Dr Patricia ClarkeCentre for Cross Border Studies, Northern Ireland

Improving health in the Irish border region:The lessons from cross-border co-operation

The Irish Border region

Cross-border research

Jamison et.al. 2001

To explore the potential for cross-border co-operation in terms of the practical benefits to patients in both jurisdictions, for health services as a whole, and in terms of economic and other considerations.

Clarke et al. 2001

To evaluate the co-operative progress of the health boards, the extent to which such co-operation has been embedded into mainstream health care and the future content of co-operation.

  

CAWT Cross-border Region

CAWT working structure

Management Board and Director General

Executive Officer Finance Forum

Secretariat Project/Finance Manager

Health Promotion

Human Resources

CAWT Resource Unit

Public Health

Primary Care

Acute Services

Learning Disability

Family/Child Care

Information Technology

Projects, Training Events, Conferences, Information Exchanges

Mental Health

Communications Co-ordinator

Office Manager

PROJECT NAME South IR£ North £Child Accident Prevention Programme 228866 280739Cross Border Flexi Workers 37500 37500CAWT Resource Unit* 345339 365953Protecting Children with a Disability 55500 55500Parenting Initiatives 69625 69500Primary Care Phase 702159 598903Drug Awareness 133333 0Improving Health in Border Areas 324912 340833Ambulance Training 177000 167000Community Youth 219000 0Cognitive Therapy 59245 82472Melvin Mental Health 235393 212571CAWTAS 28089 25000AGH/ Letterkenny Feasability Study 34832 31000Letterkenny Cancer Services 524345 95300TOTALS 3175138 2362271

EU Investment

Cross Border Acute Care

Aims and Objectives• To develop relationships between institutions, their staff,

their patients and their communities.• To improve quality of access and reduce inequity in the

provision of service.• To create employment.• To promote cross-border participation as part of everyday

life by bringing communities together for the provision of acute hospital services.

• To share information, expertise, technology and understanding for the benefit of both communities.

Early contributions

1. Improved relationships

2. Inclusive debate

3. Raised the awareness of the health-related problems of the Irish border region at a European level.

4. Developed pool of experience

5. Patient benefits?

CAWT primary objectives• Improving population health and well-being

• Exploiting opportunities for co-operation in planning and providing services

• Taking up available funding from the EU or from other third parties

• Involving other public sector bodies in joint initiatives

• Assisting border areas in overcoming problems arising from isolation

• Exploiting opportunities for joint working or sharing of resources where these would be of mutual advantage

Political endorsement

NORTHERN IRELAND ADMINISTRATION GOVERNMENT OF IRELAND

NORTH/SOUTH MINISTERIAL COUNCIL

SIX AREAS FOR CO-OPERATION through existing jurisdictional bodies

Education Transport Agriculture Health Environment Tourism

SIX AREAS FOR ALL-ISLAND CO-OPERATIONthrough IMPLEMENTATION BODIES

Inland Trade and Business Food Safety Language Special EU Aquaculture, Waterways Development Promotion Promotion Programmes Lighthouses,

Marine Tourism

Areas for co-operation

1. Accident & Emergency services

2. Planning for major emergencies

3. Co-operation on high technology equipment

4. Cancer research

5. Health promotion

Cross-cutting mobility study

Institute of Public Health and Food Safety Promotion Board

Recent progress

5 ministerial meetings February 2000 - June 2002

Programme of work

• Joint training, staff development, staff exchanges

• Exchanges of information and research

• Feasibility studies

• Operational issues

• Strategic reviews

Constraints/ Barriers

• Policy and structural differences

• Funding issues

• Reciprocation

• Public acceptance

• Professional accreditation

• Insurance

• Competing pressures

• Political context

Constraints/ Barriers 2

• Political instability and maintaining momentum

• 2001 Foot and Mouth Disease

• Defining parameters

• Phasing development in step with national strategies

Critical factors 1

Identification and definition of the problem

1. Systematic review of border problems

2. Added value of collaboration

3. Clinical-need driven

Critical factors 2

Mechanisms for innovation

1. Institutional structure

2. Resources

3. Removal of obstacles

4. Overall political context

Further details

Centre for Cross Border Studies

www.crossborder.ie