From Crisis to Reform: How COVID-19 Reshaped the Lives of Ireland’s Public Health Doctors

Emerging from the pandemic, public health doctors in Ireland find themselves at a moment of both recognition and exhaustion. A study led by the Graduate School of Healthcare Management at RCSI University of Medicine and Health Sciences in Dublin, the Department of Adult Education and Lifelong Learning at Çanakkale Onsekiz Mart University in Turkey, the Institute for Intercultural Communication at WU Vienna University of Economics and Business in Austria, and the Public Health HSE Mid-West in Limerick has captured the reflections of thirteen doctors as they look back on years of relentless work and profound institutional change. Using an innovative method that combined online interviews with six weeks of WhatsApp conversations, the research provides a rare, intimate glimpse into how these professionals, once sidelined, became the backbone of Ireland’s COVID-19 response and the subjects of long-delayed reforms.

Recognition, But at a Price

For decades, public health medicine in Ireland was an underappreciated specialty. Considered prevention-oriented, non-patient-facing, and dominated by women, it struggled to attract the recognition given to other medical fields. Reform proposals dating back to 2001 languished in policy drawers, and repeated industrial actions reflected the frustration of a workforce caught in limbo. It was only under the extraordinary pressure of the pandemic that their importance was impossible to ignore. “The pandemic shone a spotlight on our profession,” one participant recalled, noting how suddenly public health became central to national survival. In 2021, public health doctors were at last granted consultant status, aligning them with their clinical peers and permitting them to lead multidisciplinary teams. The achievement was historic and transformative, elevating their profile with both the public and fellow doctors. Yet for many, it was a bittersweet victory, one that had arrived decades too late and only after a bruising fight that had taken its toll.

The Relentless Burden of COVID-19

If recognition was the reward, the cost was extraordinary strain. Public health doctors bore some of the heaviest burdens of the pandemic, working long nights and sacrificing rest and personal time for months at a stretch. One recalled being in the office until midnight nearly every day for fourteen consecutive weeks. Others described years of “non-stop” work, coupled with the pressure of being thrust into the media spotlight and navigating the political controversies that swirled around public health decisions. By 2023, many still carried what they described as a “hangover effect” from those years. Burnout was widespread, and the absence of formal opportunities to debrief or reflect deepened the sense of isolation. As one participant put it, “nobody ever sat down with us to ask how we were doing.” The lack of institutional acknowledgment of their sacrifice left many feeling as though they had been asked to absorb a national emergency without the chance to process its human cost.

Reform Arrives Amid Fatigue

Just as pandemic pressures began to ease, a second wave of upheaval arrived in the form of long-awaited reforms. The government introduced a consultant-led model of public health, created six new regional areas, and embedded directors of public health into executive management teams. In principle, these changes were welcomed as necessary and overdue. Yet the timing meant that doctors were asked to embrace transformation while still reeling from the pandemic. Many spoke of “change fatigue,” disorganization, and confusion about their new roles. Some said they felt unsafe voicing concerns, with dissent interpreted as stress rather than constructive critique. “The tenor of meetings is to pathologise any dissent,” one participant explained. Others highlighted the widening gap between expectations and resources, with understaffing leaving little space for strategic planning, including the kind of forward-looking work essential for pandemic preparedness. For many, reforms seemed less like an opportunity than another burden piled on top of an already exhausted workforce.

A Call for Cultural Renewal

The study situates these voices within a broader conversation about organizational change in healthcare. Change, the authors argue, is not just about restructuring charts and creating new contracts but about addressing the human dimension. Without communication, trust, and psychological safety, reforms risk alienating those they are designed to empower. The researchers call on Ireland’s Health Service Executive to go beyond structural fixes and invest in cultural renewal. That means creating safe spaces for public health doctors to reflect, ensuring their concerns are heard, and building teams grounded in mutual respect and support. Frontline doctors, the study emphasizes, are not only implementers but sources of vital strategic intelligence. Ignoring their voices would undermine the very reforms intended to strengthen the system.

In the end, the portrait that emerges is of a workforce that is proud yet weary, vindicated yet vulnerable. Public health doctors in Ireland have finally gained long-overdue recognition, but at a time when many are still recovering from years of strain. Their testimony underscores a central truth: reform is not measured by new structures or titles but by whether those working within them feel valued, supported, and safe. For Ireland’s health leaders, the challenge ahead is not simply one of rebuilding systems but of rebuilding morale and trust among those who carried the nation through its gravest public health crisis in generations.