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Modelling Changing Hospital Service Accessibility in Ireland 1999-2006

On the island of Ireland, there are two distinct and separate jurisdictions, namely the 
Republic of Ireland and Northern Ireland. Both were founded in 1922 with the former 
developing into an independent state while the latter still remains a part of the United 
Kingdom. The Irish Republic operates a primarily state-funded health care system, but an 
increasing input from private health insurance has arguably created a two-tier publicprivate 
system (Wren 2003). Northern Ireland’s health care system is primarily based on 
the UK’s National Health System (NHS) with some place-based variation (Jordan et. al. 
2006). With the recent peace in Northern Ireland and the success of the ‘Celtic Tiger’ 
economy of the South, both governments are exploring joining up the economic and 
social structures across the whole island. Modelling access to health is one of the areas, 
which are currently being explored. Informally, there has been cross-border movement in 
the utilisation of health care for decades but there has been no strategic approach to 
modeling the implications of those flows. The need to plan in a cross-border setting is 
also explicitly stated in the new Republic of Ireland National Development Plan (NDP) 
for the period 2007-2013. 
With both governments being engaged in the restructuring of health care services, 
the Departments of Health in both countries were keen to explore the spatial dimension. 
As a result the potential of a GIS-based approach was identified as worthy of exploration. 
The National Centre for GeoComputation (NCG) at NUI Maynooth were approached and 
asked to develop an initial modelling of access to hospitals on an All-Ireland basis. A 
number of problems needed to be addressed related to the compatibility of spatial data, 
data merging in a cross-border environment and reliability issues. However each of these 
issues were likely to be an issue affecting the quality of the GIS analysis. The combined 
datasets were then used to examine the potential impact of policy-driven change both 
north and south of the border.