Ireland Health Profile 2012

The HSE is responsible for providing health and personal social services to everyone living in Ireland.

The public health care system of the Republic of Ireland is governed by the Health Act 2004, which established a new body to be responsible for providing health and personal social services to everyone living in Ireland - the Health Service Executive. The new national health service came into being officially on 1 January 2005; however the new structures are currently in the process of being established as the reform programme continues. In addition to the public-sector, there is also a large private healthcare market.

In 2005, Ireland spent 8.2% of GDP on health care, or US$3,996 per capita. Of that, approximately 79% was government expenditure.

Health care system

All persons resident in Ireland are entitled to receive health care through the public health care system, which is managed by the Health Service Executive and funded by general taxation. A person may be required to pay a subsidised fee for certain health care received; this depends on income, age, illness or disability. All maternity services are provided free of charge and children up to the age of 6 months . Emergency care is provided at a cost of €100 for a visit to the Accident and Emergency department.

Everyone living in the country, and visitors to Ireland who hold a European Health Insurance Card, are entitled to free maintenance and treatment in public beds in Health Service Executive and voluntary hospitals. Outpatient services are also provided for free. However the majority of patients on median incomes or above, are required to pay subsidised hospital charges.

The Medical Card - which entitles holders to free hospital care, GP visits, dental services, optical services, aural services, prescription drugs and medical appliances- is available to those receiving welfare payments, low earners, those with certain long-term or severe illnesses and in certain other cases. Many political parties support extending the availability of the Medical Card to eventually cover everyone resident in Ireland - they currently cover 31.9% of the population. Those on slightly higher incomes are eligible for a GP Visit Card which entitles the holder to free general practitioner visits. For persons over 70 years who are not entitled to a medical card or GP visit card they instead receive an annual cash grant of €400 up to a certain income.

People who are not entitled to a Medical Card (i.e. 68.1% of the population) must pay fees for certain health care services. There is a €100 A&E charge for those who attend an accident and emergency department without a referral letter from a family doctor (a visit to which usually costs €50-75). Hospital charges (for inpatients) are a flat fee of €100 per day up to a maximum of €1000 in any twelve month period, irrespective of the actual care received. Specialist assessments and diagnostic assessments (such as X-rays, laboratory tests, physiotherapy, etc.) are provided for free. If a person cannot afford to pay hospital charges, the HSE will provide the services free of charge.

Hospitals
The Rotunda Hospital in Dublin is Ireland's (and the world's) oldest maternity hospital, founded in 1745. It is also one of its largest, dealing with over eight thousand births in 2007.

Many hospitals in Ireland, such as Connolly Hospital at Blanchardstown, are operated directly by the HSE. There are also hospitals run under a voluntary basis by organisations. Some are teaching hospitals (such as University College Hospital Galway) operated in conjunction with a university. There are also many private hospitals.

Hospitals in Ireland generally offer a full range of healthcare including accident and emergency services.

 Waiting lists

The public health system, despite massive expenditure in recent years, has some problems. An ongoing issue is the "waiting lists" for those requiring, in some cases, serious operations.

In 2007, 76% of inpatients were admitted to hospital for operations immediately, 11% had to wait up to one month, 4% had to wait up to three months, 1% had to wait up to six months and 4% had to wait for over six months for operations.

For outpatients, 23% were seen on time, 44% were seen within 30 minutes, 18% waited more than an hour and 7% waited two hours.

The National Treatment Purchase Fund was set up in 2002 for those waiting over three months for an operation or procedure, and as a result over 135,000 patients on waiting lists have been treated so far. The NTPF involves the government paying for public patients to be treated for free in a private hospital in Ireland, or sometimes abroad if necessary. The NTPF has reduced waiting times for procedures to an average of between two to five months (with the average in 2009 being 2.4 months, compared to between two and five years in 2002.