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In May 2017, an Irish cross-party parliamentary committee published the 'Houses of the Oireachtas Committee on the Future of Healthcare "Sláintecare" report'. The report, known as 'Sláintecare', is unique and historic as it is the first time there has been a cross-party political consensus on major health reform in Ireland. Sláintecare sets out a high level policy roadmap to deliver whole system reform and universal healthcare, phased over a ten year period and costed. Sláintecare details reform proposals which, if delivered, will establish; a universal, single-tier health service where patients are treated solely on the basis of health need; the reorientation of the health system 'towards integrated primary and community care, consistent with the highest quality of patient safety in as short a time-frame as possible'. Sláintecare has five interrelated components: population health; entitlements and access to healthcare; integrated care; funding; and implementation. In this article, the authors use documents in the public domain (parliamentary reports, public hearings, submissions to the Committee, media coverage, the final report of the Committee, speeches by Committee members) to describe the policy process and the main contents of the proposed Sláintecare reforms. It is too soon tell if the political consensus in the policy formation can hold for its implementation.

A new Irish government came to power in March 2011 with the most radical proposals for health system reform in the history of the state, including improving access to healthcare, free GP care for all by 2015 and the introduction of Universal Health Insurance after 2016. All this was to be achieved amidst the most severe economic crisis experienced by Ireland since the 1930s. The authors assess how well the system coped with a downsizing of resources by an analysis of coverage and health system activity indicators. These show a health system that managed 'to do more with less' from 2008 to 2012. They also demonstrate a system that was 'doing more with less' by transferring the cost of care onto people and by significant resource cuts. From 2013, the indicators show a system that has no choice but 'to do less with less' with diminishing returns from crude cuts. This is evident in declining numbers with free care, of hospital cases and home care hours, alongside increased wait-times and expensive agency staffing. The results suggest a limited window of benefit from austerity beyond which cuts and rationing prevail which is costly, in both human and financial terms.

Intervention studies designed to improve neurodevelopmental outcomes of premature infants in the neonatal intensive care unit (NICU) were evaluated in this systematic review to analyze research methods, to illuminate the effectiveness of interventions, and to make recommendations for future research. Google Scholar, the Cumulative Index of Nursing and Applied Health Literature, PubMed, and Cochrane databases were investigated to identify experimental and quasi-experimental interventional studies in peer-reviewed journals. Each study was assessed in the areas of sample, design, interventional strategies, threats to validity, and outcomes. Nineteen articles were reviewed with a variety of clustered and individual strategies identified to improve neurodevelopmental outcomes of premature infants in the NICU. Developmental care in the NICU appears to have some positive effects on the neurodevelopment of preterm infants. However, there were a number of limitations identified that threaten the validity of the included studies. Going forward, components of developmental care should be operationalized more consistently, greater effort should be put into ensuring treatment fidelity, and electroencephalogram data should be collected in conjunction with behavioral outcome measures.

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