Irish patients still pay for cuts introduced in the 1980s, study claims

Irish patients are still paying the price for swingeing health cuts rolled out in the late 1980s, according to the author of a comparative study of health services in Ireland and other countries to be published on Thursday.

The research commissioned by the Health Insurance Authority (HIA) provides an international benchmarking comparison of the Irish healthcare system against those in Australia, Belgium, Germany and the UK.

The author of the comparative review section of the paper, Dr Brian Turner of University College Cork, also suggested that waiting lists have exacerbated systemic problems arising due to decades of underfunding. He said that significant reforms outlined in the Sláintecare health reform programme will need to be matched by investment.

Distinct features

Dr Turner said that while no two health systems are exactly alike and each comes with its own distinct features, the Irish health system does share common features and issues with others.

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“Ultimately, citizens pay for healthcare, whether through taxation, health insurance premiums, out-of-pocket payments or other mechanisms, and this is consistent across all the countries benchmarked,” he said.

“Additionally, questions or issues regarding equity in a mixed public/private system and sustainability of long-term increases in health spending are evident in each of the countries reviewed in the paper.”

He pointed out that in Ireland, the demand for private health insurance continues to be relatively high, which “understandably influences debate on how healthcare is provided. The proposed reforms outlined by Sláintecare to the Irish healthcare system are ambitious, but it remains to be seen to what extent they will be successfully implemented. Ultimately, the success of Sláintecare, and the resulting impact on the private health insurance market, will depend on how well funded it is.”

Bed shortages

Dr Turner’s study says that while Ireland now has “similar enough levels of spending as Germany”, waiting lists and bed shortages are more problematic here because “historically, Germany was spending double what Ireland was in the 1970s, ’80s and ’90s. We only caught up in recent years and the under-spending has caused a legacy issue.”

He pointed out that money “was taken out of the system in a major way in the late 1980s and we still have less beds today then we did in 1980 so we are still feeling the after-effects of those cuts”.

He also noted a “vicious circle” in which long waiting lists see people “treated at a later stage of their illnesses, and when you treat people at a later stage it costs more money”.

The “key thing is that we need to reform the system but we also need to invest in the system to deal with the legacy issues,” Dr Turner said.