IPA Bulletin
Around the World

MAKING PROGRESS IN IRELAND

GREGORY R.J. SWANWICK

When I wrote about Ireland for the December 1998 issue of IPA Bulletin, there were five consultants in Psychiatry of Old Age [POA] and only four services in operation. The first Irish specialist psychiatric service for elderly people had begun almost 10 years earlier in 1989, so initial progress had been slow. It is, therefore, encouraging to be able to report that over the past three years, 13 consultants in POA have been appointed to posts in the public health service. In addition, three consultants provide POA services within the private sector, 15 public services are now in operation, and three more are due to start over the coming months. This rapid expansion is welcomed. However, old age psychiatrists are concerned that the development of facilities and teams has not matched the expansion in consultant posts. Indeed there is still marked variability across the country with regard to resource provision and, therefore, the services that can be offered. 

The desired aims for the development of POA in Ireland can be considered at two levels. The first level is to meet minimum accepted standards for the provision of a Psychiatry of Old Age service (e.g., the recommendations published in The Future of Psychiatry in Ireland, a report prepared by the Irish Division of the Royal College of Psychiatrists in January 1998). The second level relates to development of the service in order to meet the Irish government’s key principles of “Equity, Quality of Service and Accountability.”

In conclusion, the expansion in the number of POA posts increasingly allows Irish consultants to emphasise that POA services must be developed to the standards provided in The Future of Psychiatry in Ireland. While such recommendations can be utilized as a benchmark for the appropriate minimum standard, further development will be necessary so that services can meet the highest possible quality standards within the available resources. A continued emphasis will need to be placed on education and training and on liaison between POA, primary care and other specialist services.

Gregory Swanwick is a consultant psychiatrist in psychiatry of old age with the South Western Area Health Board and co-ordinator of postgraduate medical education at the Adelaide and Meath Hospital, Dublin, Ireland.

References

Swanwick, G. (1998), Psychogeriatrics in Ireland is Developing, But Practice Lags Behind Policy. IPA Bulletin 13: 4
The Royal College of Psychiatrists Irish Division (1998), The Future of Psychiatry in Ireland. Dublin: The Royal College of Psychiatrists Irish Division.

Reprinted from IPA Bulletin Volume 19 Number 3