Dáil Éireann debate -
Tuesday, 2 Mar 1999

Vol. 501 No. 3

Written Answers. - Health Funding.

Proinsias De Rossa

Question:

93 Proinsias De Rossa asked the Minister for Health and Children his views on the report, Healthcare 2005 - A Prescription for Ireland and, in particular, on the level of healthcare funding as a percentage of GDP and the possibility that the EU will restrict a further increase in that percentage; and if he will make a statement on the matter. [5948/99]

Minister for Health and Children (Mr. Cowen)

My office has only very recently received this report.

The chapter in the report entitled Industry Changes claims that "Ireland has a low healthcare spend as a percentage of GDP at 7 per cent in comparison to an EU average of 8 per cent". Comparisons of health spending as a percentage of GDP are notoriously difficult given that GDP is growing at a uniquely fast rate in Ireland. The following table, which is based on the latest comparable available statistics published by the OECD, compares Irish health expenditure with the average for EU and OECD countries. The figures relate to 1996 and include both capital and current expenditure. Figures are shown for total expenditure, which is made up of both public and private expenditure, and public expenditure taken on its own. Health spending is expressed as a percentage of gross domestic product and also shown is spending per head of population which is compared using US dollar purchasing power parities.

	1996 Spending as a % of GDP	1996 Spending Per Capita in US Dollars (PPP)
Ireland	%	$
–Total	7	1,276
–Public only	5.2	947
EU Average
–Total	8	1,582
–Public only	6.1	1,227
OECD Average
–Total	7.7	1,508
–Public only	5.7	1,116

Source: OECD, 1996.

However, some caution should be used in the interpretation and analysis of these figures. Health systems deliver very different services in different countries and this is likely to influence the figures despite the fact that the OECD makes every effort to take this into consideration. In addition, the demands of the public vary between countries with, for example, continental systems having to deal with much higher proportions of their populations in older age groups. Also Ireland is only now beginning to catch up with our EU partners in terms of national income and this means that these countries have had greater resources to build up services over a long number of years. The OECD in its economic survey of Ireland published in 1997 compiled a special report on the health services. The report noted that there had been major increases in spending on community services and that there had been significant improvements in hospital productivity in recent years. The report concluded that the Irish health system, based on a mixture of public and private care, resulted in good provision of health care at a relatively low cost to the taxpayer.

In response to the Deputy's second point regarding possible EU restrictions, I want to emphasise that this Government will continue to invest in the development of our health services while at all times respecting the terms of the stability and growth pact as agreed in the Dublin European Council. This commitment is clearly demonstrated in the 1999 original health estimate which when compared with the provisional 1998 outturn shows an increase of 10 per cent, one of the largest increases in many years. This level of funding has been provided against a background of careful management of overall public finances. If the level of increased investment by this Government is sustained, I would expect that our relative position in regard to OECD as we move into the next millennium will be more favourable.