Republic leads EU in health spending - journal

Spending on health here will be among the highest in the EU this year, while education expenditure will be above the EU average…

Spending on health here will be among the highest in the EU this year, while education expenditure will be above the EU average, according to the latest edition of Irish Banking Review.

In an article published in the journal, economists Colm McCarthy and John Lawlor challenge the contention that overall public spending is lower here than in comparable economies.

Debates on health spending here have focused on our lower spend as a proportion of GDP compared with other countries.

"While as a percentage of gross domestic product public expenditure is indeed lower than the EU average, this is not a meaningful comparison, since GDP in Ireland is now 125 per cent of national income" (or gross national product - GNP), they write.

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GDP measures our total output as a nation, while GNP measures our national output less what is lost to other countries through, for example, multi-nationals' repatriation of profits.

While GDP is a lot higher than GNP here, the two almost converge in other countries, say the authors, because their national accounts do not feature "multinational transfer pricing".

They go on to argue that health spending should be measured as a proportion of GNP rather than GDP, because GNP is a truer measure of "income actually available for domestic disposition".

They write: "Health expenditure growth kept pace more or less with GNP growth during the 1990s before accelerating to its highest ever GNP share in the last number of years."

Basing their work on estimates from the Department of Finance, they say spending on health this year will total 6.4 per cent of GDP, but 8.1 per cent of GNP.

Spending on education will be 4 per cent of GDP, but 5.1 per cent of GNP.

They compare Ireland's projected spend on health this year as a proportion of GNP with the rest of the EU. At 8.6 per cent, it is highest - higher than Germany's 8.3 per cent, France's 8.1 per cent and Britain's 7.1 per cent of GNP.

The EU average is 7.1 per cent, with the lowest proportionate spend on health being the 4.6 per cent of GNP spent by Greece.

In education, Ireland's projected spend is 5.5 per cent of GNP, sixth behind Sweden's 8.5 per cent, Denmark's 8.4 per cent, Finland's 6.7 per cent and Austria and Germany's 5.7 per cent of GNP, but above the EU average of 5.3 per cent.

It has also been pointed out that services not regarded as part of the health budget in other countries, such as certain social services, account for about 10 per cent of the State's health budget.

The question of whether health and public spending should increase is "an important policy question", write the authors.

Kitty Holland

Kitty Holland

Kitty Holland is Social Affairs Correspondent of The Irish Times