Health Service Expenditure

This section summarises data and trends in public spending on health services during the past decade.  It also sets this spending in the context of overall economic growth and compares Ireland, in this respect, with its counterpart countries in the Organisation for Economic Cooperation and Development (OECD). 

Table 6.1 shows that total public expenditure on health increased by two thirds between 2002 and the estimates for 2011.  The non-capital side represents about 97% of total expenditure, and also increased more rapidly than capital expenditure over the period.  Without taking inflation into account, capital expenditure is now 25% lower than in 2002.  Provisional figures for 2011 show an estimated decrease of 9.3% in total public expenditure on health since the peak in 2009.  The trend is graphed in Figure 6.1.

Table 6.2 provides a more detailed breakdown on non-capital expenditure for the years 2007-2010.  The largest increases in spending over this period were in the areas of Care of Older People and Primary Care and Community Health.  The latter category includes the provision of services under medical card schemes.  All areas under Primary, Community and Continuing Care showed decreased expenditure between 2009 and 2010.  The National Hospitals Office, which accounted for around 38% of total non-capital expenditure (see Figure 6.2) also had a decrease in spending of 0.9% between 2009 and 2010.

Turning to international comparisons, data are available up to 2009 and show Ireland ranking 12th highest out of 34 OECD countries in terms of total public and private health expenditure per capita (see Table 6.4).  When looked at from the perspective of proportion of national production spent on health, the picture which appears depends on whether Gross Domestic Product (GDP) or Gross National Income (GNI) is used as the denominator.  Unlike most other countries, a significant proportion of Ireland’s GDP refers to profit exports which are not available for national consumption.  For this reason, GNI is a more meaningful measure.  When total health expenditure (public and private) is expressed as a percentage of GNI, Ireland records a figure of 11.4% which ranks 6th highest among 27 OECD countries for which data were available for 2009.  This figure represents a considerable rise over the past two years (see Figure 6.4).  This can be explained as the combined effect of continuing increases in health expenditure up until 2009 accompanied by the slowdown in economic growth during that time period.