When the Taoiseach (Irish Prime Minister), Brian Cowen, was Minister for Health he memorably called this particular cabinet brief ‘Angola’, because of all the unexploded political landmines he felt it contained. In fact, very few politicians have found the stewardship of the country’s health system to have furthered their careers, with the possible exception of Charles Haughey, who was able to remain focused on policy initiatives and service improvements while there. Most politicians in charge of health appear to be quickly overwhelmed by the combination of intractable problems and vocal vested interests. And just in case anyone thought that this was a peculiarly Irish phenomenon, the same is pretty much true in the UK, and as we know even Barack Obama is struggling (though perhaps with some success now) to make health reform work for his administration in the United States.
But difficult though health policy and its implementation may be, it is right at the top of everyone’s list of priorities. Right now the global health system is having to deal with H1N1 influenza, as well as the various other diseases and pandemics rampaging through parts of the world. We also know that ageing-related health issues will need to be addressed for demographic as well as social reasons. We know that the relationship between health, diet and lifestyles needs to be explored further. In short, health is everyone’s burning concern. And in that setting, we have not really worked out yet how best to structure the healthcare systems in our countries, and how to pay for them; the demand-led system of universal benefits, when applied to healthcare, has not just become unaffordable but actually unmanageable – but we struggle to work out how we could do it better.
One aspect of all this that will need a lot of attention is health research. This is important for two reasons: first, we should be addressing in high value research the key issues that are having an impact on people’s health; and secondly, we should harness the economic benefits of healthcare research as a magnet for high value investment by companies in this field, including some of the biggest blue chip companies in the world. Although these are two different reasons, they actually point us in the same direction: that we should focus on certain programmes of research where as a country we have or can reach critical mass, and we should present these areas as ones that should attract international industrial investment in Ireland. Some of these areas are already clear, such as cancer research (where the National Cancer Institute has brought together the key players from the North and South, with US partners); others show potential, such as Diabetes; and others again support health research and treatment, such as medical diagnostics (with DCU’s Biomdedical Diagnostics Institute playing a particularly important role).
All this is likely to be helped by the new strategic plan of the Health Research Board, which has prioritised research in certain key areas and has also highlighted the importance of translational research, meaning research with a programme for its use in improving or solving health-related issues.
It is important for us to think of health as an opportunity as well as a problem. Ireland has some real excellence in health research across all the universities and other institutions (such as the Royal College of Surgeons in Ireland), and therefore can both make a contribution to addressing global health issues and gain an economic benefit from doing so. It is, as they say, a no-brainer.