There’s been some discussion recently in the media about the siting of primary care centres (see these two stories today in the Irish Times, here and here).  Minister Roisin Shortall drew up a list of 20 priority locations, to which Minister James Reilly added 16 others and deleted one.  Apparently the list was drawn up using deprivation indices as the supporting evidence base.  Reilly felt that other factors needed to be used as well, such as location of existing health facilities and access to them.  The spat between the Ministers has led to suggestions of ‘stroke’ politics being employed by Reilly, who added two towns in his own constituency to the list both of which ranked lowly on Shortall’s list.

Now, in this age of evidence-based policy formulation and supposed transparency it would seem the logical thing for the Department of Health to do is to publish the data and and the algorithms/heuristics employed in its analysis to decide the location of the primary care centres.  That way everyone can assess the extent to which the list-making was in fact robustly evidence-informed.  If such a process was undertaken by both Shortall and Reilly and their teams then it should be relatively straightforward to publish as surely the data, analysis and argument exists, documented in memo/report form and held within a GIS.  And there should be no issues over confidentality as all the data will be aggregated and in the public domain already.  This should have been a relatively straightforward exercise – either use existing deprivation index data at Small Area or EA/ED area (based on Census data) and use access to health service data.  In fact both sets of data are freely available on the AIRO website as interactive maps (see here for deprivation, here for access to health services including hospitals, GPs, dentists and pharmacies).  And other data could be easily factored into this, including Northern Irish data for areas along the border and other socio-economic data.

I’m sure some convenient excuse will be made as to why the science and evidence underpinning the formulation of both lists of centres cannot be released to the public for wider scrutiny.  It would be nice, however, to be proved wrong and the evidence and analysis are released so we can assess the robustness of the data and investigation used to site new health care facilities (after all, the move to evidence-informed and transparent analysis is meant to ensure that decisions are open to scrutiny and clear to all).

Rob Kitchin

Advertisements