Given the significance of healthcare systems to their beneficiaries, it can be easy to generalize them as either “bad” or “good.” However, while both remarkably successful and disastrous systems do exist, setups like the Irish system demonstrate that a single system’s success can vary greatly between “bad” and “good.” Here is some pertinent information about healthcare in Ireland.

Background

As with most nations in Western Europe, Ireland utilizes a public healthcare system. The quality of the aid options covered by the government is inversely related to a citizen’s income and situation. Still, every Irish citizen is entitled to public hospital care, birthing services and a chance to apply for limited prescription drug or medicine payment.

Supplemental support for the Irish public system comes in the form of private health insurance companies and increasing government spending. Private healthcare has exploded into a wide field of Irish companies providing extended care to over 30% of the population. Government healthcare budgets have also grown, with an annual expenditure of 21.1 billion euros as of 2017.

Despite these traits, problems with healthcare in Ireland, especially with accessibility, remain. In fact, while Ireland has gone through four systematic changes and over six different healthcare management departments in the past fifteen years, citizen access to medical care is still an urgent issue.

Structural Accessibility Problems

While Ireland has taken great pains to offer monetary support for its public and private medical professionals, the nation’s support of citizens in need of said professionals is poor. In theory, medical aid would be distributed equally by need across Ireland’s counties. Instead, regions like the nation’s South-East have difficulty accessing support for any medical field, lacking professionals from general practitioners to speech therapists.

Additionally, Ireland faces lingering challenges due to its restructured healthcare system from the 2008-2009 global economic crisis. Ireland’s public system remained in place during the crisis but at the cost of temporarily plummeting expenditure and creating lasting widespread changes. Some of the changes to the system were:

• Specialized national directories were subsumed into an Integrated Services Directorate (ISD)
• Management of individual regions was given to locally-based Integrated Service Areas (ISA)
• The provision of healthcare became a task split between the national government and four regional departments

While Ireland’s division of hospitals and state worked during an economic crisis, over time, significant flaws have appeared. Barring emergencies, the healthcare system is simply too slow to change in accordance with the needs of Ireland’s citizens. As a result, regions with above-average health risks are left without necessary national aid. In nations with more independent local governments, this shortage might be resolved. In this case, it only leads to severe problems with healthcare accessibility in Ireland.

For example, the county of Wexford consistently provides medical care below Ireland’s national average despite a disabled population of over 20,000 citizens and theoretically widespread access to healthcare. As the amount of at-risk citizens has not quite reached emergency levels, the region simply is not prioritized despite a clear need for and a right to more healthcare access.

Private Insurance

A further limitation on healthcare accessibility in Ireland is the growth of its private healthcare system. This system was affirmed in the 1950s and initially led by the Voluntary Health Insurance Board to alleviate the concerns of private insurance owners. Today, the private system leads to conflicts of interest.

With most Irish private care still delivered in public hospitals, as opposed to private ones, a vicious cycle has formed. Due to Ireland’s restrictions on their access to public healthcare, owners of private insurance receive priority when admitted to hospitals. However, as public insurance users also rely on these hospitals, those dependent on public insurance can be forced into long waits for treatment or prescriptions. This, in turn, forces citizens in need of urgent or regular care to purchase private insurance. The more private insurance is purchased, the more other public users feel as though they need private insurance to ensure hospital access. Ultimately, this leads to even more private insurance and more pressure until certain economic groups are priced out of public hospitals, limiting already restricted access.

Potential Solutions

In terms of resolving the problems with healthcare accessibility in Ireland, several different options present themselves. The first, as demonstrated by the Irish Red Cross, is to fill the gaps in national service with volunteers. However, this solution is inherently limited in scope. The Economic and Social Research Institute (ESRI), which has devoted a research series to optimizing Ireland’s healthcare process, is leading an alternative approach. This research series, while informative and educational, has not taken any form of direct action.

Instead, the most definitive actions taken thus far have been by the Irish government. Recently, it has established Regional Integrated Care Organisations (RICO) to serve as midpoints between ISDs and ISAs to ensure faster national response times to regional welfare changes.

While Ireland has made progress in ameliorating healthcare accessibility, there is much further to go. A country with Ireland’s system and budget can do more to aid its citizens. While its situation is improving, awareness of the issues around healthcare in Ireland remain vital in ensuring its continued success.

– Chase McCall

Photo: Freepik