A PRESCRIPTION FOR CHANGE
7. Strategic Improvement Programmes
Fairer, safer and more efficient healthcare
HEALTH PLAN HOMEPAGE
UNIVERSAL HEALTH AND SOCIAL CARE
LOCAL HEALTH AND SOCIAL CARE SERVICES
HOSPITAL REFORM
MENTAL HEALTH
DELIVERING ON RIGHTS FOR DISABLED PEOPLE
STRATEGIC IMPROVEMENT PROGRAMMES
AGING AND OLDER PERSONS CARE
TACKLING ADDICTION, EMPOWERING RECOVERY
SAFE STAFFING FOR SAFER HEALTHCARE
ACCOUNTABILITY AND REFORM
OTHER KEY INFORMATION
Strategic Improvement Programmes
Current Expenditure: €502 million
Sinn Féin would implement strategic improvement programmes to deliver targeted improvements across services. These would support existing National Strategies and Action Plans, and new programmes would be developed where strategies do not exist or are out-of-date.
We would back these programmes with multi-annual funding frameworks to provide funding certainty and improve accountability, planning, and transparency. Funding would be released for specific measures on the basis of clear implementation and delivery plans underpinned by definitive metrics and timelines.
Sinn Féin would realise the potential of a truly national approach to healthcare through all-island planning and workforce development across maternity, cancer, diabetes, trauma and emergency care, rare diseases, respiratory health, and cardiovascular health, and more. We will ensure that strategies are cognisant of health inequality across population groups, such as for disabilities or marginalised communities.
The Department of Health has many national strategies which are not consistently or properly funded. Many strategies never achieve their objectives within their lifetime, if at all. For example, the Government launched a new stroke strategy in 2023, and did not fund it. The National Cancer Strategy has only been properly funded in 2 of the last 5 years.
No Child Left Behind
Our children are the nation’s future yet many of the most vulnerable children and young people in the State are being let down. Children with scoliosis and spina bifida must wait years for life-changing surgery, and many are left waiting for so long that they cannot be operated on. There are more than 200,000 children on healthcare waiting lists, with more than 15,000 waiting just for initial contact with a specialist disability team. More than 4,000 children and young people are waiting for specialist mental health services. As many as 1-in-4 of children are overweight and more than 175,000 children live in poverty, yet there are fewer and fewer public health nurses to support them every year. Thousands of children are left waiting months and years for assessments of need for educational or health supports, and then placed on waiting lists for access to services. Every child deserves a care plan. No child should be left behind.
Sinn Féin would prioritise investment in our children. Sinn Féin is committed to improving healthcare for children. Our plan addresses access to assessments and therapies, spinal or limb surgery, cancer care, dental and orthodontic care, child and youth mental health services, and GP and hospital care.
Sinn Féin would set waiting time targets for access to care. We would support the health service to meet those targets with strategic workforce planning, investment in capacity, and reform. To assist in accountability and planning, we would oblige the HSE to explain failures to meet waiting time targets, and outline any failures in care and the precise needs for meeting targets.
We would specifically target an expansion in public health programmes and supports for children and parents to improve health from a young age. Sinn Féin would introduce a €130 activity card to support families in being active. We would expand public dental teams to deliver extensive school screening to prevent dental decay. We would introduce specific measures, such as a Public Health (Obesity) Bill, to challenge negative influences on development and to support healthy behaviours.
The agonising waits faced by children with scoliosis and spina bifida are unacceptable, and these children are not alone. Thousands more are languishing on waiting lists with untreated complex conditions. Sinn Féin has developed an action plan for paediatric orthopaedic and urology services to end the calamity of mismanagement, mandate transparent care pathways for all children, ensure funded training for more specialist surgeons, and expand protected surgical and recovery capacity. Every child should have the opportunity for early intervention and wrap-around supports to manage their health. We would ensure that, where domestic services cannot treat a child on time, children who can travel have access to treatment abroad. We would ensure that children are treated on the basis of need, not the ability to pay, and reduce reliance on private clinics.
The new Children’s Hospital is essential for improving access to life-changing care for children. Sinn Féin would hold the developer to account for completing the hospital and ensure a seamless transition plan is in place to move services on-site.
There are several ongoing and extremely serious reviews and investigations involving Children’s Health Ireland. We would ensure the full independence of each review and that there are no barriers to completing the reviews in full. We would be willing to implement a statutory inquiry to ensure accountability and transparency if the review format is unable to produce definitive conclusions.
Sinn Féin Will:
Develop a No Child Left Behind health waiting list strategy
Increase the number of public health nurses and practitioners and expand public health programmes and supports for children and parents
Expand public dental teams to deliver extensive school screening
Implement an action plan for paediatric orthopaedic and urology services
Fully fund Children’s Disability Network Teams and end pay disparities between core service provider Section 39 organisations
Revolutionise Child and Youth mental health services with a major investment in primary care, community-based services, and multi-disciplinary care
Support service delivery with strategic workforce planning
Review supports for the non-medical cost of caring for a sick child
Mandate maximum waiting time targets for children for appointments, scans, and surgeries
Implement a comprehensive preventive care plan, including a Public Health (Obesity) Bill
Revise and extend the Breastfeeding Action Plan and support the development of an All-Island Infant and Young Child Feeding in Emergencies Preparedness Plan
Ensure a seamless transition plan is in place for moving to the new Children’s Hospital to ensure it is open as soon as possible
Women’s Health
Sinn Féin published a comprehensive vision for women’s health and wellbeing in 2018, which was expanded on in 2021 and 2023. In Government, Sinn Féin would build on the important steps which have been taken in recent years to improve access to care and advice for menopause, endometriosis, and maternity-related services from fertility to breastfeeding.
Sinn Féin would establish a structured care programme in women’s health to deliver a high-quality, life course approach to women and girls’ health and wellbeing in primary care. It would cover childhood and adolescence to and through menopause. It would centre on improving the quality and regularity of advice, support, and care available through GPs and community services. It would promote services such as women’s health clinics, and awareness and supports for conditions such as endometriosis and pre-eclampsia. It would cover physical and mental health and wellbeing, gynaecological and menstrual healthcare, contraception, menopause, fertility, pregnancy, chronic disease management and cervical and cancer screening. It would include access to medications, screening, and diagnostic tests as appropriate, such as staged health checks for peri/menopause, high blood pressure, high cholesterol, prediabetes, bone density, and more.
Sinn Féin would extend universal access for contraception and HRT. We would legislate for direct access to contraception from appropriately qualified pharmacists. We would permit access for adolescents to the scheme through their GPs using appropriate safeguards.
Ireland should aim to be the best country to have a child in, and to become a parent in. The current maternity strategy was compiled 7 years go and runs to 2026. Sinn Féin would review and update the National Maternity Strategy. We would support the implementation of outstanding measures and a renewed strategy with multi-annual funding. We would promote the highest standards of care and governance to prevent avoidable deaths and birth injuries of babies and mothers.
Sinn Féin would work across Government to combat violence against women and girls. Sinn Féin would work to eliminate female genital mutilation in Ireland. This extremely harmful practice has been illegal since 2012, but it is estimated that potentially hundreds of girls are at risk. There are several thousand women living in Ireland have been subjected to FGM, whether in Ireland or elsewhere, and their specific health needs are not being identified and met. Sinn Féin would support health and child protection professionals to understand, identify, prevent, and respond to FGM. We would expand access to expert clinics through primary care, improve awareness and education among GPs, and improve access to psychological supports for FGM survivors.
The Independent Review of abortion services has provided a series of recommendations for improving the operation of and access to those services in accordance with the 2018 Act. Its many complex recommendations must be worked through in a sensitive manner. Sinn Féin welcomes the work of the Independent Review of the Operation of the Health (Termination of Pregnancy) Act 2018. We would conduct a geospatial analysis of access to abortion services, invest in local and regional women’s health hubs, improve access in primary care, fully commission hospital services, decriminalise medical professionals, and repeal the three-day wait.
With the passage of the Assisted Human Reproduction Act, 2024, the legislative framework is in place for the development of public and funded access to assisted reproduction services, such as IVF and altruistic surrogacy. Sinn Féin would fund the establishment of the Assisted Human Reproduction Regulatory Authority, implement the legislation, and develop public access to services.
Sinn Féin Will:
Develop a comprehensive structured care programme for women’s healthcare in primary care
Resource the full expansion of the universal contraception scheme
Implement a free HRT scheme
Revise the Maternity Strategy to make Ireland the best place to have a child and set new targets to drive improvements in maternity care
Improve community midwifery services and home-based care
Advance development of the new National Maternity Hospital
Improve knowledge and awareness of female-specific symptoms and conditions, improve care pathways for secondary and tertiary gynaecological services, and invest in community-based gynaecology services
Reduce inequalities in access to reproductive healthcare, decriminalise medical professionals, and repeal the three-day wait
Improve access to publicly funded IVF and establish the Assisted Human Reproduction Regulatory Authority
Implement an improvement plan for endometriosis that encompasses education, diagnosis, treatment, and research
Work across Government to implement an updated Women and Girls Strategy
Invest in health and social care supports for survivors of abuse and domestic violence, including treatment services for FGM
Invest in cancer screening to improve early diagnosis rates among at-risk groups, and expand age-based access to screening following evidence-based clinical advice
Prevent Today, Prosper Tomorrow
Prevention is better than cure, for the individual and the wider health system. Health systems are demand-led, and reorienting care to the community will only go so far towards reducing pressure on acute hospitals. While early intervention is essential, prevention and demand reduction is as if not more important. Responsibility for public health and prevention is shared across the individual and their primary care clinicians, wider society, and the regulatory state.
The state plays a pivotal role in creating an enabling environment for healthy living. The state is responsible for access to sports and exercise facilities, physical and nutrition education, air quality, healthy eating, public health monitoring and planning, immunisation and awareness, food regulations, advertising rules, public transport and active travel, housing and environment standards, and screening services. Our environment has a significant impact on our health, with air pollution and dampness being significant causes of childhood illnesses. It is not a coincidence that asthma and obesity rates are higher among children from lower income backgrounds. Public health policy, and the level of Government commitment to enabling healthy living conditions and tackling health inequalities, has a significant effect on health outcomes across all ages.
According to the HSE, Ireland has one of the highest levels of obesity in Europe, with 60% of adults and over 1-in-5 children and young people living with overweight and obesity. This rises to 1-in-4 children in less affluent and disadvantaged areas. In a striking commentary on modern lifestyles, Dr Aileen McGloin of Safefood Ireland recently told the Joint Oireachtas Committee on Health that “we know from Irish research that many pre-school children recognise unhealthy food brands before they learn to read or write.”
Cancer and cardiovascular diseases are the leading causes of mortality in Ireland. They are, to a great extent, diseases of the modern lifestyle. While these diseases have always existed, there is a strong and established body of research which clearly demonstrates that our diet and exercise habits are a leading contributor to ill-health. Unhealthy lifestyles, diets, and behaviours carry significant long-term health risks ranging from diabetes to depression to cancer and cardiovascular disease and premature death.
Structural and socio-economic inequalities are well known drivers of health inequality, but more than that, intensive working hours, time poverty, mental or physical ill-health, and/or a desire to spend free time with family can lead to consumption habits and inactivity which are not conducive with a healthy lifestyle, and which radically increase the chances of ill-health and disease. We cannot expect people to lead healthy lives, at additional personal cost, when they live in a structurally unhealthy environment.
Sinn Féin would support people to lead healthier lives. That will not be achieved by scolding but, in the short-term, by incentivising behavioural changes in the least disruptive ways possible, and in the medium- and long-term through education, expanding access to sports and recreation, instilling healthy habits from a young age, and ensuring that healthy eating is accessible and that the cost of convenience is appropriately factored into the production and retail of processed foods.
These efforts would be led by an office for consumption-related harm reduction, which would drive development, implementation, and research of policy related to healthy living, alcohol, vaping, smoking, and food content and reformulation. This would be led at a senior-level from within the Department of Health with clear responsibility and accountability for each policy area.
We would target measures to support new parents, healthy childhoods, and reduce the level of childhood obesity, which has grown rapidly in recent decades. Policy should, for example and where it is appropriate to women’s personal circumstances, support breastfeeding over milk substitutes, which has several important benefits for children, not least a reduction in the likelihood of obesity.
Sinn Féin would review the Sugar Sweetened Drink Tax to inform the development and implementation of a potential extended levy, and to inform options related to sodium and fat content in processed foods which target producers rather than consumers. We would introduce a system of mandatory reformulation targeting a reduction in sodium contents to provide a level-playing field for producers and reduce excessive sodium consumption.
Sinn Féin Will:
Establish an office within the Department of Health for consumption-related harm reduction to drive coherent cross-Government development, implementation, and research of policy and fiscal measures related to healthy living, alcohol, vaping, smoking, and food content and reformulation, and the alignment of climate action and public health policies
Develop robust structures for health promotion, preventive health, and public health in the Department of Health with clear responsibility and accountability for each policy area
Introduce a Public Health (Obesity) Act to tighten rules around marketing, packaging, advertising, including online, of unhealthy food and drink products; formulation of such products; empower local authorities to implement no-fry zones; and prevent advertising of high fat, sodium, and sugar products near schools or on public transport, buildings, and other public infrastructure
Introduce maximum sodium limits in processed foods and bread with a 3-year lead in time, and examine mandatory reformulation of additional food products
Evaluate the performance and impact of the Sugar Sweetened Drink Tax to inform development and implementation of a potential extended levy, and inform options related to sodium and fat content in processed foods which target producers rather than consumers
Legislate to regulate marketing, packaging, contents, and flavouring of nicotine-inhaling products, and to ban disposable vapes
Review tobacco cessation supports, smoking prevention measures, and the potential of ‘de-nicotinisation’ to reduce smoking rates and nicotine addiction
Review the Healthy Ireland framework and associated policy initiatives, care models, and action plans to address structural and socioeconomic drivers of chronic disease and ill-health, support cross-sectoral actions to tackle the root causes of ill-health and health inequality, and support the development of skills and knowledge of healthy foods
Implement Sinn Féin’s Activity Card (2024) policy to support children’s participation in sport and physical activities
Examine pricing, economic, and structural incentives and disincentives related to healthy and sustainable foods to inform future policy development and develop synergies in the use of taxation and subsidies in maximising public health benefit
Ensure that healthy Ireland, cardiovascular health, respiratory health, healthy weight, and other activity- and lifestyle-related action plans and strategies are sufficiently resourced on a multi-annual basis to deliver tangible improvements
Work across Departments and on an all-Ireland basis to implement clean air, sustainable foods and agricultural practices, age friendly, healthy living, and disease prevention-related strategies, and school-based meals, food skills, and exercise programmes
Conduct further research into the commercial determinants of health to inform public health policy related to marketing, advertising, food content, and habit formation
Develop and implement a new Public Health Strategy incorporating the recommendations of the Public Health Reform Expert Advisory Group, bringing all public health policy together in a single, coherent, and ambitious programme of reform
Expand the network of public health nurses and primary care health services to provide access to information, awareness, appropriate screening and testing services for at risk groups, and early intervention-focussed care
Develop proactive clinical networks for allergy management, treatment, awareness, and where possible prevention
Implement a public health campaign to inform people about vaccine safety and increase uptake,
Continue access to HPV catch-up vaccination programmes and implement the strategy to eliminate cervical cancer by 2040
Develop and implement a comprehensive adult and older person vaccination programme including targeted RSV and shingles immunisation programmes
Support the delivery of the Healthy Childhood Programme and essential vaccination and educational programmes
Cancer
Survival rates for cancer have increased dramatically over the last 30 years. Today, more than 60% of people survive at least 5 years after treatment and most do not die from cancer. Cancer does, however, remain the leading cause of death ahead of circulatory diseases. In 2023, 29% of deaths in Ireland were attributable to cancer. The burden of cancer across the population is likely to double by 2045, and half of us get cancer at some point in our lives. Early diagnosis is essential for improving survival rates.
According to analysis conducted by the Irish Cancer Society, only 4 National Cancer Strategy Key Performance Indicators were met in 2021, and only 28% of patients did not access radiotherapy in the recommended timeframe, 25% of patients were unable to access rapid access clinics in the recommended timeframe, and half of lung and prostate cancer patients did not access surgery in the recommended timeframe. Radiation therapy is facing significant staff burnout and low morale. Four radiation therapy machines are closed due to staffing shortages and as many as 120 cancer cases a day are not being treated.
Sinn Féin would deliver sustained improvements in cancer services by ringfencing funding for the Cancer Strategy. We would enable multi-annual funding to improve access to cancer services, screening, workforce development, and supports. Sinn Féin would support rapid access clinics to deliver timely care and widen the age limit for breast cancer screening to 45 – 74 and for bowel cancer to 50 – 74. We would establish pilot programmes to test lung, prostate, and gastric cancer screening programmes in line with the European Council Recommendation on cancer screening. We would ensure core funding certainty for community cancer support centres through a standardised funding arrangement via the National Cancer Control Programme. Sinn Féin would ensure a continuous supply of new medicines to ensure that all patients have access to the most appropriate care and treatment. We would fund awareness, education, and outreach on early cancer symptoms and eligibility for screening.
Sinn Féin would fund a cancer catch-up programme to tackle missed or delayed scans and treatment. Significant delays in radiology pre-dated Covid-19 but the pandemic had a sizable impact on cancer services. We know that several thousand cancers went undetected due to the Covid-19 pandemic. Cancer screening, treatment, and trials were disrupted by viral outbreaks, and capacity was constrained by infection prevention and control.
Waiting lists for diagnostic scans are months long and even urgent scans for potential cancers can take too long. Patients with potential cancers are left waiting by the public system and many families must go private to be seen urgently. This compounds health inequalities which already disproportionately impact lower income households and communities. Sinn Féin would support cancer services to ensure all eligible people avail of screening and manage increased pressure on treatment services. Sinn Féin’s community care reforms would ensure direct GP access to community radiology, and we would use community diagnostic facilities to reduce waiting lists and hospital-related delays.
Sinn Féin would publish the independent review of the radiation therapy profession and act on its urgent recommendations to improve training, recruitment, and retention. Radiotherapy centres are significantly short staffed, with staff deficits running from 20-40% across sites. As a result of vacancies, new machinery is sitting idle, including in some instances for several years. Many radiation therapists have agreed to facilitate longer working days to make up for staff shortages, but burnout, over-work, and lack of career incentives are proving to be a major deterrent and retention issue.
Preventing cancer is as important as identifying, responding, and treating it. Preventive healthcare has often been paid naught but lip service. Sinn Féin would include a specific focus on preventing cancer in the implementation of a comprehensive preventive healthcare strategy. Re-orienting care to the home and community is a major priority for Sinn Féin, and our multi-annual funding plan would enable the provision of adequate home care, night nursing, and digitally assisted care.
Sinn Féin Will:
Deliver multi-annual funding of the Cancer Strategy to improve access to cancer services, screening, workforce development, and supports
Fund a cancer catch-up programme to tackle missed or delayed scans and treatment
Support cancer services to ensure all eligible people avail of screening, and fund awareness, education, and outreach on early cancer symptoms and eligibility for screening
Deliver direct GP access to community radiology and diagnostic services
Invest in diagnostic equipment and the radiography workforce to protect and expand diagnostic pathways, and ensure access to diagnostic tests within recommended timeframes
Review and develop the appropriate cancer services workforce to meet the needs of cancer patients and survivors
Provide funding certainty to cancer care and support centres through a standardised funding arrangement via the National Cancer Control Programme
Fund the model of care for psycho-oncology services for patients aged 0-24 years and their families
Widen the age limit for breast cancer screening to 45 – 74 and for bowel cancer to 50 – 74
Establish pilot programmes to test lung, prostate, and gastric cancer screening programmes in line with the European Council Recommendation on cancer screening
Ensure protected time for clinicians and adequate research and support staff
Ringfence funding for access to clinical trials and ensure a continuous supply of new medicines
Resolve inequities in allowances for hairpieces and post-mastectomy products
Introduce legal protections for cancer survivors to exercise a right to be forgotten in the context of financial products and services
Publish the independent review of the radiation therapy profession and develop the radiotherapy workforce to make full use of available machines
Include a specific focus on preventing cancer in the implementation of a comprehensive preventive healthcare strategy
Enable the provision of adequate home care, night nursing, and digitally assisted care
Cardiovascular Health
Cardiovascular diseases are a leading cause of death alongside cancers, yet Governments have not given it the same priority. The responsive focus on acute care is not sustainable and misses the opportunity which early intervention and prevention provide for improved quality of life and more cost-effective services. In 2023, 28% of deaths in Ireland were attributable to circulatory diseases. As many as 1-in-3 heart failure patients are readmitted to hospital within 90-days, often for the lack of basic information and support. GPs, nurses, pharmacists, and physiotherapists can do a lot more to provide care and support for patients, but access is not structured to support those who need it.
Sinn Féin would develop, publish, and implement a comprehensive cardiovascular health plan. This would include a mix of population-wide and high-risk focussed measures covering prevention, early detection, timely diagnosis, and access to care and rehabilitation. This plan would integrate the important measures included in the Stroke Strategy, but go much further to place a focus on reducing incidence of stroke and cardiovascular diseases as well as increasing access to quality care. It would build on the expired Building Healthier Hearts and Changing Cardiovascular Health policies, and a renewed Healthy Ireland framework. We would support delivery of this plan with ringfenced multi-annual funding and the development of a cardiovascular imaging services.
Sinn Féin would work with clinicians to develop a targeted community-based ‘Heart Health Check’ programme to improve awareness and detection of conditions such as hypertension/high blood pressure, atrial fibrillation, heart valve disease, and high cholesterol. This would be a first step towards implementing a structured, prevention-focussed approach to cardiovascular diseases. We would work to include all high-risk cardiovascular conditions in the chronic disease management programme. We would develop a role for community pharmacy in cardiovascular health screening and management as part of broader pharmacy reforms. We would expand community radiology services including imaging services such as echocardiograms and angiograms.
Many people feel abandoned once discharged from hospital or being handed a diagnosis due to the lack of community services. Stroke and heart patients suffer high levels of psychological distress and symptoms consistent with post-traumatic stress disorder, but just 1-in-5 stroke units and 1-in-9 hospitals treating heart failure have any access to psychological services. Sinn Féin would improve access to community-based mental health and psychosocial supports as well as services for rehabilitation and primary care needs.
There are more than 3,800 patients on cardiology procedure waiting lists and nearly 40,000 waiting on a consultation with a cardiologist. Sinn Féin would support the development of acute and emergency cardiology services to tackle waiting lists and reduce regional disparities in access to care. We would complete and publish the review of specialist cardiac services along with an implementation plan. We would ensure that it is genuinely national in scope, taking into account all capacity across the island. The northwest and the southeast are particularly underserved in emergency cardiac care due to deficits in PPCI cover. For example, there is no 24/7 cover at all for the southeast region at University Hospital Waterford. Access to emergency cardiac care in Donegal is provided at Altnagelvin in Derry, and it is unclear to what extent this was considered as part of the review of cardiac services. We would ensure that every region of our island has safe and rapid access to regional emergency and specialist cardiology services.
Sinn Féin Will:
Develop and implement a comprehensive cardiovascular health plan including both population-wide and high-risk focussed measures covering prevention, early detection, timely diagnosis, psychosocial supports, and access to care and rehabilitation, supported with ringfenced multi-annual funding
Develop a targeted community-based ‘Heart Health Check’ programme to improve awareness and detection of conditions such as hypertension/high blood pressure, atrial fibrillation, heart valve disease, and high cholesterol
Fund a multi-annual high blood pressure awareness campaign
Work to include all high-risk cardiovascular conditions in the chronic disease management programme
Develop a role for community pharmacy in cardiovascular health screening and management as part of broader pharmacy reforms
Expand community radiology services including imaging services such as echocardiograms and angiograms
Complete and publish the review of specialist cardiac services along with an implementation plan
Ensure that every region of our island has safe and rapid access to regional emergency and specialist cardiology services
Establish the number of stroke survivors in Ireland, conduct a comprehensive assessment of their needs, and implement a plan to meet those needs
Fully implement the 2023 model of care for cardiac rehabilitation
Establish clear responsibility and accountability for cardiovascular health policy and delivery within the Department of Health and the HSE
Provide funding certainty to community heart failure and stroke support services that reduce hospital admission rates and the need for long-term care through standardised funding arrangements with the HSE.
Diabetes
It is estimated that more than 300,000 people have diabetes in this State, which is more than 5% of the population. Diabetes is expected to grow in prevalence due to modern lifestyles. Disabled people are at a much higher risk of angina, cardiovascular disease, stroke, or heart attack than otherwise. It is also associated with blindness, amputation, cancer, obesity, and depression. Structured access to information, advice, care, and medication is essential for condition management and prevention. The chronic disease management programme is an important development, but it is widely acknowledged that a wider, new approach is needed.
Sinn Féin would implement a new strategy for diabetes prevention and care. This strategy would optimise the use and coherence of existing resources and would receive additional multi-annual funding to drive implementation forward. This strategy would follow a review of state- and island-wide diabetes services with a view to reducing incidence, better using existing resources, improving care, and improving people’s quality of life.
Sinn Féin Will:
Complete a review of state- and island-wide diabetes services to inform a Diabetes Strategy
Review eligibility for subsidised and free access for glucose monitoring devices
Support the development of chronic disease management teams in primary care
Ensure equitable and sensible access to appropriate diabetes equipment to improve prevention and management
Develop and implement a new model of care for diabetes
Respiratory Health
In 2023, 12% of all deaths were attributable to respiratory diseases. Respiratory illnesses, such as COPD and pneumonia, are a major driver of emergency hospital admissions, particularly during winter. Chronic respiratory conditions present significant additional risk, especially when unmanaged. A significant proportion of chronic diseases are preventable, and respiratory conditions are no different. Smoking is one of the largest contributors to chronic diseases and chronic disease deaths, particularly respiratory conditions, along with socio-economic status, physical inactivity and other factors.
Sinn Féin would develop a respiratory health action plan targeting the most common respiratory conditions. The Scottish Government recently published a plan targeting the 5 most common conditions which make up 90% of their respiratory disease burden. Our action plan would pull together immediate, medium-term, and long-term measures to support prevention, diagnosis, care management, self-management, and workforce development. This would include targeted prevention campaigns such as for healthy and warm homes, clean air, vaccinations, and smoking cessation. It would ensure that services are accessible for people with respiratory conditions, such as structured GP access, diagnostic tests, pulmonary rehabilitation, and psychosocial supports. Structured access to GP and pharmacy care is essential for monitoring conditions and ensuring appropriate medication use, such as the right inhaler, dosages, and sufficient oxygen provision. Pulmonary rehabilitation is essential for improving quality of life and health for patients with many respiratory conditions, including incurable conditions such as pulmonary fibrosis.
The chronic disease management programme has begun to address preventable hospitalisation and deaths by improving condition management for those who qualify. The programme currently covers asthma and COPD.
Sinn Féin Will:
Develop a 5-year respiratory health action plan to improve prevention, primary, community, and acute respiratory health services
Work across Government to improve clear air quality
Establish a dedicated vaping and smoking cessation service to support adolescents and young adults to quit
Legislate to regulate marketing, packaging, contents, and flavouring of nicotine inhaling products, and to ban disposable vapes
Review tobacco cessation supports, smoking prevention measures, and the potential of ‘de-nicotinisation’ to reduce smoking rates and nicotine addiction
Health and Life Sciences and Access to Medicines
Ireland can be a world leader in health and life sciences. The level of innovation coming in the next decade, from genomics and personalised medicine to AI, will be unprecedented. Sinn Féin would ensure that Ireland can be at the cutting edge of health and life sciences. We would work across Government to implement a life sciences strategy to build on the strong research and manufacturing base that exists in Ireland today. We would aim to make Ireland a world leader in clinical trials by establishing a streamlined set-up process for regulatory compliant clinical trials. We would support an innovation ecosystem that can attract new investment in quality jobs, quality research, and quality care. We would increase funding for research available through the Health Research Board. We would work across Departments, and particularly with Enterprise and Research, Innovation and Science, to cover R&D, trials, manufacturing, patient access, and supporting infrastructure.
Sinn Féin would implement a multi-annual funding framework to ensure timely access to new medicines and therapies, and increase staffing to speed up approval and reimbursement evaluations. We would introduce a voice for doctors in the prioritisation of new medicines, to be considered when allocating funding. It is widely recognised that it takes too long for new medicines and treatments to be approved for reimbursement or become available through the public system, and there is a gap with private health insurance. Irish patients wait longer than the EU average for new medicines to become available to them through the public system. Increasingly, novel therapies are becoming available through private insurance only and are not available in the public system. Medicine shortages are occurring due to policy shortcomings as well as due to global challenges. Expenditure on pharmaceuticals is expected to rise significantly in the coming years as our population ages. This must be managed while ensuring a continued flow of new medicines.
Sinn Féin would appoint a senior official in the Department of Health with responsibility for pharmaceutical policy. Their remit would be to improve access to new medicines, orphan drugs, clinical trials, and high-tech products, develop an early access pilot scheme, boost the supply and use of generic and low-margin products, and inform strategic policy development.
Sinn Féin Will:
Aim to make Ireland a world leader in clinical trials and the development of new medicines and therapies
Develop an interdepartmental life sciences strategy to ensure Ireland succeeds in research, development, and application of new technology in health and life sciences
Provide multi-annual funding certainty to improve access to new medicines and orphan drugs
Appoint a senior official with responsibility for pharmaceutical policy in the Department of Health
Maximise use of generics to ensure cost-effective management and supply of medicines,
Enable a voice for doctors in deciding the prioritisation of new medicines for funding,
Improve staffing levels and productivity across the various bodies involved in approving new medicines for reimbursement
Review pricing arrangements for commonly out-of-stock medicine and ensure that a rapid licensing process for substitute products is in place
Identify critical supply shortages, introduce an essential medicine list, and work with industry to boost manufacturing and diversify supply
Examine options for procurement partnerships with similar sized countries
Review the Medical Cannabis Access Programme and legal classifications to support access to appropriate treatments, clinical trials, and further research
Rare Diseases
Up to 6% of people in Ireland have a rare disease. People with rare diseases face significant difficulties in accessing diagnoses, treatment and care due to the rarity of their conditions, limited availability of specialists, delayed diagnosis, disjointed and uncoordinated care, lack of care in the community, inability to access psychological supports, delays in approval of new medicines, and, in many cases, a lack of basic knowledge and understanding of the lives of those living with rare diseases.
Sinn Féin would work with the Rare Disease Steering Group to urgently complete and publish a new Rare Disease Strategy and Implementation Plan. The new Plan must outline capacity requirements, timeframes, and funding requirements.
Community and social care supports are essential, particularly for people whose conditions need to be managed. Cutting edge technologies, including genomics, AI, and advanced therapy medicinal products offer significant opportunities to advance diagnosis and care for people with rare disease across the island. An all-island approach is particularly important due to the extremely small number of people with some conditions and the lack of available expertise.
Sinn Féin Will:
Urgently complete and publish a new Rare Disease Strategy and Implementation Plan
Establish a Rare Disease Plan Implementation Oversight Group
Improve and expand care pathways rooted in coordinated care and community services
Implement a multi-annual funding framework for the rare disease plan
Fund specialist home care and support for those who need it, such as people with EB
Develop a Rare Disease Register which is integrated with electronic health records systems across health sectors
Review approval, pricing, and reimbursement arrangements for orphan medicines
Target access to new medicines within 14 months of regulatory approval
Expand the Newborn Bloodspot Screening Programme and work with European partners to standardise and further develop services for newborns across Ireland and Europe, and ensure prompt implementation of SMA screening
Work with European partners to integrate rare disease care, research, and training through established European Reference Networks
Work to improve awareness among healthcare professionals and the public of rare diseases and care pathways
Promote participation in national and international research, and enrolment in clinical trials.
Genetics and Genomics
Sinn Féin supported the development of a strategy for genetics and genomics. Genomic medicine promises to enable a more dynamic care that is personalised, predictive, preventative, data-driven, and cost-effective. We would support the implementation of the strategy for accelerating genetic and genomic medicine in Ireland with funding. This investment would benefit many groups of patients in understanding their health and treatment options.
Sinn Féin Will:
Fund development of genetics and genomic medicine
Develop laboratory capacity to support the national strategy
Gender and Sexual Health
Equality and human rights are core values of Sinn Féin. We believe that healthcare is a fundamental human right, and should be accessible to everyone regardless of their gender or sexual identity. We believe that transgender people have a right to gender recognition and the best support and care possible. Sinn Féin recognises that healthcare should be driven by appropriately qualified and regulated clinical professionals, not politicians or criminal law, and that care should be made available to transgender people based on clinical evidence, including access to gender affirming treatment for adults.
There is a clinical review of the model of care for gender identity underway. The new model of care must be based on a complete review. Clinical pathways and treatment options must be determined by clinicians, and the type of care a person receives is a private matter for them and their family or support network as appropriate. Domestic services should put informed consent and care in the community at the heart of service delivery.
Sinn Féin would extend and update the national sexual health strategy. This process would include the voices of people who use sexual health services, healthcare professionals, service providers, and community organisations.
Sinn Féin Will:
Implement a new and holistic model of care for gender identity services
Extend and update the national sexual health strategy to address long waiting lists for PrEP and reduce rates of STIs and HIV
End of Life Care
Sinn Féin would resource a national approach to end-of-life care, including palliative care and bereavement. This would focus on equity of access across palliative care in the home, nursing homes, and primary care settings, including out-of-hours and night supports. We would work to ensure that more people can spend the rest of their time in the best care setting for them in a way that is planned with them, regardless of their wealth. End-of-life care would be an important part of a statutory home care scheme. Sinn Féin is committed to supporting family carers, including the abolition of the means-test for Carers Allowance.
Bereavement and grief can be exceptionally difficult. Sinn Féin would implement a consistent approach to bereavement care with links to HSE primary care and counselling.
The Assisted Decision Making (Capacity) Act legislation must be considered and incorporated into the new policy. End of life care planning is a critical aspect of the care trajectory, and this legislation holds a key role for informing this work.
Sinn Féin acknowledges the final report of the Joint Committee on Assisted Dying. The Committee recommended to legislate for assisted dying only in certain restricted circumstances, with very clear definitions and a review after three years. It called for an updated palliative care strategy to be published to deliver accessible and equitable services across the State in advance of assisted dying. This has since been published. It called for an independent national body for assisted dying, responsible for assisted dying services with full oversight. The Committee set out a number of recommended safeguards, including assessing decision-making capacity, protecting against coercion, and far greater end-of-life care and supports.
Sinn Féin is in favour of legislating for limited access to assisted dying conditional on proper investment in palliative care, mental health services, and disability services. We support limited grounds for access only for people who are nearing end of life as outlined in the final report of the Joint Committee on Assisted Dying, with access only available in limited and defined circumstances. We do not support mental health conditions or disability as grounds for assisted dying. Appropriate supports for carers, coupled with investment in mental health services and palliative care are critical in ensuring all people are fully supported in achieving a dignified and high quality of life, including end of life care, and that assisted dying is not a replacement for palliative care.
Recognising the sensitivity of the issues related to assisted dying, that any legislation that may be introduced to provide for assisted dying must be thoroughly and carefully considered with appropriate safeguards in place to ensure that there are no unintended consequences, and considering the divergent views of patients, advocates, international experts, representative groups, and people generally, we would advance legislation on this matter only following extensive scrutiny and only once we have properly resourced palliative care services.
Sinn Féin Will:
Fund the development of 50 more palliative care beds
Implement the new adult palliative care policy
Resource a national approach to palliative, end-of-life and bereavement care
Increase the capacity to deliver quality end-of-life care in the community
Invest in and resource community bereavement supports
Commence pre-legislative scrutiny of a legal framework for assisted dying following the publication of a multi-annual, funded palliative care policy implementation plan
Sepsis
Sepsis is largely preventable, yet it continues to be a major source of mortality. Adequate infection prevention and symptom awareness are essential for reducing sepsis deaths. There were more than 3,000 sepsis deaths in 2022, from nearly 15,000 detected cases. Significant advances have been made in Ireland in sepsis awareness and monitoring. The latest annual outcome report, the National Sepsis Report 2022 (2024), has identified public awareness, clinical education, mandatory refresh training, antimicrobial stewardship, and research as key areas for action to reduce sepsis deaths.
Sinn Féin Will:
Implement a 5-year Sepsis Strategic Action Plan, including awareness, prevention, care, and dedicated research capacity
Fund research nurses in every emergency department
Climate and Health
Sinn Féin would fund a €1 billion multi-annual climate action plan for the health service to improve energy efficiency and achieve sectoral emissions reductions. As a major organisation with a large footprint, and as the largest employer in the State, the HSE has significant obligations to deliver on. Despite this, data and record keeping on building energy ratings has been poor. The HSE has not maintained full records on energy ratings, delaying implementation of a climate action plan.
Sinn Féin would support public health departments to equip the public and the health service for the health consequences of climate change.
Sinn Féin Will:
Ringfence €1 billion for retrofitting, energy efficiency, and climate action across the health service
Complete an energy review of HSE capital stock to inform a programme of retrofitting
Mandate all Health Regions to develop Health and Climate Change Action Plans and ensure adequate climate-related resourcing of Public Health units
Implement a multiannual funding framework for the HSE Climate Action Strategy, including retrofitting and use of solar panels on suitable buildings
Increase funding for research and development for climate action and research
Ensure that new builds in the health sector are built to high energy standards
Social Inclusion and Equality
There are many marginalised groups in need of targeted healthcare and supports, including new Irish, Irish Traveller communities, migrant communities, and deprived working-class communities. Sinn Féin would support sustained investment in social inclusion and tailored services for marginalised groups to reduce health inequalities across gender, age, and background. These inequalities are most stark in mental health and suicide prevention but carry across mainstream health services.
Sinn Féin Will:
Ringfence funding for the Traveller Health Action Plan
Fund and implement a Social Inclusion and Equality Strategy
Gaeilge, Gaeltacht, Culture, and Arts
Sinn Féin recognises the important of supporting access to care through Gaeilge. We would work with the HSE and education institutes to train and recruit sufficient number of clinicians to provide Irish language services for Gaeltacht communities in medical centres, hospitals, and nursing homes.
Sinn Féin Will:
Plan for Irish language health and social care services to support Gaeltacht communities
Develop a plan to incorporate culture and art into life in care homes, assisted living institutions, and healthcare settings, and to explore options for using art as therapy
Other Strategies
There are many other strategies and clinical programmes competing for funding. Sinn Féin would ensure fair, independent, and transparent investment across strategies and clinical programmes based on cost effectiveness and outcomes for patients. One important example of this is the Trauma Strategy, which is covered in the hospital reform section.
A Prescription for Change - Sinn Féin's Healthcare Plan
Sinn Féin has the plan, vision, and determination to deal with the big challenges in healthcare. Our plan sets out in detail how we will deliver better access to healthcare when you need it, improve access to a GP when you need one, and end the crisis in our Emergency Departments.
Our plan will transform your experience of our health service and to deliver fairer, safer and more efficient healthcare.
