Sir, – The Irish Society of Specialists in Public Health Medicine (ISSPHM) is proud that Ireland is welcoming people displaced by the Russian invasion of Ukraine seeking protection. The HSE has responded swiftly to this humanitarian emergency, and is working hard to prioritise plans to care for this unprecedented influx of people into our health service. However, there are a number of issues which we as a society of public health doctors feel need to be highlighted in relation to this emergency.
People fleeing war or persecution often have urgent and complex physical and mental healthcare needs that require holistic and complex GP-led care as well as access to secondary and tertiary care specialist services. While the provision of a GMS medical card is welcome, in itself it is not sufficient to ensure necessary access to primary care when many GP services are already oversubscribed and unable to accept new patients. This is a classic example of the inverse care law, where those with the greatest need for healthcare tend to have the least access.
Supply of sufficient and appropriate housing for people fleeing the conflict in Ukraine is also of key importance. Acknowledging the pressure in identifying such housing, ISSPHM advises against the routine and long-term use of large communal accommodation settings as it substantially increases the risk of spread of infectious disease such as Covid-19, measles and tuberculosis. The public health management of any infectious disease outbreak in these facilities is incredibly challenging given the congregate nature of the settings and lack of adequate isolation facilities.
Responding to this unprecedented influx of people into our increasingly strained, under-resourced healthcare system will require a more sustainable, long-term approach. ISSPHM recommends we use the lessons learned from this experience to build an adequately resourced, permanent and sustainable migrant health programme that can provide care for all people seeking protection in our country, regardless of where they are from.
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Clear governance structures and information sharing across Government departments are critical in ensuring a timely, effective and safe response. – Yours, etc,
Dr DOUGLAS HAMILTON,
(Chair),
On behalf of
Irish Society of Specialists
in Public Health Medicine,
Banagher,
Co Offaly.