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Rapporteur report

Dr Sara Burke

30 January 2017

Evidence needs to meet policy in healthcare – deciphering shades of grey

Watch Dr Burke's presentation on You Tube at the link below

Quick summary:

  • Media portrayal of health is often black and white; research needs to shine light on the shades of grey 
  • HRB-funded research has informed and continues to inform the Department of Health and Oireachtas Committee on the Future of Healthcare about the impact of specific healthcare policy decisions and funding cuts 
  • Health researchers need to communicate evidence so it is used to inform healthcare policy decisions. 

Dr Sara Burke is in an unusual position. As a journalist and broadcaster, she knows the value of clear communication and getting the message across to a broad public about healthcare policy and practices. But, as a healthcare policy researcher in Trinity College Dublin, she also knows that the findings of research are often complex and nuanced. Yet this in depth research is what is needed to inform healthcare policy decisions, so the onus is on researchers to make the decision-makers aware of evidence, she told the HRB 30 Conference in Dublin Castle. 

Dr Burke spoke about how she started reporting for RTE radio on healthcare topics at the same time that she started her HRB-funded PhD in Trinity. It was an ‘amazing opportunity’ to explain problems and sometimes solutions in healthcare, but it wasn’t always easy. 

‘The media tends to portray stories in black and white, whereas often what good health research does is throw some light on those thousand shades of grey in between’, she said. ‘One of the many challenges for health researchers is to analyse and understand those shades in between black and white, and to explain them in a way so that they are useful to policy makers, to health service leaders, to health service managers, to our political leaders and to the public’. 

Her own PhD research looking at health policymaking that increased the privatisation of hospital care in the early 2000s. ‘This found little, if any, evidence was used to form the three policies that I analysed’, said Dr Burke. ‘It found instead personalised, covert policymaking processes driven by the ideology of the political economy of the time’. 

She next worked on the Resilience Project at Trinity, which monitored the impact of cuts to the health budget. The trends they uncovered had an impact. ‘[Indicators showed that] the health system managed to do more with less during for the first few years of the crisis, 2012, 2013, the health system had no choice but to do less with less’, explained Dr Burke. ‘This work contributed to making the case for the health service budget not to be cut in 2015’.

The research also showed that 450 million Euro more was paid out of pocket by citizens in 2014 than had been in 2008 as a result of just a few changes in policy – and the Department of Health had not realized the extent of the transfer of costs to people until the Lancet published the data.  

Dr Burke is currently working on a project called Pathways to Universal Healthcare, and is engaging with the Oireachtas Committee on the Future of Healthcare through presentations and expert-led workshops.   This kind of engagement and communication is key to ensuring that evidence meets policy, she noted, directing the audience’s attention to a comment that morning by Minister for Health Simon Harris, TD, that ‘no longer can we have hokey pokey policy decisions, we must follow the evidence’. 

Dr Burke said: ‘And I suggest that the challenge is not just for policy makers and for politicians the Challenge is for health researchers, it’s for those of us in the room, it is our responsibility as publicly funded researchers to provide evidence, to make that evidence accessible, to communicate it clearly to the public, to politicians, to policy makers, to health service managers and leaders so that they have no choice but to use it’. 

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