcare have emerged in health policy debates in the last twenty years. This paper reports on comparative research which seeks to add to this discourse by looking at the health policy agenda in the Irish health care context and reporting on findings from field work in Canada.