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The Irish health system: developments in strategy, structure, funding and delivery since 1980


  • Miriam M. Wiley

    (The Economic and Social Research Institute, Dublin, Ireland)


As the Irish health system embarks upon its first major structural reorganisation in over 30 years, developments within this system over the past two decades are assessed. Real cuts in health expenditure achieved in the 1980s contrast sharply with the unprecedented increase in resources devoted to the health system in the 1990s. While successive statements of health strategy have prioritised the objectives of equity, efficiency and quality of care, questions arise regarding the return achieved with the increased investment. With higher levels of economic growth, more people have been buying private health insurance such that almost half the population are now privately insured. At the same time, the numbers with eligibility for health services without charge have decreased while those from lower socio-economic groups continue to have higher levels of utilisation. Equity issues arise, however, with regard to access to public hospitals as the rate of growth in admissions for private patients outstrips that for public patients. The establishment of a National Treatment Purchase Fund to purchase treatment in private facilities for public patients on waiting lists raises efficiency and equity questions as the treatment of private patients in public hospitals is heavily subsidised while the State pays full cost for the treatment of public patients in private facilities. Copyright © 2005 John Wiley & Sons, Ltd.

Suggested Citation

  • Miriam M. Wiley, 2005. "The Irish health system: developments in strategy, structure, funding and delivery since 1980," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 169-186.
  • Handle: RePEc:wly:hlthec:v:14:y:2005:i:s1:p:s169-s186 DOI: 10.1002/hec.1034

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    References listed on IDEAS

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    Cited by:

    1. Kozlowski, Dawid & Worthington, Dave, 2015. "Use of queue modelling in the analysis of elective patient treatment governed by a maximum waiting time policy," European Journal of Operational Research, Elsevier, vol. 244(1), pages 331-338.
    2. Jacqueline O'Reilly & Miriam M. Wiley, 2007. "The Public/Private Mix in Irish Acute Public Hospitals: Trends and Implications," Papers WP218, Economic and Social Research Institute (ESRI).
    3. Cheng, Terence C. & Joyce, Catherine M. & Scott, Anthony, 2013. "An empirical analysis of public and private medical practice in Australia," Health Policy, Elsevier, vol. 111(1), pages 43-51.
    4. González, Paula & Macho-Stadler, Inés, 2013. "A theoretical approach to dual practice regulations in the health sector," Journal of Health Economics, Elsevier, vol. 32(1), pages 66-87.
    5. Jacqueline O'Reilly & Miriam M. Wiley, 2008. "How Local is Hospital Treatment? An Exploratory Analysis of Public/Private Variation in Location of Treatment in Irish Acute Public Hospitals," Papers WP237, Economic and Social Research Institute (ESRI).
    6. Briggs, Adam D.M., 2013. "How changes to Irish healthcare financing are affecting universal health coverage," Health Policy, Elsevier, vol. 113(1), pages 45-49.
    7. Garcia-Prado, Ariadna & Gonzalez, Paula, 2007. "Policy and regulatory responses to dual practice in the health sector," Health Policy, Elsevier, vol. 84(2-3), pages 142-152, December.
    8. Johannessen, Karl Arne & Kittelsen, Sverre A.C. & Hagen, Terje P., 2017. "Assessing physician productivity following Norwegian hospital reform: A panel and data envelopment analysis," Social Science & Medicine, Elsevier, vol. 175(C), pages 117-126.
    9. Socha, Karolina Z. & Bech, Mickael, 2011. "Physician dual practice: A review of literature," Health Policy, Elsevier, vol. 102(1), pages 1-7, September.

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