Ireland is a small country with many international visitors. If you haven’t lived in Ireland, though, you probably aren’t familiar with how healthcare operates there. In fact, Ireland’s healthcare system has a lot to offer its citizens.
It’s also undergoing a process of transformation due in large part to recent changes to Ireland’s economy. The Economic Freedom Index ranks Ireland second among 44 countries in the Europe region. Its overall score is well above the regional and world averages.
In this article, we’ll discuss how Irish healthcare has evolved over centuries. Then we’ll look at how it’s structured today.
The History of Healthcare in Ireland
Healthcare, in general, especially in industrialized countries, has come a long way in the past couple of centuries. For example, modern-day sterile surgical measures weren’t in place anywhere until the late 1800s.
Ireland is no exception. Like other countries, its hospital facilities used to be more about easing pain and discomfort for the sick and injured. They did little to actually resolve their conditions.
The 1700s
Before the 18th Century, Irish hospitals, such as they were, were reserved for the wealthy and elite. It wasn’t until the 1700s that care was available for ordinary people who were sick or injured.
This role was taken on by “voluntary hospitals,” which offered a degree of help. Some were for those with curable illnesses or treatable injuries. Others were homes for hopeless cases.
Both were “funded by donations, legacies and public subscriptions.” The first volunteer hospital was in Dublin, but soon they appeared in other Irish cities.
By the end of the century, county infirmaries had been mandated by parliament for every county in Ireland. The British also established workhouse infirmaries in urban areas at this point.
Both types of infirmaries were intended mainly to keep the country’s workforce healthy and robust.
The 1800s
By the 19th Century, the Irish had begun to take stock of contagious illnesses. Perils like tuberculosis, smallpox, and ravaging fevers were rampant. “Fever hospitals” began to appear throughout the country.
These, along with the other institutions discussed above, were called “medical charities.” They flourished by serving the poor and protecting the wealthy from diseases presumably spread by the poor.
In Ireland, there were a lot more poor people than wealthy. The poor received little to nothing from the 1838 Relief of the Poor Act—intended mainly to investigate the medical charities.
In what’s now known as the Great Famine, starvation and famine-related diseases led to over 1,000,000 excess deaths in Ireland between 1845 and 1852. At least another 1,000,000 people emigrated to other countries.
More than enough remained in Ireland, though, to overwhelm the medical institutions with their hunger and illness.
At the same time, the hospitals, workhouses, and infirmaries had their mission revised through the Poor Law. They would accommodate the destitute poor into the 1920s.
There were some improvements to Irish healthcare in the late 1800s. However, problems remained. For example, virtually all nursing care was handled by diligent but untrained nuns. Training wasn’t required until close to 1900.
Ireland’s Healthcare System in the 20th Century
Irish healthcare made tremendous strides during the 1900s, especially during the latter decades of the century. The earlier part of the century saw domination by the Catholic Church.
It also saw a fight for independence from Great Britain—which had ruled Ireland for centuries.
The Struggle for Independence
A movement for Irish home rule originating in the late 19th Century escalated in the early 20th Century. In 1916 Irish nationalists launched the Easter Rising to fight the British government. The rebellion failed, but the show of support for independence grew.
In 1919, the Irish Republican Army (IRA) launched a guerrilla campaign against the British. Two years later, a cease-fire was declared. In January 1922, a faction of Irish nationalists signed a peace treaty with Britain.
They called for the partition of Ireland, with the south becoming autonomous. The six northern counties would remain part of the United Kingdom.
Following a civil war, the Irish Free State was finally achieved with a victory over the Irish Republican forces in 1923. We should point out here that most of this happened during World War I.
The constitution adopted by the Irish people in 1937 declared Ireland to be “a sovereign, independent, democratic state.” Eire became the name of the new Irish Free State.
It wasn’t until 1948 that the Republic of Ireland Act finally severed the last remaining link with the British Commonwealth.
Irish Healthcare: Through the 1950s
Meanwhile, Irish advocates for healthcare reform had been carrying on with their work. By this point, social reformers were amenable to a role for the State in formulating and implementing policy.
It didn’t hurt that a sharp rise in inflation severely diminished the donations that once supported voluntary hospitals.
In May 1920, the Irish Public Health Council resumed its prewar role of advising and assisting the government in promoting health policies.
No sooner had formal independence been granted to the new Republic of Ireland than their new government began to finally and systematically dismantle the horrible Poor Act.
The dismantling had been in process since the end of World War II. During those intervening years, free medical service had been established for mothers and children under sixteen, regardless of income.
Dr. James Ryan was Minister for Health and Social Welfare. In 1952, he proposed extending this provision to all but the highest-earning 15% of the population.
It became law the following year despite objections from the Catholic Church and many in the medical professions.
The Voluntary Health Insurance Act of 1957 was created to provide community-rated health insurance for those with higher middle incomes. They formerly were required to pay for their own care in public hospitals.
This option was also available to anyone wishing to opt for private care in hospitals—even those who were entitled to free or significantly subsidized care. The health insurance could also be used in private hospitals that were not supported by the State.
Irish Healthcare in the Late 20th and Early 21st Centuries
Ireland witnessed a great deal of economic growth during the 1960s and 1970s. This growth allowed for improvements to Irish healthcare. New facilities and services for both public and private patients became available.
Unfortunately, the 1980s brought a cycle of economic stagnation, and there were some cutbacks in public health service. This period was short-lived, though, with the economy returning to an upswing in the 1990s.
In 2001, the government proposed more widespread availability of GP services. They also established multi-disciplinary primary care teams (with GPs, nurses, health care assistants, therapists, social workers, etc.).
Then in 2005, the health service went through a major reorganization to create a more unified and efficient health service. The restructuring was to make the health service less vulnerable to local and regional pressures. It was called the Health Services Executive (HSE).
It wasn’t as popular as had been hoped, though.
Ireland’s Healthcare System Today
In August 2019, Simon Harris, the Irish Minister for Health, announced that the HSE would be divided up to create six regional health authorities.
These entities would be responsible for budgets, management, planning, and delivery of health services in their respective jurisdictions. It makes sense since Ireland has had a region-based economy for a very long time.
How Is the Irish Healthcare System Structured and Supported?
Ireland’s healthcare system (overseen by the HSE) is complicated. It’s actually two different systems: public and private.
Public Healthcare
Although it’s funded by taxpayers, not everyone pays the same cost for services. “Whether or not the state healthcare system works in your favor might hinge on one key question: if you’re eligible for a Medical Card or not.”
You’ll be eligible if you earn less than a certain amount each week, depending on your circumstances. Determining factors include marital and family status, rent or mortgage payments, childcare, and work commute.
The GP (general practitioner) Visit Card is for those over the income threshold for a Medical Card. It’s also for people under age six or over age 70. It allows free GP visits but not the other benefits that come with a Medical Card.
Private Healthcare
There are also several private insurance providers in Ireland. This costs more than public insurance, but offers an extra degree of comfort from private and high-tech hospitals and can save waiting time for treatment.
Private insurance is regulated by Ireland’s Health Insurance Authority (HIA).
What is the Role of the GP in Irish Healthcare?
Primary care in Ireland is the role of a GP (general practitioner or family doctor). A GP is the first doctor someone with a medical concern typically would see. The GP would refer them for tests, x-rays, or a specialist as needed.
GPs offer many different services to their patients. They are also central figures in their communities. They usually provide this service to patients throughout the patients’ lifetimes. Ireland has no pediatricians.
Most of Ireland’s GPs are private practitioners. The majority provide services, on behalf of the HSE, to people with Medical Cards, GP Visit Cards, and so on. Most GPs also give free immunizations for their patients.
People without either Medical Cards or GP Visit Cards will pay for GP visits out of pocket.
Who Else Serves Patients in Irish Healthcare?
There are specialist physicians (known in Ireland as consultant physicians). They generally work in hospitals, not private practices.
If you’re a public patient, you don’t have to pay for the consultant’s services, but you also don’t get to choose your consultant.
There are numerous other healthcare occupations in Ireland.
Should You Need Healthcare In Ireland…
If you’re an Irish citizen or otherwise have access to Ireland’s healthcare system, consider yourself fortunate. Healthcare professionals there are well trained, and public healthcare is very affordable. Even private insurance isn’t all that costly.
You can tell from this brief history and overview that Ireland has faced many struggles throughout its history. Among them has been providing healthcare services to those who need them. It even had to struggle for its independence from Britain along the way!
Do you know that we play a significant role in Irish healthcare? Check out our website to learn about all the things we do for healthcare and those who provide it.