Bernard Allen
Ceist:580 Mr. Allen asked the Minister for Health and Children the reason the French health system is not seen as an appropriate model for Ireland due to its cost implications; and if he will make a statement on the matter. [22082/01]
Written Answers. - Health Strategy.
In most developed countries, governments have significant involvement with both the financing and delivery of health care. By intervening in the market through both regulation and public ownership, governments are able to achieve social policy goals such as fairness and consumer protection. The model of health care that exists in France differs from the Irish model in a number of ways, particularly in regard to its method of financing.
The French health care system is based on a national universal compulsory insurance system linked to employment and financed by both employers and employees at roughly a 65:35 ratio. Funds cover pensions, family benefits and medical care. There is no competition between the sickness funds as they are organised strictly along occupational lines. Since the mid-1990s, the system has been the subject of a series of reforms introduced to cover social security deficits, cost containment and longer term reforms. There has been a progressive widening of financing sources from payroll contributions towards general tax revenue. Currently, there are plans to finance an increasing proportion of collective health expenditure from a direct tax based largely on household incomes. The 1998 figures indicate that the public expenditure on health accounted for 7.2% of GNP in France as against about 5% in Ireland.
In considering various funding systems in the context of the new national health strategy, the strategy consultative forum sub-group on funding concluded that because of spare capacity in the system, waiting lists are not a feature of the French system which is seen as particularly responsive. However, waiting list figures recently released for this country for the June 2001 quarter indicate that there have been significant reductions since June 2000 for target specialities: cardiac surgery down by 52%; gynaecology down by 35%; ENT down by 30%; ophthalmology down by 23%; orthopaedics down by 14%.
Hospital waiting lists must be viewed against the background of a hospital system which discharged some 870,000 in-patients in 2000. The number of people currently on hospital in-patient waiting lists represents just 3% of all in-patient discharges in 2000.
As the Deputy points out, in the World Health Organisation Report, 2000, France was assessed as being the best performer overall, with Ireland ranked as 19th out of 192 countries. It is worth noting, however, that Ireland ranked higher than France in the level of fairness with which people make contributions to health care finances.
The Deputy will be aware that through the consultative forum for the national health strategy, a number of models of health care were examined, including social insurance. The results of their deliberations have informed the strategy which I intend bringing to Government shortly.
Bernard Allen
Ceist:581 Mr. Allen asked the Minister for Health and Children if he has received a response from the Irish Hospital Consultants' Association to his health strategy document; and if so, the contents of that response. [22083/01]
Bernard Allen
Ceist:603 Mr. Allen asked the Minister for Health and Children if he will make a statement on recent comments (details supplied) on the health strategy document on primary care. [22105/01]
I propose to take Questions Nos. 581 and 603 together.
The documents to which the Deputy refers have not yet been published. I expect to publish them in the coming weeks. The comments of all interested parties will be welcomed at that stage.