The latest OECD report into the health of people in its 34 member countries is especially interesting as it includes data on how health systems have evolved during the economic crisis. Health at a Glance 2013 is a mine of comparative information on patient outcomes, health expenditure and health system staffing across the countries.
Unsurprisingly, countries hit hardest by the economic crisis have witnessed the biggest cuts in health expenditure growth. Greece and Ireland experienced the sharpest declines, with per capita healthcare spending falling by 11.1 per cent and 6.6 per cent, respectively, between 2009 and 2011.
The short-term impact has been both good and bad. Suicide rates have risen sharply in some countries, while in Greece the infant mortality rate, long held to be a reliable “marker” for the quality of a state’s health system, has begun to creep up.
But other health indicators tell a different story. For example, mortality from road traffic incidents, including in Ireland, has declined. Such deaths had already been steadily falling in most OECD countries, but the rate of decline accelerated after 2008 in some countries that were hard hit by the recession. The most likely explanation for this is that less economic activity means fewer cars on the roads, and therefore fewer incidents.
Alcohol and tobacco consumption in a number of countries has fallen in the immediate aftermath of the crisis.
Ireland continues to have a below-average numbers of doctors practising per 1,000 people. Along with Canada, New Zealand, Chile and the Netherlands, we have the lowest number of obstetricians and gynaecologists per 100,000 women across the OECD.
This shortage emerged as a factor requiring urgent remedy in the Hiqa report into the death last year of Savita Halappanavar from sepsis.
Patient safety
The OECD report rather optimistically states that "countries can make further gains in patient safety, thereby reducing costs and health burdens associated with adverse events". But with health spending continuing to fall, how is this to be achieved in places like Ireland, Portugal and Greece?
We have the third highest hospital bed occupancy across the OECD, with only Israel and Norway worse off.
The real question remains: how will continuing cuts impact in the medium term on areas such as cancer care and mental health?