ESRI concerned at 'fiscal sustainability' of healthcare system

About 25% of Government spending last year went on health and social care, which the ESRI said was 'one of the highest proportions among European countries'.

The Economic and Social Research Institute has raised concerns about the "fiscal sustainability" of the healthcare system, warning public spending was already high by EU standards while patients continue to face lengthy waiting times.

Examining how other countries are responding to demographic changes, the ESRI medium-term review of Irish health and social care said further increases in public healthcare funding may be "less viable in the Irish context".

Instead, it called for a cross-Government approach to maximise advances such as artificial intelligence to protect the fiscal sustainability of the health service.

The ESRI said "significant increases" in healthcare spending were still expected as Ireland's population continues to grow and more people are living into their 80s and beyond.

About 25% of Government spending last year went on health and social care, which the ESRI said was “one of the highest proportions among European countries”.

Despite this, the ESRI identified major challenges for patients across health and social care.

“Even within this budget, access to some healthcare services remains curtailed, with long waits for a range of services, and the majority of the population continues to pay out of pocket for primary care services,” it said.

The report authors looked at international examples of policy options being used to help balance the books in healthcare. 

The ESRI pointed to the drive for increased productivity in Irish hospitals as an example. It also mentioned long-term investments under the State's Future Ireland Fund.

It said the option of increasing spending on public health was one avenue “likely to be less viable in the Irish context”.

It also assessed alternative financing mechanisms, including greater private-sector involvement, and concluded such approaches were less likely to succeed.

Overall, the ESRI called for a co-ordinated response across Government departments and State agencies to maximise the opportunities arising from demographic change.

It said this must be done against the backdrop of major challenges, including global uncertainty and climate change.

However, some of those challenges also presented opportunities, particularly through advances in technologies such as AI, the report suggested.

“However, a cross-Government and agency approach is required to harness all potential benefits, to ensure the fiscal sustainability of the healthcare system and the economy at large over the medium term,” the report concluded.

Sheelah Connolly, co-author and associate research professor at the ESRI, said: “Ireland has begun to plan for higher health and social care demand, but demographic change will require sustained action.

“Expanding capacity needs to be accompanied by increased efficiencies and a stronger emphasis on preventing ill health.”