Vol. 544 No. 5
135 Mr. Broughan asked the Minister for Health and Children his views on the recent report published by the World Health Organisation which ranked Ireland 32nd in a global league table of health systems and behind relatively underdeveloped countries such as Morocco and Costa Rica; the steps he intends to take to address this situation; and if he will make a statement on the matter. [29375/01]
The report to which the Deputy refers is the World Health Organisation report 2000 entitled, Health Systems: Improving Performance, published by the World Health Organisation. Com parison of the performance of health systems in an accurate and meaningful way is at a relatively underdeveloped stage as the report itself acknowledges. The fact that WHO intends to publish similar comparative indices on a regular basis in future world health reports should give an added impetus to improvement and refinement of the comparison measures.
In the report to which the Deputy refers Ireland was ranked 19th among 190 countries in terms of the overall performance of its health system – above Germany which ranked 25th and the USA which ranked 37th. Performance was measured by relating achievement of health system goals in terms of health and its distribution; responsiveness and its distribution and fairness in financing to health expenditure.
Ireland ranked very well – 6th-7th – in terms of fairness of financial contribution but did less well on measures of health and on responsiveness. On health performance we ranked 32nd. Health performance took into account not only health status, which was measured by disability adjusted life expectancy but also inequalities in the distribution of health in the population. However as indicated above, the Deputy should be aware that in the paper that gave rise to the publicity about Ireland's position the authors stated, "Our conclusions are of course tentative. The quality of the data across countries varies greatly and only some of this is accounted for in our uncertainty analysis."
A number of reports, including the 1999 report of the chief medical officer, have drawn attention to the links between lower socio-economic position and poorer health status. In examining health status, it is important to recognise that it is influenced by several factors. These include people's natural endowment; the physical and emotional nurturing they receive; the lifestyle they adopt; the degree to which the health services and the wider environment support and complement their attempts to prevent disease and to improve their health as well as the access they have to quality health and personal social services in times of need.
A high proportion of mortality and morbidity rates in Ireland are caused by chronic diseases such as cardiovascular disease, chronic respiratory disease and cancer. A range of measures are in place to improve health status and mortality rates. These include the national cancer strategy, the national cardiovascular health strategy and the health promotion strategy. Last year I launched the health promotion strategy for the years 2000-05 which includes specific strategic aims and objectives to contribute to the overall health improvement of the Irish population.
I am currently developing a national health strategy which will be published shortly. The new national health strategy will build on the current strategy, Shaping a Healthier Future – 1994, and will provide a blueprint for the strategic development of the health services over the next seven to ten years.
