Ireland's healthcare system has been ranked bottom of the league in Europe when it comes to waiting times for patients to access services.
It and Sweden scored worst out of 29 European countries when waiting times for patients were examined.
The findings are contained in the 2007 Euro Health Consumer Index published yesterday.
However, the overall ranking of Ireland's healthcare system in the report has improved since last year. It is now ranked as having the 16th most consumer-friendly healthcare system in Europe. Last year it was ranked 25th out of 26 states.
The latest report says: "The Health Service Executive reform seems to have started improving an historically dismal performance." But it said there were "still severe waiting list problems and less than fantastic outcomes".
Its main recommendation for Ireland was that it should first and foremost cut the waiting lists, as "they are still far too long".
Dr Arne Bjornberg, research director for the index, said that although Ireland was doing far better overall this year, it remained "at the bottom for waiting times".
Ireland was rated poorly in terms of direct access to specialists, access to major non-acute operations within 90 days and access to MRI scans within seven days.
It got an intermediate score for access to same-day family doctor services.
Access was better in Greece and Latvia, where healthcare investment is less.
But the report noted Irish patients have good access to new drugs.
In terms of patient outcomes, Ireland was rated poorly on MRSA and on the intermediate scale in terms of five-year cancer survival.
It was also rated on the intermediate scale in terms of patient rights to second opinions and to their own medical records.
MRSA infections in hospitals, according to the report, "are now a significant health threat in one out of two measured countries".
Countries were also rated in terms of the "bang for the buck" they were getting in terms of healthcare expenditure.
In this, Ireland came in 21st place. Estonia was in first place, followed by Austria and the Netherlands.
Overall, Austria came out on top in the survey, followed by the Netherlands, France, Switzerland and Germany.
Ireland scored 592 points out of a possible 1,000 in the survey.
The UK was ranked 17th in Europe and the report says its overall score was dragged down by waiting lists and uneven quality performance.
The Euro Health Consumer Index ranks healthcare systems on the basis of 27 performance indicators across five categories including patients' rights and information, waiting times for common treatments, care outcomes, the generosity of the system and access to medication. It is compiled from a combination of public statistics and independent research.
The National Treatment Purchase Fund, which collates waiting list figures, disputed the poor rating given for access to major non-acute operations within 90 days.
It claimed waiting times for the four main operations which the index looked at (hip and knee replacements, angioplasty and coronary artery bypass graft) were between two and four months at present.