Crisis and Renewal in Irish Public Health: Analysis of a Neo-liberal State

Approaches to health in Ireland have been traditionally based on the curative biomedical model, with public health infrastructure underdeveloped and typically focused on the treatment of disease rather than its prevention. Based on three papers presented at the Critical Issues in Irish Society Network conference (2012) ‘Health in Crisis’, this article explores to what extent Ireland is moving towards addressing the broader social structures which both enable and constrain health and wellbeing. It will argue that despite isolated examples of patient-centred approaches to care, a less atomised and more holistic understanding of the treatment of illness is required in Ireland. Similarly, Ireland’s record on addressing the wider social determinants of health (SDH) through specific public policy measures, even when compared with similar liberal welfare regimes (UK, Australia and Canada) remains poor. While a strong evidence base on the SDH has emerged in Ireland in recent years, the historical weakness of the welfare state, in combination with the present day dominance of neo-liberal governance, means that specific policy actions remain subordinate to an individualised approach to health promotion. It will conclude by arguing that in countries such as Ireland where there is a significant absence of political will to address the SDH, the need for a ‘public sociology’ which raises awareness of the relationship between class, inequality and health to audiences outside of the academic and political spheres is critical.