The report projected that thousands more GPs and hospital beds would be required by 2040 to keep up with the increasing and ageing population. Shutterstock/Gitanna
ESRI
The ESRI said “continued action” will be needed to ensure the long-term sustainability of the system.
IRELAND’S GROWING AND ageing population is set to increase pressure on health services and public finances in the coming decades, according to a new report.
The report, published today by the Economic and Social Research Institute (ESRI), states that there is an “ongoing concern” about the fiscal sustainability of the health and social care system as a result.
It pointed out that in 2023, total health and social care expenditure in Ireland was around €35.1 billion, an increase of 81% on 2014.
While Ireland’s population is relatively young, around €26 million was allocated to health and social care last year. Along with being one of the highest proportions in Europe, this was also a quarter of current government expenditure, surpassed only by spending on social protection.
As people live longer and more people arrive in Ireland, the report states that expenditure requirements are expected to “increase significantly” in the coming years.
The ESRI projected three scenarios based on the 2022 Census data – central, low and high. In each scenario, mortality and fertility were dealt with in the same way; however, migration differed across the scenarios.
In the central scenario, net immigration was projected to average 35,000 per annum up to 2030 and 20,000 thereafter. The low scenario assumed 10,000 less net immigration per annum, while the high scenario assumed 10,000 more net immigration per annum.
In the central scenario, the ESRI estimated that the population would increase by 863,000 by 2040. The increase in the low scenario was 658,000, while in the high scenario, an increase of 1.07 million was expected.
It projected that those aged 65-84 would increase by almost 60%, while the population aged 85 years and over would double by 2040.
Reflecting the different assumptions and scenarios and building on previous ESRI analyses on population growth, the report also looked at the estimated effect on the health service as a result of larger population.
It estimated that within the public hospital system, an additional 5,083–7,780 day and inpatient beds will be required between 2023 and 2040 to meet the additional projected demand.
Within the long-term residential care sector, an additional 20,695–27,207 beds will be required by 2040, it estimated.
It also projected an addition 943-1,211 GPs would be needed to meet the growing demand.
The ESRI said there are a number of potential policy options to ensure the financial sustainability of the health system, including exploring alternative funding sources, increasing public expenditure and improving efficiency and maximising population health.
It noted that a number of measures are ongoing, including saving for the future through the Future Ireland Fund and seeking efficiency gains, in particular within the hospital setting.
“While these measures are to be welcomed, the ageing of the population means that there will be an ongoing need to ensure that existing and planned capacity keeps up with the growing demand,” it stated.
“In particular, there is an urgent need to focus on those services which are predominantly used by older people, including long-term care.”
The report said other policy options, like seeking private funding and continuing to increase the amount spent on healthcare, “are likely to be less viable in the Irish context”.
It said moving expenditure from the public to the private would conflict with the currently Sláintecare policy, which aims to reduce out-of-pocket payments on healthcare services, while upping the amount spent on health each year is unlikely to be feasible due to other expenditure demands, including on pensions.
Looking ahead, it said more consideration could be given to policies which positively impact population health “both as a means of improving the quality of life of the population and reducing demand for health and social care services”.
It stressed that the challenges to the financial sustainability of the health and social care system also need to be considered in the context of other long-term challenges, including an uncertain geopolitical environment, climate change and increased digitalisation and AI.
“Ireland has begun to plan for higher health and social care demand, but demographic change will require sustained action,” report author Sheelah Connolly said.
“Expanding capacity needs to be accompanied by increased efficiencies and a stronger emphasis on preventing ill health.”