The geographies for the six Health Regions were approved by Government Decision in 2019. A series of research, analysis, and consultation was undertaken by the Department of Health to support the identification of the optimal boundaries for the new regions. This included a review of approaches taken internationally and in previous reforms in Ireland, a public consultation process, and a detailed analysis of service usage patterns.
This analysis of service usage patterns across the country examined patient flows to establish the extent to which hospitals in a given location serve patients who live in that area. The regions were designed to be as self-contained as possible – this is critical in the move to a population-based planning and funding model. In the South Tipperary area, the analysis showed that the best alignment of patients to the hospitals they are most likely to attend was accomplished by including Tipperary University Hospital in Area C.
Another important consideration in any potential geography was ensuring minimum disruption to existing services. The majority of health and social care services are provided outside of hospitals and are delivered locally, closer to people’s homes. The nine CHOs have clearly identified catchment areas, whereas most Hospital Groups do not. Drawing boundaries to fit unclear hospital catchment areas would have proven disruptive. While considerable attention was paid to observing county boundaries where possible, certain necessary deviations from these (i.e. Dublin, Wicklow, and Tipperary) were done in favour of current boundaries associated with the delivery of community services. With regard to the area surrounding Tipperary University Hospital, the geography boundaries approved by Government respects the existing CHO 5 boundary, ensuring that all services in CHO 5 are delivered within the same region (which also includes Wexford, Carlow, Kilkenny, and Waterford), and ensuring there is minimum disruption to the delivery of those services.
At this time, Government does not plan to revise the geographies of the forthcoming Health Regions.
My officials have sought further information from the HSE regarding care pathways and their implications and we will revert as soon as is practical to the Deputy in writing.
