Substantial investment in healthcare services needed

Substantial investment in primary, community and long-term healthcare will be required in the coming years, as a result of increasing costs and an ageing population, new research by the Economic and Social Research Institute (ESRI) has found.

It has projected expenditure for most primary, community and long-term health services, and social care services, for the period 2019-2035. New ESRI population and macroeconomic projections that incorporate the expected impact of Covid-19 have been taken into account, as have a range of scenarios for changes in demographics, healthy ageing, policy measures and costs.

According to the findings, among the services assessed, the biggest increases in expenditure are projected to be for high-tech medicines dispensed in the community, long-term residential care and home support services.

The ESRI projects nominal expenditure requirements for public and private general practice of between €1.6 and €2 billion in 2035. This implies a 2.9-4.5% average annual growth in expenditure.

It also projects nominal expenditure requirements for high-tech medicines of between €2.3 and €4.4 billion in 2035, implying a 6.1-10.5% average annual increase.

For public and private long-term residential care, the projections are of between €3.8 billion and €5.7 billion in 2035, implying a 4.3-6.9% average annual increase. The ESRI noted that an ageing population is the key driver of this expected increase.

For public and private home support, the projections are of between €1.2bn and €3 billion in 2035, implying a 4.4-10.4% average annual increase. Likely increases in demand following the establishment of a statutory home support scheme is the key driver of this projected expenditure growth.

The ESRI said that these findings provide an evidence base for workforce and capacity planning and for the implementation of important Sláintecare proposals. However, it acknowledged that the scope of the analysis was hampered by the poor data available for many services.

It suggested that policymakers should prioritise development of a health data infrastructure that caters for the requirements of both local and national level service planners.

"This report highlights that substantial investment in primary, community and long-term healthcare will be required in the coming years. The results provide policymakers with evidence on what funding pressures are likely to arise in different parts of the system,” commented one of the report’s authors, Brendan Walsh.

He pointed out that continuing current trends “will lead to expenditure growth on high-tech medicines and long-term residential care that far exceeds that of general practice and home support in the medium term”.

“This information should help policymakers frame decisions about what parts of the system should be prioritised for investment and where to focus policies to contain cost pressures,” Mr Walsh added.

The report, Projections of Expenditure for Primary, Community and Long-Term Care in Ireland, 2019–2035, Based on the Hippocrates Model, can be viewed here.