Health – a vital investment

Dr Audrey Derveloy, Managing Director of Novartis Pharmaceuticals Ireland and National President.

What are your daily responsibilities?

As Managing Director, I am responsible for the day-to-day operations of the pharmaceutical division. We have a broad portfolio spanning different therapeutic areas including Cardiology, Neurology, Oncology, Dermatology and Rheumatology.

My role as National Chairman is to work closely with the Managing Directors of the Novartis Global Service Center (NGSC) and Novartis Ringaskiddy to ensure that our 1500 employees are focused on the development and delivery of innovative medicines in Ireland and the -of the.

What is your professional background?

I am a doctor by training and have been practicing general medicine for several years in major public hospitals in Paris. I also previously worked for several pharmaceutical companies in France and Asia. I moved with my family to Ireland in January 2020 to take up my current position.

My medical background, combined with my experience in the pharmaceutical industry, has given me a strong sense of purpose and a passion for improving human health and health systems.

How will COVID-19 impact healthcare spending?

I think the impact of Covid-19 means that healthcare is no longer seen by government or society as just a cost, but rather as a vital investment.

Health care was re-prioritized in society and for the first time, health and the economy were inextricably linked. I think this will be a permanent change and there is now a greater public appreciation of the importance of a functioning healthcare system. Spending will likely need to increase in areas such as critical care capacity if we are to ease potential new lockdowns for this pandemic, or the next. Irrespective of the pandemic, in my view, health care spending will have to increase due to changing demographics and additional funding will be needed just to counter the aging population.

It was a positive development to see additional funding in the 2022 budget for Covid-related healthcare spending, and in my view, that money needs to stay in the healthcare system.

Will health outcomes deteriorate after virtual shutdown of “elective” procedures?

Waiting lists have increased due to the pandemic, which will inevitably lead to further health inequalities in access to care, with those who can afford it seeking private care. Investments and sustained progress in this area are therefore essential. As the pandemic tragically took lives and filled our hospitals in Ireland, the ripple effect meant that other debilitating illnesses went undiagnosed and untreated; and patients with chronic conditions saw their care interrupted.

Through our work in the healthcare system, we know that many patients postpone care to avoid high-acuity places such as hospitals and emergency rooms. We have yet to see the full impact of this, but it is likely that delayed diagnoses will result in patients presenting at more advanced stages of disease, which could lead to poorer clinical outcomes. We therefore risk living for a long time with the consequence of delayed care.

I hope COVID-19 will put more emphasis on the implementation and funding of Sláintecare, which has become even more critical now. The pandemic has shown that care can be provided based on need rather than ability to pay. I hope this will continue, and I believe that Sláintecare is the starting point for this model to become the norm. We need to structure our health care system for the future.

What lessons have we learned for the next crisis?

I think the most critical lesson we’ve learned is that a strong, functioning health system underpins everything. Covid-19 has taught us that a health crisis can have extremely significant effects on society and the economy. Globally, no health system was prepared. Due to this, almost every element of society and the economy has come to a halt at some point. To mitigate this kind of impact in the future, we need to restructure, with more emphasis on preventive health care, and treating people in the community outside of hospitals will go a long way. We also need to revitalize public health and improve our preparedness for future events.

Covid-19 has provided the impetus to demand governments develop sustainable solutions for health systems, to ensure we are able to meet future major health challenges. And we have proven that through collaboration and partnership, these solutions can be adopted efficiently and quickly.

What opportunities will emerge from the current crisis and eventual recovery to transform healthcare?

I hope the opportunities for more public-private partnerships will continue, as this will require all players to be at the table to address some of the systemic issues and transform healthcare. And here in Ireland, I think we have a unique ecosystem of stakeholders to make that happen – Ireland is a hub for many leading pharmaceutical, medical and digital companies, among others; we have a very strong academic community and I think if we use all that talent we can give Ireland a head start in healthcare transformation.

With Covid-19, we have witnessed the largest and fastest mobilization of global scientific capacity against a public health crisis, as collectively we have made disease the enemy. We now have the opportunity to tackle other areas of chronic disease with the same sense of urgency and unity. Take the example of cardiovascular disease (CVD), which is currently the leading cause of death worldwide. The reduction in CV mortality has reached a plateau with a large and persistent unmet need, necessitating a new wave of innovation to advance the management of LDL-C (bad cholesterol). This can and must be changed urgently because we know that cardiovascular disease is preventable if managed well. Refocusing policy and practice to ensure we can manage these types of illnesses would have a positive impact on the health of the people of Ireland.

Finally, the growth of digital health, remote monitoring and personalization of care all offer opportunities to transform the way healthcare is delivered – moving from our traditional acute care model to more community-based care and residence. To ensure that the pace of these innovations does not slow once the Covid-19 emergency passes, policymakers must ensure an enabling policy framework that maximizes the potential of digital health solutions.

What will the healthcare experience look like by the end of this decade?

I am confident that by 2030, the shift in focus from hospital-centred acute care to integrated care will have occurred. The burden of care will have shifted from secondary to primary and community care because throughput in hospitals can simply never be the same after Covid, mainly due to Ireland’s aging population – the system was at full capacity even before the pandemic and it’s not sustainable. Routine hospital referrals for outpatient imaging need to become a thing of the past, so we should see many more diagnostic services available in primary care.

But it’s not just the structure of our health care system that needs to change. As a pharmaceutical company, we at Novartis know that our role in sustainable healthcare must also grow in the future. It can no longer just be about the drugs we discover. To be a trusted partner, we must bring to market therapeutic products that will solve the problems of our health system.

So we try to work more according to the needs of the system, understanding their priorities and how we can help them. And we have recent and exciting examples. One is our unique collaboration with international private healthcare provider UPMC, where we have partnered in a care program to positively impact the cardiovascular health of patients. Another is the creation of a new biome, which will serve as a partnership platform for Ireland’s unique and rich healthcare ecosystem to address specific healthcare system issues.

Finally, by the end of this decade, overall trust in the Irish healthcare experience needs to be strengthened and improved from the perspective of both the patient and our healthcare staff. The patient experience should be such that care is delivered based on need and at the most appropriate level to improve health outcomes. Our healthcare workers need to experience a positive working environment that makes them want to stay and work in Ireland. Retaining talent is an issue that must be tackled if we want a stable and functional health system in 10 years. The pandemic has highlighted that our healthcare workers are our most valuable and vital resource.

Dr. Audrey Derveloy will speak at the 18th National Health Summit on February 8, 2022. For more information, visit www.healthsummit.ie

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