Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-27T22:30:07.506Z Has data issue: false hasContentIssue false
  • English
  • Français

Equity in health care: the Irish perspective

Published online by Cambridge University Press:  17 September 2010

Samantha Smith  and
Charles Normand
Samantha Smith*
Affiliation:
Post-Doctoral Fellow, Health Research & Information Division, Economic and Social Research Institute, Dublin, Ireland
Charles Normand
Affiliation:
Edward Kennedy Professor of Health Policy and Management, Trinity College, Dublin, Ireland
*
*Correspondence to: Dr Samantha Smith, The Economic and Social Research Institute, Whitaker Square, Sir John Rogerson’s Quay, Dublin 2, Ireland. Email: samantha.smith@esri.ie
Get access Rights & Permissions [Opens in a new window]

Abstract

Equity is espoused in many national health policy statements but is a complex concept and is difficult to define. The way in which equity is defined in policy has implications for how the health-care system should be structured. Conflicts between different definitions of equity are identified in theory and policy. This paper discusses these issues, with specific focus on the equity principles underpinning the Irish health-care system. The complex mix of public and private funding in the Irish system brings the challenges in identifying (and achieving) equity objectives more sharply into view, and serves as a warning system for other countries.

Type
Articles
Information
Health Economics, Policy and Law , Volume 6 , Issue 2 , 16 March 2011 , pp. 205 - 217
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baker, J., Lynch, K., Cantillon, S.Walsh, J. (2004), Equality From Theory to Action, Basingstoke: Palgrave Macmillan.Google Scholar
Barrington, R. (2000), Health Medicine and Politics in Ireland 1900–1970, Dublin: Institute of Public Administration.Google Scholar
Brick, A., Nolan, A., O’Reilly, J.Smith, S. (2010), Resource Allocation, Financing and Sustainability in Health Care: Evidence for the Expert Group on Resource Allocation and Financing in the Health Sector, Dublin: Department of Health and Children and Economic and Social Research Institute.Google Scholar
Central Statistics Office (2007), SILC Microdata File 2007, Cork: © Government of Ireland.Google Scholar
Commission on the Future of Health Care in Canada (2002), Building on Values. The Future of Health Care in Canada, Saskatoon: Commission on the Future of Health Care in Canada.Google Scholar
Culyer, A. J. (1995), ‘Equality of What in Health Policy? Conflicts Between the Contenders’, Centre for Health Economics York Health Economics Consortium, Discussion Paper 142.Google Scholar
Culyer, A. J.Wagstaff, A. (1993), ‘Equity and equality in health and health care’, Journal of Health Economics, 12: 431–457.CrossRefGoogle ScholarPubMed
DOHC (2001), Quality and Fairness: A Health System for You, Dublin: Stationery Office.Google Scholar
DOHC (2008), Press Release: Government Statement re Medical Card for People aged 70 and over, Department of Health and Children, Government of Ireland, http://www.dohc.ie/press/releases/2008/20081021b.html [26 November 2008].Google Scholar
European Observatory (1999), Health Care Systems in Transition: United Kingdom, Copenhagen: WHO Regional Office for Europe on behalf of the European Observatory on Health Care Systems.Google Scholar
Health Service Executive (2009), Performance Report October 2009, http://www.hse.ie/eng/services/Publications/corporate/October_2009_Performance_Report_.pdf [11 January 2010].Google Scholar
Kymlicka, W. (2002), Contemporary Political Philosophy, Oxford: Oxford University Press.Google Scholar
Layte, R.Nolan, B. (2004), ‘Equity in the utilisation of health care in Ireland’, The Economic and Social Review, 35: 111–134.Google Scholar
Le Grand, J. (1984), ‘Equity as an economic objective’, Journal of Applied Philosophy, 1(1): 39–51.CrossRefGoogle Scholar
McPake, B.Normand, C. (2008), Health Economics, Routledge: An International Perspective.Google Scholar
Nolan, A.Nolan, B. (2007), ‘The Utilisation of GP Services’, in B. Nolan (ed.), The Provision and Use of Health Services, Health Inequalities and Health and Social Gain, Dublin: The Economic and Social Research Institute, 35–62.Google Scholar
O’Reilly, D., O’Dowd, T., Galway, K., Murphy, A., O’Neill, C., Shryane, E., Steele, K., Bury, G., Gilliland, A.Kelly, A. (2007), ‘Consultation charges in Ireland deter a large proportion of patients from seeing the GP: results of a cross-sectional survey’, European Journal of General Practice, 13(4): 231–236.CrossRefGoogle Scholar
Oliver, A. (2005), ‘The English National Health Service: 1979–2005’, Health Economics, 14(Supplement 1): S75–S99.CrossRefGoogle ScholarPubMed
Olsen, J. A. (1997), ‘Theories of Justice and Their Implications for Priority Setting in Health Care’, Journal of Health Economics, 16: 625–639.CrossRefGoogle ScholarPubMed
Rawls, J. (1971), A Theory of Justice, Oxford: Clarendon Press.CrossRefGoogle Scholar
Red, C. (2004), Opinion Poll on A&E Services in Ireland: Unpublished Poll by Red C Market Research for the Centre for Insurance Studies, Dublin: University College Dublin.Google Scholar
Sen, A. (1992), Inequality Reexamined, Oxford: Clarendon Press.Google Scholar
Smith, S. (2007a), ‘Characteristics of Emergency Department Attendances in Four Irish Teaching Hospitals’, Working Paper no. 26, Research Programme on Health Services, Health Inequalities and Health and Social Gain, Dublin: Economic and Social Research Institute.Google Scholar
Smith, S. (2007b), ‘Emergency Department Utilisation in Four Irish Teaching Hospitals’, Working Paper no. 25, Research Programme on Health Services, Health Inequalities and Health and Social Gain, Dublin: Economic and Social Research Institute.Google Scholar
Smith, S. (2010), ‘The Irish “health basket”: a basket case?’, European Journal of Health Economics, 11(3): 343–350.CrossRefGoogle ScholarPubMed
Smith, S.Normand, C. (2009), ‘Analysing equity in health care financing: a flow of funds approach’, Social Science & Medicine, 69(3): 379–386.CrossRefGoogle ScholarPubMed
The Competition Authority (2009), Competition in Professional Services. General Medical Practitioners, Dublin: The Competition Authority.Google Scholar
Thomson, S., Foubister, T.Mossialos, E. (2009), Financing Health Care in the European Union. Challenges and Policy Responses, Denmark: European Observatory on Health Systems and Policies and WHO.Google Scholar
Wagstaff, A.van Doorslaer, E. (2000), ‘Equity in Health Care Finance and Delivery’, in A. J. Culyer and J. P. Newhouse (eds), North Holland Handbook of Health Economics, Amsterdam: North-Holland.Google Scholar
Whitehead, M. (1990), The Concepts and Principles of Equity and Health, World Health Organisation, http://www.who.dk/Document/PAE/conceptsrpd414.pdf [14 November 2005].Google Scholar
Williams, A. (1988), ‘Priority setting in public and private health care’, Journal of Health Economics, 7: 173–183.CrossRefGoogle ScholarPubMed
Wren, M.-A. (2003), Unhealthy State: Anatomy of a Sick Society, Dublin: New Island.Google Scholar