The Impacts of Health Care Reconfiguration on Patient Access to Services: A Case Study of Nenagh General Hospital

Access to health care is becoming a popular area of research in health geography especially in relation to service provision and policy planning. Since 2006, many changes to health policy have been made by the Irish government which have been both supported and opposed at a local level. The principal objective of this thesis was to account for the changes which have been made to acute care services in North Tipperary and look at how these changes have impacted the community in regards to access to care. Using both qualitative and quantitative methods in the form of interviews, questionnaires and already available hospital statistics, conclusions were drawn as to how access to care has changed especially from the perspective of the community and workers within the medical community. Two questionnaires, one for the general public and one for medical professionals, focused on access to health care in North Tipperary and the attitudes of the two groups towards centralisation of care. The interviews conducted with medical professionals also focused on access to health care and the recommendations that participants had for a safer service. The hospital statistics studied were for used for the purpose of contrasting case studies into how the local hospital in Co. Tipperary has changed since centralisation began. The results of this study revealed that the current reconfiguration process is not fully supported by either the public or medical personnel in Nenagh and Limerick and that the Health Service Executive reneged on their promise to work with the public and the health care providers to develop this new service and put support services in place at a local level. This has left the public and medical professionals regarding the health service in North Tipperary as unsafe and inaccessible and has resulted in extra pressure being put on ambulance personnel to provide high quality care to the patient- care which was once available to them at the local hospital