Ireland

6.7%CHE/GDP

10.7%OOP/CHE

21%GGHE-D/GGE

529BGDP (USD)

5MPopulation

5.6%Catastrophic Health Spending

1.5%Unmet Needs - Total

2.5%Unmet Needs - Female

1.5%Unmet Needs - Male

Ireland is a high-income country in north-western Europe that shares the island of Ireland with Northern Ireland. Ireland had a population of about 5.1 million people in 2022 and an average life expectancy of 82 years in 2021^[1]. The Sláintecare policy underpins the current health system reform programme as it moves towards universal health coverage (UHC). The following background information on Ireland’s health system is drawn from the European Observatory on Health Systems and Policies.

The health system: a mix of public and private providers and payers

“The public health system is accessible to all residents”; however, private health insurance (PHI) allows people to gain preferential access to some services and many public services have substantial waiting lists”.

The Department of Health provides overall stewardship, policy direction and performance oversight, and allocates the health budget. The Health Service Executive (HSE) is responsible for managing and delivering health and social care services. These are provided through its own hospitals and structures of Ireland’s Community Healthcare Organisation. General practitioners (GPs), pharmacists and other health professionals are contracted, complemented by large voluntary hospitals and providers of social care.

“[A]ccess and associated charges for services in the public system are determined by an individual’s circumstances. Some public health services are provided universally free of charge, such as maternal and infant care and immunizations”. Approximately 36% of the population benefits from having medical cards for publicly funded services. The cards grant free access to some medical services, including GP services and hospital care, and the cards lower costs for prescription medicines. While the remaining 64% of the population does not benefit from medical cards, “some households may qualify for a GP visit card (10%), granting free GP care but requiring payments for all other services in the public system. GP visit cards are also provided to children under 6 and adults above 70. Around 46% of the population [has] PHI with another 20% not covered by a medical card, a GP visit card or PHI” ^[2].

Funding and health expenditure in Ireland

Ireland’s national health service is primarily funded through general taxation^[3]. Health care expenditure peaked above 10% of GDP between 2009 and 2013. This percentage decreased sharply in 2015 to 7.3% and remained around the same, at 6.7% in 2021, which is lower than the European Union (EU) average (above 9.8% since 2009)^[4]. Ireland’s per capita health expenditure has been above the EU average since 2000, reaching US$ 6092 in 2020, while the EU average was US$ 3735^[5]. Public sources comprised 78.4% of health expenditure (2021)^[6], slightly below the EU average (81.1% in 2021)^[7]. Out-of-pocket (OOP) payments as a percentage of total expenditure on health peaked at 14.3% in 2014 and have improved – only 10.3% in 2021^[7], which is lower than the EU average of 14.5%^[3]. Ireland has made strides to expand eligibility to free services. Measures are being taken to alleviate waiting lists in public^[3].

References

[1] “Ireland.” World Bank Open Data. Accessed 4 June 2024.

[2] European Observatory on Health Systems and Policies. Ireland Health System Information: Country Overview. Accessed 5 June 2024.

[3] OECD. Ireland: Country Health Profile 2023. Organisation for Economic Co-operation and Development, 2023. OECD iLibrary.

[4] “Current health care expenditure (% of GDP) – Ireland, European Union”. World Bank Open Data. Accessed 4 June 2024.

[5] “Current Health Expenditure per Capita (Current US$) – Ireland, European Union”. World Bank Open Data. Accessed 4 June 2024.

[7] “Domestic General Government Health Expenditure (% of Current Health Expenditure) – Ireland, European Union”. World Bank Open Data. Accessed 5 June 2024.

[6] “Out-of-Pocket Expenditure (% of Current Health Expenditure) – Ireland”. World Bank Open Data. Accessed 5 June 2024.