Health Care for All in Ireland? The Consequences of Politics for Health Policy

• Author: Vivienne Byers
• Published date: 01 March 2017
• Date: 01 March 2017
• DOI: http://doi.org/10.1002/wmh3.217

Health Care for All in Ireland? The Consequences of

Politics for Health Policy

Vivienne Byers

The Irish health-care system is a complicated mix of public and private providers, with inequitable

and unclear routes for health-service users to access and navigate the system. In 2011, the Irish

Government committed to signif‌icant health reform to develop a universal single-tier health system.

In line with other European nations this was to be underpinned by the principle of social solidarity,

with equitable access based on need rather than ability to pay. The road to this reform and its recent

collapse highlights the practical implications of political and policy choices in health care, and has

implications for f‌inancing and delivery, but ultimately for the delivery of national public health.

KEY WORDS: health policy, universal health care, public health, politics, health reform

Background

Ireland is a small country on the western edge of Europe with a population

of about 4.6 million. It has a modern, trade-dependent economy, and has been

subject to an austerity program since the recession of 2008 until very recently.

Before then, Ireland had enjoyed one of the highest economic growth rates in

Europe, as between 2005 and 2008 public expenditure rose by nearly 40 percent

(Thomson, Jowett, & Mladovsky, 2014). Despite this growth, the Irish health-care

system has remained chronically underfunded for decades, as well as plagued by

increasing waiting lists due to limited access to services (Pillinger, 2012). Crucial

health-care delivery issues have included lack of resources such as limited public

hospital capacity, as well as failure to develop community and primary care

services suff‌iciently. This has led to inadequate provision in areas such as mental

health, chronic disease management, with limited emphasis on health promotion

and preventative work (Byers, 2009; Pillinger, 2012).

The health-care system in Ireland is a complicated mix of public and private

providers, with inequitable and unclear routes for service users to access and

navigate the system. In 2011, the government committed to signif‌icant health

policy reform to develop a universal single-tier health system underpinned by the

principle of social solidarity, with equitable access based on need rather than

World Medical & Health Policy, Vol. 9, No. 1, 2017

138

1948-4682 #2017 Policy Studies Organization

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