Ireland's health care system : some issues and challenges

A variety of recent reports and strategy documents have highlighted the intimidating range of challenges facing Ireland's health system as it seeks to improve its performance. In this short paper we cannot deal with these in any comprehensive fashion, but instead focus on three specific issues. First, we illustrate the value of trying to benchmark performance against other countries, as well as some of the difficulties that arise in such an exercise. Secondly, with primary care a central focus of official strategies we look at the use of general practitioner services by people at different income levels and in particular by those with and without entitlement to free GP care. Finally, we discuss the complex web of issues in relation to both equity and efficiency that arise from the unique role which private health insurance plays in the Irish healthcare system.