IRELAND’S health service is improving steadily and moving up the EU ranks, but patients are yet to be convinced.
The annual index put together by the Health Consumer Powerhouse in Brussels ranks Ireland 13th out of 33 countries with a mark of 70% – ahead of Britain but behind the winner, Netherlands, with 87%.
“Ireland has been climbing steadily for the past few years. But the feedback from patients does not reflect this. The system has a domestic marketing problem,” said Dr Arne Bjornberg, the director of the index. “Patients often have irritatingly good memories and even when things improve, it does not register.”
On waiting times, he said that according to patients’ feedback, the situation is much worse than it actually is, judging by the five different sources they have used.
One of the big problems is the way hospitals are financed.
“Rural hospitals get only 40% of the resources that hospitals in Dublin do for the same amount of work – which is typical of kind of central historic funding mechanism that is being used in Ireland. They need to introduce paying for the healthcare provided,” he said.
On a recent visit to Irish hospitals, Dr Bjornberg was shown how revenues from patients outside the hospital’s geographical area are put into the accounts as a negative cost, thereby penalising the hospital and its staff.
“This needs to be changed – it’s only an administrative change but it would make a big difference,” he said.
Health institutions and staff also perpetuate the poor reputation of health services by being forced to campaign for the funds it needs by pointing out how bad things are and to the deficiencies.
“This needs to be replaced with performance-based funding, where they get funds based on the work they are doing,” he said.
Waiting lists are still a reality in Ireland, however, and Dr Bjornberg recommends publishing them, which, he says, will also show that things are not as bad as they were. However, he said the authorities should work to get to the situation, such as in Belgium and some other countries, where nobody waits for treatment.
Some of Ireland’s waiting lists are down to the fact that specialists divide their time between public and private practice.
“Perhaps they should adopt the Austrian system where the state pays senior doctors comparatively modestly on the understanding they are free in the afternoons to run their own private practices.”
Ireland lost most marks in the e-Health area as doctors and others are slow to computerise patients’ records.
The countries with the best health care are the Netherlands, Denmark, Iceland and Austria. They engage patients in their care, giving them information and choice.
“This builds pressure from below for improvement. The countries at the other end of the scale have stuck to old style health care, filled with hierarchies and a lack of transparency,” the report said.
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