OECD says Irish health staff are well paid

The latest OECD study will not be very popular within the health service

Dr James Reilly: Whoever succeeds him as Minister for Health  will have to decide whether we should be spending more on health. Photograph: Julien Behal/PA Wire
Dr James Reilly: Whoever succeeds him as Minister for Health will have to decide whether we should be spending more on health. Photograph: Julien Behal/PA Wire

There may be lies, damn lies and statistics, but western countries still rely on the OECD to process and make sense of reams of comparative international data .

Its studies are often assailed by those who don’t like the results, but they play a major role in determining policy in many countries.

This is as true in Ireland as anywhere else, with OECD reports into health and education playing a major role in leading debate. However, in our current economic state, the real significance of the OECD's observations on the Irish health system is the importance the troika which oversaw our debt until the end of last year attaches to them.

The European Commission and the IMF, two of the three troika members, have repeatedly asserted that Ireland pays its health staff too much and that we pay too much for our medicines. Within Government, the Department of Public Expenditure, the enforcer of fiscal rectitude, has kept up the pressure on the HSE and the Department of Health in the face of repeated spending overruns.

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Spending too much

Only last month the European Commission reiterated previous sentiments by the troika about health expenditure, and claimed the Government was spending too much on health.

So what should we make of the latest study from the OECD, and in particular its finding that Ireland actually spends less, not more, than other countries on health?

That bulletin from the commission last month calculated spending as a proportion of gross national income rather than gross domestic product (GDP). As health analyst Oliver O’Connor has pointed out, this strips out the repatriated profits of multinationals in Ireland. The effect is to boost the figure – artificially, some might argue.

Western Europe

In contrast, the OECD relied on GDP to come up with the finding that Irish health spending ranks 25th out of 34 countries and is lower than virtually anywhere else in western Europe.

Ireland has a relatively low number of doctors and hospital beds, and a relatively high number of nurses, according to OECD Health Statistics 2014.

The study appears to lend strength to the argument that, in spite of all the cuts made over the past six years, Irish healthcare workers are relatively well paid by international standards. Consultants and nurses appear to enjoy high salaries relative to OECD averages, although there must be caveats about the breadth of data available and the way some calculations are made.

This is not a finding that will be very popular within the health service, where there is a growing consensus from the top down that all the cuts that can be made have been made.

Indeed, salary trends look set to go the other way, with pay rises likely for consultants and senior managers because qualified staff cannot be found.

For the rest of us, and particularly for whoever succeeds James Reilly, assuming he is replaced in the forthcoming Cabinet reshuffle, the question is whether we should be spending more on health, which in turn would have to be paid for from taxes.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.