Unhappiness with health service goes public

This is a report the Government would probably rather voters didn't see

This is a report the Government would probably rather voters didn't see. It confirms the vast majority of Irish people are unhappy with the public health service.

The ESRI's Perceptions of the Quality of Health Care in the Public and Private Sectors in Ireland - a report to the Centre for Insurance Studies, Graduate Business School in UCD - was funded by BUPA-Ireland, which has 8 per cent of the private health insurance market.

It includes a survey of 3,000 people, which shows "there is considerable criticism of the overall quality of care in the public health system, with fewer than half of respondents giving it a positive rating".

For years, people without private health insurance have endured waiting lists for consultant appointments and procedures, delays of months or even years for surgery and last minute cancellations for those scheduled for operations.

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The strongest criticism in this research comes from those least likely to have direct experience of the public health system: those in the professional and managerial social group and those with private health insurance.

The ESRI survey goes beyond Government spin - "£125 million spent on waiting lists in the past seven years" - and straight to the consumer. In the past 12 months, eight out of 10 women and seven out of 10 men have used the public or private health service. One in eight has spent a night in hospital in the past year - one in 15 has spent a night in a public hospital bed. One in 20 has used a hospital accident and emergency department.

When criticising the public health service, consumers know what they are talking about and they have given it the thumbs down. Only two-fifths believe the public health service is "good" or "very good". One in three thinks the service is "adequate" and almost one in four describes the service as "bad" or "very bad".

Ninety-six per cent of people want the Government to spend more to improve the service. What is surprising is that the less likely we are to need the public health service, the more critical we are of it. Researchers have found that positive ratings of the public health service decline as the respondents' educational and earnings levels increase.

Public patients, who are most likely to experience these hardships, are happier with the public health service than private patients. Six out of every 10 people who have been hospitalised as public patients in the previous 12 months give a positive rating to the quality of care in the public health system. But only a minority (36 per cent) of people who have been hospitalised as private patients rate the public health system positively.

Poorer people have better things to say about the health service. Two-thirds of those with a total household income under £200 a week see the public health service as "good" or "very good" compared to only one-third of those whose household income is £450 a week or more. The professional and managerial classes are most critical of the public health system, with only 33 per cent giving it a positive rating, compared to 49 per cent of those in the skilled and unskilled manual social group.

Older people are also likely to be happier with the health service: half of retired people regard it as "good" or "very good". Widows, who tend to be older, tend to rate the public health system positively (60 per cent), especially when compared to adults who are divorced or separated (32 per cent). The other population segment likely to approve of the public health service are young people under 30, only 19 per cent of whom regard the health system as very bad or bad.

This is in contrast to 29 per cent of those aged 30 to 49 and 24 per cent of those aged 50 to 64. Young people, it would seem, haven't thought about having to use the public health service to the extent of passing too harsh a judgment on it. After reading this ESRI report, however, they may think again.