Healthcare in the Republic of Ireland

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 2019 Ireland spent €3,513 per capita on health, close to the European Union average,[2][3] of this spending approximately 79% was government expenditure.

[6] In his Confessio Authoris, published posthumously by Jan Baptist van Helmont (a chemist from Brussels) in 1648, he noted that "The Irish nobility had in every family a domestic physician whose recommendation was not that he came from the College loaded with learning but that he was able to cure disorders; which knowledge they have from their ancestors by means of a book belonging to particular families that contains the marks of the several diseases, with the remedies attached; which remedies where vernacula the production of their own country - for this reason the Irish are better managed than the Italians who have a physician in every village".

The only medical conditions carrying automatic entitlement to a card are having thalidomide syndrome, having a surgical symphysiotomy, and children with cancer.

Persons over 70 years who are not entitled to a medical GP visit card can instead receive an annual cash grant of €400 up to a certain income.

There is a €100 charge for those who attend an emergency department without a referral letter from a family doctor (a visit to which usually costs €45–75, though some practices offer rates as low as €25-35 for over-65s and students[9]).

Hospital charges (for inpatients) are a flat fee of €80 per day up to a maximum of €800 in any twelve-month period, irrespective of the actual care received.

[10] Everyone living in the country, and visitors to Ireland who hold a European Health Insurance Card, are entitled to use the public healthcare system.

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

There are also hospitals run on a voluntary basis by organisations who receive public funding but operate with some degree of autonomy.

Ireland has a lower than OECD-average number of hospital beds according to the 2013 OECD Health at a Glance Report[11] The same report also noted that Ireland has fewer doctors (2.7 doctors per 1,000 population) and more nurses (12.2 nurses per 1,000 population) than average in other OECD countries.

Consultants in the publicly funded hospitals are allowed to spend some of their time (typically 20%, though there is little supervision) on private practice.

According to the index, reports by patients on waiting times were considerably more pessimistic than official Irish waiting-time statistics.

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.

There are cases where essential care is needed urgently but not made available by the HSE under their NTPF, and contrary to relevant judgements by the European Court of Justice.

Health centres provide a wide range of primary care and community services in towns and villages throughout Ireland, and are run by the HSE.

Most GPs also offer house visits to their patients, with emergency "out-of-hours" GP services available in all parts of the country.

[19] Some private health insurance plans provide partial reimbursement up to the Drugs Payment Scheme threshold.

[23] The health service was said to have a ‘frail IT system’ and a ‘very-low level of cyber security maturity’ in a report by PricewaterhouseCoopers on ransomware attacks in 2021.

People can also claim tax relief on medical expenses not covered by the State or by private health insurance.

[29] A survey, commissioned by the HSE in 2007, found that patient satisfaction with the health service was quite high, with 90% of inpatients and 85% of outpatients saying they were satisfied with their treatment.

[5] Noël Browne attempted to introduce free state-funded healthcare for all mothers and children aged under 16 in 1948, but was defeated by Irish Medical Organisation and the Catholic Church, which objected to the expansion of "socialized medicine", so healthcare continued to be delivered by family doctors and in religious and charitable hospitals.

It is still a state-owned corporation which undermines the idea of a universal, single-tier public health service as laid out in the Sustainable Development Goals to which the government is committed or Sláintecare as advocated by the Social Democrats.