The public health challenges in the 21st century are substantial and quite diverse and complex and according to Clarke (2004) the importance of health workers in public health settings highlights society's efforts to tackle these challenges. The nurses are a force for health and a social model of health focuses on the environment, historical, political, cultural and social structures. Clarke (2004) discusses public health in Ireland and the challenges of multi disciplinary team approach as well as communication and the need for a stronger political and social structure within the public health systems. Clarke's work is presented through examples from public health work and he also discusses future developments in care and management in Ireland.
Chavasse (1998) discussed the role of key players and processes that tend to influence public policy in Ireland and highlights the need or lack of policy in healthcare. According to Chavasse (1995), the lack of specific policies in healthcare can have a detrimental effect on primary health care and nursing values with emphasis on fewer appropriate policies. The emphasis is on getting public health workers more involved in policy making and to ensure that policies reflect values and concerns of the health care workers and are recommended to the Irish Government's Commission on Nursing (Chavasse, 1998).
Public health nurses or PHNs work as part of a multidisciplinary team within community care services in the Republic of Ireland and Hanafin and Cowley (2003) suggest that proper interdisciplinary communication is vital for offering the best care to patients. A national survey of PHNs has been reported on families and infants and the public health nurses report good working relationships with other professionals such as speech therapists, medical officers and community welfare officers. Working with multidisciplinary teams is an important part of public health system and a broader social healthcare system and the PHNs admitted that they do receive feedbacks from GPs, eye specialists and social workers. A positive statistical correlation was found between working relationships and frequency of feedback from different health professionals. Communication and team working are two primary elements of health care in the Republic of Ireland. Thus not just within nursing, but multidisciplinary team working approach is encouraged within the entire health care system and is largely associated with communication.
Hanafin et al (2002) bring out the policy and conceptual basis of public health service provision in Ireland in an international context and also proposes a new model of public health service provision to provide an understanding of service delivery through vertical equity. The public health nurse for instance has wide responsibilities in the areas of primary, secondary and tertiary care at the levels of individual, family and community life. There are many expectations and demands on the public health