Health service will have to deal with extra 1,000,000 people by 2030

Ireland’s population is set to increase by almost a quarter by 2030, with the major driver being inward migration, according to new projections by the Economic and Social Research Institute (ESRI).

The growth in overall numbers, combined with a projected increase of up to 94 per cent in the number of people aged 80 or over, will have significant implications for the health service, according to a report, Projections of Demand for Healthcare in Ireland, 2015-2030, which is published on Thursday.

The report uses population data from the 2016 Census and statistics from the previous year regarding use of a range of healthcare services, including public and private hospital inpatient care, emergency department use, GP services, long-term and intermediate care such as nursing home care, and home care.

The information was fed into a new analysis model, which the ESRI has called the Hippocrates Model, to project healthcare needs up to 2030. The institute says the report is the “most comprehensive mapping of public and private activity in the Irish healthcare system to have been published”.

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According to the report, demand across all health and social care sectors will “increase substantially” every year up to 2030. The report notes that between 1996 and 2016, Ireland’s population bucked the trend elsewhere in the EU, growing by 31 per cent as opposed to just 6 per cent across the union.

The report’s nine authors project that Irish fertility rates (the number of children born to women of child-bearing age) will remain at 1.94, which is below the rate of 2.1 necessary to sustain a population at its current level.

Life expectancy

Ireland’s population growth will come from inward migration, which they expect to average 9,000 people a year up to 2021, rising to 13,000 a year thereafter. This will result in a population of 5.35 million to 5.79 million people by 2030, compared to 4.77million now.

Apart from the demands this growth will place on healthcare services, the authors project that life expectancy at birth will rise from 78.4 years to 82.9 years for men and from 82.9 years to 86.5 years for women by 2030.

This will result in the number of people aged 65 and over increasing by 60-64 per cent, and the number aged 80 and over rising by 89-94 per cent.

The report projects this will result in a 32-37 per cent increase in demand for inpatient bed days in public hospitals, equivalent to up to 1.2 million extra bed days in 2030.

Day patient demand will rise by 23 per cent to 28 per cent and emergency department demand will rise by 16-26 per cent, with 292,000 extra attendances in 2030.

Private hospitals will see an increase in inpatient bed day demand of up to 32 per cent, and day patient demand rise by up to 28 per cent.

Major implications

Nursing home demand will rise by up to 54 per cent (equivalent to up to 15,600 extra places in 2030). Home help hours demand will also rise by up to 54 per cent, and demand for home care will rise by up to 66 per cent.

Demand for GP services are also projected to increase markedly. Visits will rise by up to 27 per cent, with up to 27.4 million extra prescription items being issued in 2030.

The report concludes that the projections have "major implications for capacity planning, capital investment, workforce planning and training", and that increased demands will have to be met if existing demands, currently high in Ireland when compared to other countries such as Australia, New Zealand and Norway, are not to grow further.

The cost implications of meeting projected demands are not detailed in the report. The authors hope to do this in a follow-up report, due in about a year, but note that an increased population will, assuming employment levels increase also, result in more money being available to fund meeting increased demand.

Commenting on today’s report, one of its authors, Maev-Ann Wren, said the key driver of the projections was increased population and the parallel expected rise in the number of older people.

“To us, the overriding message of this report emerges from the demographics,” she said. “Ireland is unusual in its recent and projected rapid population growth. Its population growth is a major driver of demand and population growth in older age cohorts will be a major driver of demand, even if our optimistic healthy aging assumptions prove correct.”