Health spending – the OECD’s view

Sir, – Did it ever occur to Pat O’Brien (“Health spending and insatiable demands”, Letters, July 4th) that the Department of Public Expenditure and Reform might have an agenda? Could it be the case that it suits its current masters to convey the notion that the failures in the provision of social services are due to the inefficiencies of those working in those sectors and that funding is adequate to meet demand?

Here is a quote from OECD Economic Surveys Ireland (December 2022) which addresses all the points your letter writer raises: “Overall, the health of the Irish population has improved substantially during recent decades and is quite good compared with other OECD countries. However, spending is elevated, partly reflecting a system that is strongly based on hospitals. Population ageing is exacerbating spending pressures. In addition, the health sector is dealing with past underspending, particularly in capital outlays in the years following the global financial crisis that has constrained service delivery, contributing to substantial waiting lists and heavy pressure on staff.”

The report goes on to raise concerns about the “interaction of the public and private parts of the system in which private patients enjoy easier access to care, leading to concerns about a two-tier healthcare system” However, it is optimistic about the future based on the “wide-ranging reforms, termed Sláintecare, with the aim of broadening the coverage of universal care, decentralising provision and enhancing the integration of primary, community and hospital care”. It concludes by stating: “stepping up the efforts to address legacy issues and move forward on the reforms is now key to meet the coming challenges while using resources effectively”.

In short, it places the responsibility for delivering good public services where it belongs, on the Government. – Yours, etc,