Ireland

Ireland’s health system is characterized by a complex overlap between public and private providers and payers. The public health system is funded primarily through general taxation and is accessible to all residents. However, significant capacity constraints in public outpatient and inpatient care services mean that nearly half of the population purchases voluntary health insurance to obtain expedited access to care and some coverage for copayments. The Department of Health provides overall stewardship, policy direction and performance oversight and is responsible for allocating the health budget, while the Health Service Executive (HSE) is responsible for managing and delivering health and social care services.

Ireland does not have universal coverage for primary care, and access and associated charges for services in the public system are determined by an individual’s circumstances. There are two main categories of entitlement to public services. Access to the most comprehensive set of publicly financed healthcare services is reserved for holders of a medical card (Category I), with eligibility subject to a means test. Residents who do not meet the medical card criteria (Category II) may qualify for a similar scheme if they have a long-term condition, or they may be eligible for another card that exempts them from the cost of GP visits if they fall under specific criteria, such as being under 8, over 70 or passing a less restrictive means test. Those who are not eligible for a GP visit card are required to pay the full cost of GP and other outpatient care services. Some public health services are provided universally free of charge, such as maternal and infant care and immunizations. 

 Ireland is committed to a series of foundational reforms under its Sláintecare programme. The core vision of Sláintecare is to create a universal, integrated health service where every resident, regardless of income or geographic location, has access to timely, high-quality healthcare. The program was developed in 2017 following a cross-party agreement and is designed to reshape how healthcare is delivered in Ireland over the next decade.