Planning in the Irish healthcare system: Legislative strategy or administrative control?

Abstract

Although strategic planning in healthcare has been in evidence in many OECD countries since the 1970s, it did not emerge in Ireland until the advent of legislatively mandated service planning in the 1990s. This occurred in the context of significant managerial, organisational and environmental change. One of the central mechanisms of the Strategic Management Initiative is the devolution of accountability and responsibility from the centre to the periphery. Service planning in the health sector in Ireland is seen as part of this strategic planning ethos. This paper reports on part of a wider study that examined both the intent and the consequences of this legislatively mandated service planning and looked at the process of its implementation in Irish healthcare. This has important implications for Irish health policy due to the continuing budget overruns, the embargo on recruitment of frontline staff and the reported lack of strategic planning. This paper posits explanations for the difficulty in aligning strategy and planning after nearly a decade of service planning.