A new WHO study on Ireland’s Sláintecare, a ten-year programme for health and social care reform, shows how important implementation of those reforms is to strengthening equitable access to health care and financial protection, building on steps already taken in response to COVID-19.
The WHO report’s lead author, Dr Bridget Johnston from the Centre for Health Policy and Management at Trinity College Dublin, said, “This research is the first of its kind in Ireland. It shows how even low user charges are a barrier to access and lead to financial hardship for some households. Although the health system successfully protects many, there are clear gaps in coverage for the poorest people.”
WHO’s analysis of survey data from 2009–2010 and 2015–2016 finds that although catastrophic spending on health in Ireland is low on average, reflecting one of the lowest levels of out-of-pocket payments in Europe, it has increased over time.
These, and other gaps in coverage, were linked to cuts to public spending on health and to the health workforce, and several other measures taken after the 2008 financial crisis.
Private health insurance covers around half of the population; although it reduces exposure to some out-of-pocket payments, it represents a significant financial burden for many people.
In response to the COVID-19 outbreak, the government has taken steps to address longstanding inequalities in access to health care, for example, providing universal access to testing, diagnosis and treatment for COVID-19 without charge and free teleconsultations for all COVID-related symptoms.
Ireland’s new government can now build on these achievements by introducing universal entitlement to health care. The report outlines other progressive steps towards universal health care that can be made, many of them in keeping with the principles of Sláintecare, including that care should be provided free at the point of delivery, based entirely on clinical need.