The health service does not need more money to improve the service radically and about €2bn should be reallocated to provide more doctors in the system, according to Dr Edward Walsh, the founding president of the University of Limerick. Dr Walsh was speaking at the National Association of General Practitioners‘ annual general meeting in Dublin.
He said Ireland had the highest hospital prices in the OECD, as well as its most inefficient health system, and that €1.7bn would need to be taken off the health budget to make it as efficient as the average OECD country. A further €2bn would need to be taken off to make Ireland as competitive as New Zealand.
However, said Dr Walsh, the problem was not that Ireland spent too much on healthcare, but that it was being spent in the wrong way.
He said the service itself had as many people as the city of Cork – 101,000, of whom only 8,334 were doctors. The doctors are supported by 15,722 managers, who in turn are supported by 9,987 support staff and 17,142 ‘others’. With an average salary of €70,000 per annum, reducing this workforce by 25 per cent would yield savings of €1bn, he said, and this needed to be done, despite the political difficulties.
He also pointed to savings that could be made in the drugs bill – which, at €1.9bn, is one of the highest in the OECD – and estimated savings could be made of €500m.
Dr Walsh commented that absenteeism in the health service was far too high at an average of 5 per cent and said that reducing it to the average in the private sector (2.5 per cent) would also yield millions in savings.
Altogether, Dr Walsh estimated that €2bn could be saved with these measures and that the money should then be used to fund more doctors within the system.
He said that by introducing a state-of-the-art computer system, a lot of unnecessary paperwork could be eliminated. Dr Walsh cited the example of Estonia, where every citizen has all their health information held on one personal card. He said this also allowed the people who run the system to see what was happening within it.
“People should only be asked for their information once, as they are in Estonia. It would free up a lot of time and eliminate tons of paperwork – not to mention making the huge numbers of office workers in the health system unnecessary,” he said.
The money saved should be used to fund more consultants and GPs. Ireland had only 12 per cent of doctors working in primary care, whereas the OECD average was 25 per cent.
This, he said, was a vital service on the front line of medicine, which was needed to help keep people healthy and out of hospitals, which were much more expensive.
Dr Walsh said that an extra €400m should be spent on GPs and another €400m should be spent in supports for general practice.
He also called for a doubling of the number of consultants and GPs and said Ireland had one of the highest rates in the world for younger doctors emigrating and that this needed to be reversed.
Dr Walsh added that while Ireland had reduced the number of nurses in the last few years by 4,000, Ireland would still need to reduce nursing numbers by 6,000 in order to reach the OECD average.