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Irish Studies in International Affairs ; 32(2):117-141, 2021.
Article in English | ProQuest Central | ID: covidwho-2296336


Providing healthcare services commands the largest allocation of public funding on both sides of the Irish border and concerns over the efficiency and effectiveness of these systems are perennial. Over the past two decades health has been identified as a key area for cross-border collaboration. However, in the absence of an overarching framework or strategy, there is little clarity about objectives. Using the responses to the COVID-19 pandemic as a case study it demonstrates that even in the face of an existential crisis, political leaders default to debates over culture and identity. The paper sets out how the healthcare systems in the two jurisdictions share similar core principles and values and face similar social, economic and political pressures. They have adopted broadly comparable approaches to tackling systemic issues, such as an ageing and growing population, evolving healthcare needs, workforce planning and financial pressures. It argues that there is potential for greater cross-border cooperation but this requires high-level political agreement and must be based on robust evidence. As this paper shows, there are significant barriers to developing all-island approaches, but these are not insurmountable.

Irish Studies in International Affairs ; 32(2):413-447, 2021.
Article in English | ProQuest Central | ID: covidwho-2296335


Over the past two decades health has been identified as a key area for increased cross-border working on the island of Ireland. To date though, the approach has been minimalist and often project specific. The global pandemic, the continuing fallout from Brexit and the establishment of the Shared Island initiative have pushed the broad issue of healthcare cooperation up the policy agenda. Theoretically, closer cooperation could deliver economies of scale, value for money, opportunities for clinical specialisation, and facilitate the sharing of knowledge. However, despite its obvious potential and policy significance, cross-border collaboration in healthcare has been the subject of remarkably little research attention. This small-scale qualitative study is based on in-depth interviews with 49 individuals with expertise and experience in this area. From these interviews six broad themes emerged: support for collaboration, lack of strategic direction, knowledge sharing, CoviD-19, data and opportunities for future cooperation. Given the similar social, economic and political pressures faced by both healthcare systems, it is concluded that leveraging the strengths from cross-border collaboration should be a policy priority.