Health in Ireland: Key Trends 2009
1 December 2009
The Department of Health and Children today, (1st December, 2009) published Health in Ireland: Key Trends 2009. This is the second edition of this report (previous report was published in 2007) which presents, in booklet format, a range of data on significant trends in health and health care over the past decade.
Health in Ireland: Key Trends 2009 covers population and health status as well as trends in service provision. It is a quick and handy reference guide to trends in health and health care over the past decade. Each section of the booklet has a brief introduction summarising key statistics.
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 investment and provision. Threats to health gain are also evident particularly in the area of lifestyle factors such as alcohol consumption and obesity.
Some of the key findings include:
- Ireland continues to have the highest levels of self-perceived health of those countries in Europe participating in the EU Survey on Income and Living Conditions. 83.9% of men and 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)
- Over the past decade, Ireland has achieved a rapid and unprecedented improvement in life expectancy. During a period when the average life expectancy in the EU has continued to rise, Ireland has gone from a position of nearly 1 year below the EU average life expectancy, to almost 1 year above. (Figure 1.3). Much of this increase is due to significant reductions in major causes of death such as circulatory system diseases.
- Since 1999 there has been a 16% increase in in-patient hospital discharges. There has also been a 148% increase in the number of day cases seen in public acute hospitals. (Table 3.1 and Figure 3.1) Improved and less invasive medical practice is largely responsible for the rapid growth in day patient activity.
- Numbers in psychiatric hospitals have fallen by 31% over the period reflecting continuation of a policy of more appropriate community-based models of care. (Table 3.3 and Figure 3.2)
- Number of prescription items dispensed under the General Medical Services has rapidly increased from 20 million to about 45 million since 1998. (Figure 4.1)
- Immunisation rates have been increasing since 2002 and are now approaching the 95% rate as envisaged by the ‘Immunisation Guidelines for Ireland’, (2008). (Table 4.5)
- Total public health expenditure has risen from €5.7 billion in 2000 to over €15.2 billion in 2008. (Table 6.1)
- Capital expenditure increased by 192% over the period 1998-2007. (Table 6.3)
In welcoming the publication, Mary Harney, TD, Minister for Health and Children said “the last ten years have witnessed sustained investment in our health services and unprecedented improvement in the health of the Irish population. Life expectancy has increased from 1 year below the EU average in 1999 to 1 year above. In the space of just ten years almost four additional years have been added to life expectancy in Ireland. Irish males can now expect on average to live until they are 76.8 years while females can expect to live until they are 81.6 years. Death rates from diseases of the circulatory system have decreased by over 40%. The health services have played a significant role in these remarkable improvements. The capacity of the health services has expanded and new and more effective methods of treatment continue to be introduced.”
In pointing to increased efficiency in the health services the Minister noted that:“While inpatient admissions have increased by 16% over the period, daycases have gone up by 148% to over 600,000 per year and, for the first time in 2008, outnumber inpatients. ”
The report also identifies some worrying trends in lifestyle amongst Irish young people and adults and highlights the need for continuing efforts to protect and improve health. The Minister said that: “The realities of a growing and ageing population and of current economic constraints present real challenges, but also give a focus to our efforts to consolidate health gains and to improve the efficiency, effectiveness and equity of our health services.”
Further key trends, by section of the booklet, are highlighted 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 18% in the last decade. (Table 1.2)
- Annual births are now over 75,000, the highest level in the history of the State (Table 1.3). Ireland now has the highest fertility rate in the EU (Figure 1.1).
- Population ageing is a key feature which has clear implications for health service planning. The number of people over the age of 65 is projected to almost double between now and 2026, and almost triple by 2041. (Table 1.4 and Figure 1.2)
Section 2: Health of the Population
- 10% of all adults in Ireland have been diagnosed at some point with high blood pressure (hypertension). (Figure 2.2)
- Diseases of the circulatory system and cancer continue to be the major causes of death, but there have been very significant reduction in both over the last decade. There has been a reduction of 41% in the former and 10% in the latter since 1999. Death rates from circulatory system diseases have experienced a reduction of 65% over the last 30 years. (Table 2.4-2.5 and Figures 2.3 and 2.4)
- Suicide overtook motor vehicle accidents as a principal cause of death in the mid 1990’s.
- Obesity in Ireland is now one of the major challenges which faces the health services into the future. In 2007, 59% of men and 41% of women self-reported as either being overweight or obese. (Table 2.6)
- Alcohol consumption in Ireland has declined from a peak reached in 2001 and has levelled off in recent years. Tobacco consumption has also declined in the years since the introduction of the smoking ban, though consumption has been stubbornly constant in the most recent years. (Figure 2.6)
- While the year-on-year comparison of 2008 over 2007 indicates some rise in mortality for cancer overall and for breast cancer specifically, this cannot be seen as indicative of any particular trend. Year-on-year figures can fluctuate relatively sharply. However, over the ten years from 1999 to 2008, mortality rates have fallen for cancer overall and for breast cancer specifically. Furthermore, it is also important to note that, for all causes of death, while the figures up to 2006 are final, the 2007 and 2008 figures are not final and should be treated with caution.
Section 3: Hospital Care
- Average length of stay for inpatients has shown a slight decline of 4.4% since 1999. (Table 3.1)
- There has been a reduction of about 36% in in-patients discharged from District/Community hospitals over the period since 1998. (Table 3.2)
- The elderly are the most likely group to use all hospital services, with the exception of A&E services which seem to be used more by younger age groups. (Figure 3.3)
Section 4: Primary Care and Community Services
- 69% of adults had at least one GP visit in the 12 months prior to interview. For all forms of health consultation, rates increase with age, and women have higher rates than men. (Table 4.1)
- In 2008, 32.5% of the population was covered by the Medical Card or the GP Visit Card. The percentage of the population covered by the Medical Card since 1999 has decreased slightly by 0.5%. (Table 4.2)
- Numbers of children in care shows an increase of about 27% between 1999 and 2008. The percentage of children in foster care has continued to increase and now represents almost 90% of all children in care with a much reduced proportion of children now accommodated in residential care. (Table 4.3)
- In Intellectual Disability Services, day attendees and full-time residents show moderate increases of 6.7% and 5% respectively since 1999. (Table 4.7)
- The percentage of food establishments inspected where infringements were found has declined each year since 2000. (Table 4.8)
Section 5: Health Service Employment
- Overall employment in the public health services increased by nearly 39% whole time equivalents between 2000 and 2009. However the total numbers employed has seen reductions since 2007. (Table 5.1 and Figures 5.1 and 5.2)
- All categories of staff experienced increases, but the largest rise, of 110%, to about 16,000 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 almost 49% since 2000. (Table 5.2 and Figure 5.3)
- Numbers of General Medical Service GPs (i.e. participants in the Choice of Doctor Scheme) increased by 44% since 1998. (Table 5.3)
Section 6: Health Service Expenditure
- Expenditure on Primary, Community and Continuing Care has increased by 37% (gross) since 2005. (Table 6.2 and Figure 6.2)
- Health spending per capita increased between 1998-2007. Ireland’s total health expenditure as a % of Gross National Income (GNI) was 8.9% in 2007 and ranked 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 and Figure 6.3)
