The new system of health accounts in Ireland: what does it all mean?

Private correspondence with the Central Statistics Office has revealed that plans are in place to publish detailed data for 2011 and 2012, based on the SHA methodology, but that these will not be published until 2017. Therefore, the only years for which SHA data are available for Ireland at the time of writing are 2013 and 2014.

GDP is defined as the total value added (output) in the production of goods and services in the country. Gross National Product (GNP) is defined as the sum of GDP and Net Factor Income from the rest of the world, the latter of which is the difference between investment income and labour income earned abroad by Irish resident persons and companies (inflows) and similar incomes earned in Ireland by non-residents (outflows). GNI is equal to GNP plus EU subsidies less EU taxes [5]. Since net factor income in Ireland is heavily influenced by foreign multinationals, there is a larger difference between GDP and GNP/GNI in Ireland than in most countries.

The change in methodology in Ireland would not have significantly affected the OECD figures.

However, a counter-argument is that all of the income counted in GDP is taxable and is therefore relevant to public spending—see http://​www.​nerinstitute.​net/​blog/​2016/​05/​14/​do-we-overspend-on-health/​.

In a similar manner, recently released figures showing a 26 percent increase in GDP in 2015 will mean that health spending as a percentage of GDP will fall sharply for 2015, without a fall in health spending itself.

However, there may be some data and/or methodological issues regarding private expenditure, particularly out-of-pocket payments. This is discussed further in the “Discussion and conclusions” section.

Preventive services are defined as those services “having the primary purpose of risk avoidance…” and include “information, education and counselling programmes; immunisation programmes; early disease detection programmes; healthy condition monitoring programmes; epidemiological surveillance and risk and disease control programmes; and preparing for disaster and emergency response programmes.” [4, p. 7] In an Irish context, this category primarily relates to the services provided by the HSE’s Health and Well Being Division.

Under the 2011–2016 Programme for Government, it was proposed to extend access to GP services without fees at the point of use to the entire population. It was estimated that this measure would cost €389 million [18]. If this figure were incorporated into the SHA figures (i.e., an additional €389 m into public expenditure and a corresponding fall of €389 m in private expenditure), it would shift the balance of public versus private current expenditure (in terms of percentages, based in the 2014 figures) from 69:31 to 71:29.

See http://​www.​oireachtas.​ie/​parliament/​oireachtasbusine​ss/​committees_​list/​future-of-healthcare/​role/​ for full details of the Committee’s role.