Madam, - Maurice Quinlivan (March 13th) is not quite correct in his assertion that Ireland's health expenditure is at the lower end of OECD countries if real expenditure per capita, rather than as a percentage of GDP, is considered.
In fact, Ireland comes in 15th of the 30 countries, spending about $2900 per person annually.
We spend exactly the same as Sweden, which has an enviable healthcare system, but less than half of what the United States spends. The proportion of expenditure that is publicly funded is 85 per cent in Sweden, 78 per cent in Ireland and 45 per cent in the US.
Furthermore, the latest Central Statistics Office data show that Ireland's infant mortality - one of the best indices of a state's healthcare system - has recently fallen to the same level as Sweden's and is much better than that of the US. Life expectancy here is now above the average for OECD countries and we can expect to live about two years longer than the high-spending Americans.
These data prove conclusively that the predominantly private health system of the US provides citizens with relatively poor value for money compared with the largely public-funded health systems of enlightened European countries.
Mr Quinlivan is on the right track, nonetheless. There is no doubt that there are major health black spots in Ireland, such as in neurology, cancer and the maternity services.
Even the Government seems to accept this.
Three things need to be done. There must be investment, funded by increased taxation, in the public health system (very difficult); there must be a move towards developing a national consensus on health policy that would replace the present routine of bad-tempered, demoralising and unproductive debates (very difficult); and, in the interest of both efficiency and democracy, the principle of subsidiarity, where matters are handled by the smallest and lowest competent authority, needs to be re-established within the HSE's monolithic structure (easy).
- Yours, etc,
Dr G. BURKE, Consultant Obstetrician, Steamboat Quay, Limerick.