Anne O’Connor: Tracing the evolving model of Irish healthcare delivery
Anne O’Connor discusses her remit as Managing Director of Vhi Health and Wellbeing, and the evolving role of the semi-state healthcare provider.
Most publicly recognised for her role leading the HSE’s operational response to the Covid pandemic and the cyber-attack of 2021, O’Connor’s experience spans an almost 30-years in public health, having initially trained as an occupational therapist in the UK before moving back to Ireland.
In the main, she has spent much of that career in mental health services, an area which she describes as her “first love”. A decade of service in management roles from 2000 onwards culminated in her appointment as the National Director of Mental Health in 2014, and in 2018 she was appointed deputy Director General and Chief Operation Officer.
Given the length of O’Connor’s tenure and breadth of her experience, her announcement in April 2022 that she would be leaving to join the largest health insurer in the State as its Managing Director of Health and Wellbeing, came as a surprise to many.
Asked about her decision to join Vhi, she says: “It is a very different construct. Vhi is the only health insurer on the market that exists solely for the benefit of our members. Any profits made are reinvested on behalf of our members to enhance Vhi members healthcare and services. This is an important differentiator for me.”
“Vhi is the only health provider that exists solely for the benefit of our members. Any profits made are reinvested… This is an important differentiator for me.”
Anne O’Connor, Managing Director, Vhi Health and Wellbeing
She said “Vhi’s strategy aligns with the objectives of Sláintecare, supporting improved healthcare delivery in Ireland by providing better access to healthcare, delivering efficiencies, and enhancing healthcare outcomes.”
O’Connor’s decision to transition into health insurance is symptomatic of the accelerated evolution of traditional health insurers such as Vhi, and the changing model of healthcare provision.
With almost half the population of the State now holding private health insurance, organisations like Vhi have not only broadened the health care expenses they are willing to imburse, including around community care and wellbeing, but also provide urgent care and other clinical services to members.
O’Connor is overseeing Vhi’s provision of a wider range of services in its larger ‘360 Health Centres’, including diagnostics, targeted screening, women’s health, paediatrics, orthopaedics, wound care, physiotherapy, psychology, and dermatology.
Alongside the 360 Health Centres – currently operating in Dublin, Limerick, and Cork – O’Connor’s remit includes clinical call centre, digital platforms, and Vhi’s Hospital@Home service.
“What really attracted me was that Vhi, as the largest health insurer in the State, has a strong commitment and strategy to develop health services for its members,” O’Connor explains.
Asked about her initial reflections upon joining Vhi, she says: “With more than 1.2 million members, it had a scale that was appealing to me and having been in public healthcare in various remits, I wanted to go somewhere that would challenge me and where I could learn. A regulated insurance company with a group structure is a very different environment than what I had become used to.
“Interestingly, I quickly acknowledged that I, and many other senior decision-makers working in the public health service, know very little about the work organisations like Vhi do within the health sector. The healthcare ecosystem is much larger than many people realise, and I think there are barriers to recognising innovation and effectively collaborating on delivering new systems and solutions.”
O’Connor asserts that, despite its relatively small population by global standards, the State’s healthcare demands exceed the volume of its services, even if both public and private services were fully utilised.
As a result, she says: “There is an onus on us to decide who does what. Who is best placed to respond to certain demand and how can we best break down the gap in supply and demand.”
Outlining her assessment that the public health service must serve the most vulnerable and most in need, she insists: “Healthcare should not be a competition. There are people who attend health services who will have had interactions with many state agencies and who have multiple conditions and morbidities. They need very complex care and the public health services, situated alongside the other vital public services should be ideally placed to help those people.”
The Health and Wellbeing Managing Director identifies the Covid-19 pandemic as a point of inflection around how the private sector supported the State’s healthcare delivery. Reiterating that roughly half of Ireland’s population now actively choose to have private health insurance, she says that this choice is driving the expansion of services on offer.
Importantly, she states, those services and the requirements within those services are underpinned by the exact same fundamentals driving public health care delivery, namely: quality, patient safety, and skilled staff responding to need.
Describing the impact of the pandemic on evolving demands for healthcare and wellbeing services, O’Connor explains: “We see a big focus on people trying to stay well and taking a preventative approach toward their health. I believe that a greater focus on individual wellness during the pandemic has driven that.
“In the HSE, as part of the response to Covid, we stood up a whole workstream around access to online healthcare, mainly because we had to at the time. Now, within Vhi, and indeed, many other healthcare providers, telehealth is a mainstay, because people saw the benefits of it and now expect it. Simultaneously, there was a discernible benefit for healthcare providers being able to efficiently respond to demand.
“There is a recognisable advantage in the ability to scale digital healthcare responses in a way that is not possible face-to-face, and I think there is definitely scope for further cross sector collaboration, instead of reverting to traditional models of delivery.”
Future outlook
With much of Vhi’s healthcare provision predating O’Connor’s arrival – the Vhi 360 Health Centre in Carrickmines, for example, providing members with access to urgent care for minor injuries and illnesses, 365 days a year – the Managing Director of Health and Wellbeing says that her focus has been on integrating its available services and becoming a more cohesive and networked organisation, utilising multi-disciplinary teams.
“Ultimately, we are all on the same journey of attempting to bend the cost curve of healthcare delivery, whether that is in public systems or healthcare providers. Essentially that means trying to intervene earlier to reduce the need for people to use higher cost, higher complexity services. Vhi is no different and in response we are developing integrated pathways for our members, delivered by the right professionals.”
O’Connor points to the introduction of solutions such as a single electronic patient record across all Vhi’s services, as an example of a shared goal between public and private providers, but one which has faced greater barriers in the public system.
Discussing alignment with the delivery of Sláintecare, Ireland’s plan for reforming healthcare delivery, she says: “Vhi’s purpose is to support our members to live longer, stronger, and healthier lives. Our core values are centred on supporting people to stay well. There is total alignment with Sláintecare’s drive towards early intervention, ensuring services are available at the right time and in the right place.”
Summarising her ambitions for the year ahead, O’Connor says: “In 2025 we intend to open our Galway 360 Health Centre, which is part of a broader assessment of developing our physical footprint and our services. Simultaneously, I want to continue to foster those relationships and partnerships with the public healthcare sector and other providers, to share innovations and respond to the demands of the population.”
