A comparison of the Irish and French health care.
The Irish health budget for 2020 is €17.4 billion for less than 5 million people, while France has €222.3 billion for the health budget for the same year and a population of 67 million. In overall terms, it is true that the French health budget is 25% higher than the average of the European Union, but the Irish government does have a consequent amount of money to bring a normal prestation.
The rate of doctors in active employment in France and Ireland is fairly close to just over 300 doctors per 100,000 inhabitants in France and just under 300 in Ireland, i.e. slightly below the EU average. The ratio between GP and specialist doctors is also close between these two countries, i.e. around 54% of general practitioners in Ireland compared with around 46% in France. This ratio is important because it shows that Ireland and France both have a significant supply of local general practitioner care for their populations when the EU average is around 33% (Data 2014/2015 DREES). Moreover, for nursing supervision, the ratio is close between the two countries: one nurse for every 17 people in France and one for every 19.
The Irish government has an apparently sufficient budget to ensure normal provision, as well as sufficient structures and sufficient medical staff, but the system does not work satisfactorily.
So what is the problem? What is the government doing with the health care budget?
According to the OECD, 94.9% of beds are occupied in Ireland compared to 75% in France, which gives us a better understanding of the state of saturation in which Irish hospitals find themselves, which apparently work at maximum capacity throughout the year. It means that in case of pandemic, how is it possible to manage a situation like the covid-19?
It can also be seen that in 17 years, from 2000 to 2017, Ireland has almost halved the number of hospital beds, from 23,000 to 14,000. According to Dr Ruimi: “Over the last twenty years the number of beds in Irish hospitals has literally melted away. Their care institutions no longer have the capacity in terms of places to accommodate the current needs of the Irish population. Healthcare staff are demotivated and patients are overwhelmed.” In France, the number of beds has also fallen over the same period, but by only 19%, from 484,000 to 399,000, a ratio that is twice as high as that of the populations of the two countries; in concrete terms, an Irish citizen has twice as many chances of finding a place in a hospital as their French counterpart. (source OECD). The number of hospital days per patient is also 35% higher in France 8.8 days/patients/year compared to 5.7 in Ireland. (source OECD 2017).
In other words, Ireland is implementing an austerity policy that consists of saving money by reducing costs, the main tool being a massive reduction in the supply of care in terms of availability of hospital beds and shorter average hospital stays. One of the lowest in the EU according to OECD data. According to the French GP: “It must be noted that, whatever country we are talking about, management in the form of savage restriction of health budgets is not the right solution to implement the medicine of the future.” He also added: “We must, of course, bear in mind the need to remain reasonable in terms of the cost of health care for the community. But I believe that this will be achieved more through policies of health education, prevention and comprehensive patient care than through the pursuit of drastic savings in health costs.”
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