Ireland's takeover of private hospitals during the COVID-19 pandemic.

In Ireland, the coronavirus disease 2019 (COVID-19) pandemic has led to a total of 230,599 cases of infection as on 20 March 2021, and 4323 deaths. Although the Irish hospital network has not been overwhelmed, it has faced pressures, with a total of 13,313 persons hospitalised, including 1402 admitted to the intensive care unit. Out of caution, in spring 2020, in anticipation of possible surges in hospitals in light of international experience, the Irish government reached an agreement with private hospitals to access their capacity for three months to alleviate pressure on the public system, as part of its comprehensive response to the pandemic. This piece analyses the agreement with private hospitals, based on the legally binding Heads of Terms of the agreement, which were signed by the parties, along with publicly reported details from media reports and Oireachtas (parliamentary) committee hearings. We argue that although the new relationship could, in theory, have paved the way to the nationalisation of the whole hospital system, in fact, the experiment is best interpreted as a lost opportunity to integrate and simplify Ireland's hospital system.

The Public-Private Mix in Primary Care Development: The Case of Ireland.

In 2001, Ireland announced a Primary Care Strategy that has led to the implementation of primary care centers (PCCs) throughout the country. This article examines the nature and extent of private and public sector involvement in establishing the PCC network since 2001. The study is based on a PCC dataset constructed using unpublished data obtained from Ireland's Health Service Executive (HSE). The dataset includes the date when PCCs became operational and their mode of delivery: public procurement, private lease, or public-private partnership. The results show that 140 PCCs have or will become operational by the end of 2019: 35% (49 PCCs) are public, 55% (77) are leases with private landlords, and 10% (14) are public-private partnerships. Before 2009, PCCs were delivered by traditional public procurement, but since 2009, private delivery methods have been prioritized. In conclusion, the PCC network has been increasingly implemented by relying on the private sector. This results in a more commercialized network subject to financial risks associated with public-private partnerships.

Privatization in the Irish hospital sector since 1980.

Background: Privatization has transformed health care systems over the last several decades. This article examines trends in bed supply in Ireland between 1980 and 2015 within the context of government policy on bed provision in a system of inequitable access to care. Ireland has not published bed data on private hospitals since the 1980s, even if they comprise about one-quarter of all hospitals. However, this article presents, for the first time, annual bed data since the 1980s collected from private hospitals and used to trace the evolution of bed supply over time. Methods: Bed data were collected for private Irish hospitals for the years 1980-2015, mainly through direct requests to hospitals. Additional sources included the Irish Medical Directory, private health insurance data, hospital company records and newspaper archives. Results: Subject to data caveats explained in the article, between 1980 and 2015, total inpatient beds decreased by 25.5% nationally. Inpatient bed numbers in private for-profit (PFP) hospitals rose from 0 to 1075 but decreased from 9601 to 5216 in private not-for-profit (PNFP) hospitals and from 7028 to 6092 in public hospitals (using the Irish hospital classification, beds in private hospitals increased from 1518 to 1910 but decreased from 15 111 to 10 473 in public hospitals). Also, by 2015, 24.1% of PFP hospital beds were day beds, compared to 17.7% for PNFP and 15.7% for public hospitals (using the Irish classification, by 2015, day beds accounted for 23.8% of beds in private hospitals and 16.1% in public hospitals). Conclusions: Trends in bed supply in Ireland between 1980 and 2015 are documented empirically for all Irish acute hospitals and contextualized within government policy on bed provision. The Irish acute hospital system has experienced privatization reforms supported by the government over the last several decades.

Media Coverage of Alcohol Issues: A Critical Political Economy Framework-A Case Study from Ireland.

There is a growing literature on news media representations of alcohol-related issues. However, current scholarship has neglected critical political economic frameworks to interpret media coverage of alcohol. This paper presents such a framework that conceives of news organisations as corporations that share the values and interests of political and economic elites. The media are thus expected to present viewpoints that are more aligned with the alcohol industry than the scientific consensus on public health policy would warrant. The media are also expected, but to a lesser extent, to present a certain amount of support for public health perspectives because these are supported by a few socioeconomic elite groups (the medical professions, progressive politicians). The case of Ireland from 2012 to 2017 illustrates the framework empirically. Four main newspapers' coverage of the Public Health (Alcohol) Bill and related policies is examined. Results show that, overall, 44.0% of articles support public health measures and 56.0% are opposed or remain neutral. It is argued that the media are not strong proponents of public health for multiple reasons: there are more articles opposed to or neutral toward public health measures than supporting them; the number of supportive articles remains relatively small and there are still many pieces presenting drinks industry views; there are virtually no calls in the media for stronger measures; supportive coverage is partially explained by the pub owners lobby's support for minimum unit pricing; the media often downplay or ignore the negative consequences of alcohol, such as its role in accidents; many news articles normalise drinking and promote events sponsored by the industry; there is not a single Irish journalist covering alcohol issues systematically; and other policy issues that are prioritised by elites receive multiple times more media coverage than public health measures. In short, the media reflect the views of the political and economic establishment on public health measures: there is some support from the medical professions and progressive politicians, but overall, there is a clear reluctance to support strong public health strategies. One main recommendation for public health advocates to promote their perspectives is to diversify the mass media and make them less commercial in nature, as well as to engage with non-corporate, so-called progressive "alternative media" outlets.