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Health in Ireland: Key Trends 2007

30th October 2007

Health in Ireland: Key Trends 2007 is a new publication. It presents a range of data, in booklet form, designed to provide a quick and handy reference guide to trends in health and health care over the past decade. It covers population and health status as well as trends in service provision. Each section of the booklet has a brief introduction summarising key statistics. The booklet is downloadable from the Department of Health and Children’s website here.

In presenting a summary of key trends, the overall picture which emerges is one of population growth and population ageing, of major improvements in health status and life expectancy, and of increasing health service provision.

High level summary statistics can mask specific health problems in sub-sections of the population and in areas of the health services. In some of these areas, consistent data are not available over a ten year period to show reliable trends. Better sources of information are still required to measure equity, performance and outcomes. It is also clear that lifestyle related risks such as obesity and excess alcohol consumption can lead to longer term consequences for population health if not tackled effectively. On the positive side, significant health benefits from the smoking ban, pioneered by Ireland, can be expected in future years.

Some of the key trends, by section of the booklet, are summarised below:

Section 1: Population and Life Expectancy

• In recent years, the population of Ireland has been growing more rapidly than at any time since the foundation of the State, and has increased by almost 16% in the last decade. (Table 1.2)
• Population ageing is a key feature which has clear implications for health service planning. The numbers of people over the age of 65 are projected to increase by about 80% to over 800,000 people between now and 2025. (Table 1.4 and Figure 1.2)
• Life expectancy in Ireland is now above the EU27 average for the first time. There has been a rapid increase, unmatched by any other EU country, since 1999. (Figure 1.3). Much of this increase is due to significant reductions in major causes of death such as circulatory disease. (see next section).
• Ireland has the second highest fertility rate in the EU, exceeded only by France. (Figure 1.1)

Section 2: Health of the Population

• Ireland has the highest levels of self-perceived health of those countries in Europe which have conducted a survey. 83.7% of men and 82.1% of women rate their health as being good or very good. The survey also shows significant chronic health problems in the older age groups. (Tables 2.1-2.3 and Figure 2.1)
• Diseases of the circulatory system and cancer continue to be the major causes of death, but there have been very significant reduction in rates of circulatory system disease. There has been a reduction of 38% since 1997 and a reduction of 50% over the last 30 years. (Table 2.4-2.5 and Figures 2.2 and 2.3)
• Suicide overtook motor vehicle accidents as a principal cause of death in the mid 1990’s
• Alcohol consumption in Ireland is now one of the highest in the EU. The largest percentage increase has been in wine consumption although this still represents less than 20% of total alcohol consumption. (Figure 2.5)

Section 3: Hospital Care

• Since 1997 there has been close to a 50% increase in hospital discharges. This can be broken down into a 13% increase in total inpatients and a 130% increase in day case discharges. (Table 3.1 and Figure 3.1) Improved and less invasive medical practice is largely responsible for the rapid growth in day patient activity.
• Average length of stay for inpatients has show little change since 1997 and remains at 6.3 days. (Table 3.1)
• There has been a reduction of about 30% in in-patients discharged from District/Community hospitals over the period since 1997. (Table 3.2)
• Numbers in psychiatric hospitals have fallen by 28% over the period reflecting continuation of a policy of more appropriate community-based models of care. (Table 3.3 and Figure 3.2)

Section 4: Community Services and Residential Care

• Medical card coverage as a percentage of the population has decreased by about 5% to 28%. Statistics presented, up to 2005, do not reflect the introduction of the doctor only medical card in November 2005. (Table 4.1)
• Number of prescription items dispensed under the General Medical Services has rapidly increased from 20 million to about 38 million since 1997. (Figure 4.1)
• Numbers of children in care shows an increase of about 38% between 1996 and 2004. These figures are influenced by the introduction of a new reporting system in 1998 which has incrementally resulted in more standardised and complete reporting from the former health board areas over the period. (Table 4.2)
• Nursing home care (i.e. long stay care) shows increases in both the average age and average levels of dependency of residents. (Figure 4.2)
• Immunisation rates show moderate improvements (Table 4.4)
• Table 4.6 shows an increase in use and provision of Community Health Services over the period with numbers attending day centres increasing by 84% and numbers of places in community residences rising by 9%.
• In Intellectual Disability Services, day attendees and full-time residents show moderate increases of about 5% since 1996. (Table 4.7)

Section 5: Health Service Employment

• Overall employment in the public health services increased by nearly 57% to over 105,000 whole time equivalents between 1997 and 2006. (Table 5.1 and Figures 5.1 and 5.2)
• All categories of staff experienced increases, but the largest rise, of 150%, to about 15,000 whole time equivalents was in the category of Health and Social Care Professionals which largely consists of paramedical professions. (Table 5.1 and Figures 5.1 and 5.2)
• Numbers of Hospital Consultants and of Non-Consultant Hospital Doctors (NCHD) rose by just over 60% . (Table 5.2 and Figure 5.3)
• Numbers of General Medical Service GPs (i.e. participants in the Choice of Doctor Scheme) increased by 38%. (Table 5.3)

Section 6: Health Service Expenditure

• Total public health expenditure has risen from €3.6 billion in 1997 to over €12.3 billion in 2006, an increase of more than 236%.
• There have been increases of over 200% in nearly all non-capital Programmes and Services. The largest increases, of more than 300%, have occurred in the Community Protection and Community Health Services programmes. The largest component of health expenditure continues to be the General Hospital programme which accounts for 45% of all non-capital spending. (Tables 6.1-6.3 and Figures 6.1 and 6.2)
• Capital expenditure has increased in-line with non-capital expenditure.
• Health spending per capita has increased between 1997-2005. Ireland’s total health expenditure per capita as a % of Gross National Income (GNI) ranks midway in a list of OECD countries. Use of GNI is more appropriate than Gross Domestic Product (GDP) for Ireland since GNI does not include repatriated profits of multinational companies. (Table 6.4)