Health in Ireland : Key Trends - Health service expenditure

Source:
Revised Estimates for Public Services (2014 - 2021); HSE National Service Plans (2014–2022); and HSE Performance Reports (2014-2024), HSE Annual Report and Financial Statements (2021-2023), Department of Health Appropriation Accounts (2022-2024), Department of Social Protection Appropriation Accounts (2022-2024).

Notes:
(i) In 2014 funding of c. €540 million was transferred, in the context of the establishment of the Child and Family Agency, from the HSE Vote to Vote 40 (Office of the Minister for Children & Youth Affairs). For comparison purposes, this table has been revised for the period 2010-2013 to exclude expenditure in respect of children and family services. Data from 2015 also excludes expenditure in respect of children and family services.
(ii) In 2015 the Vote of the HSE was disestablished and the funding transferred to Vote 38 (Office of the Minister for Health) from which Vote grants are now paid to the HSE. As a consequence, income previously accounted for as Appropriations-in-Aid in the HSE Vote is collected directly by the HSE and shown in the HSE accounts but no longer incorporated in Vote terms. For comparison purposes, the figures above for 2015 and after including these income figures - €1.075bn in 2015, €1.061bn in 2016, €1.054bn in 2017 and €1.085bn in 2018 and 2019.
(iii) Public Non-Capital Expenditure refers to net HSE expenditure Vote in the Appropriation Account for Public Services and expenditure sourced from the Department of Health and Department of Social Protection appropriation accounts; excludes expenditure in respect items not considered health expenditure, such as expenditure in relation to the State Claims Agency.
(iv) Public Non-Capital Expenditure refers to the Health Vote and HSE Vote in the Appropriation Accounts for Public Services: excludes expenditure in respect items not considered health expenditure, such as expenditure in relation to the State Claims Agency.
(v) In 2023, the Disability Services budget was transferred from the Department of Health to the Department of Children, Equality, Disability Integration, and Youth Affairs. This resulted in the exclusion of disability services from the 2023 Department of Health budget. However, for comparability purposes, Disability spend is still included in this table.

Source:
Revised Estimates for Public Services (2014 - 2021); HSE National Service Plans (2014–2022); and HSE Performance Reports (2014-2024), Department of Health Appropriation Accounts (2022-2024), Department of Social Protection Appropriation Accounts (2022-2024).

Notes:
(i) In 2014 funding of c. €540 million was transferred, in the context of the establishment of the Child and Family Agency, from the HSE Vote to Vote 40 (Office of the Minister for Children & Youth Affairs). For comparison purposes, expenditure in respect of children and family services has been excluded from the Table.
(ii) In 2015 the Vote of the HSE was disestablished and the funding transferred to Vote 38 (Office of the Minister for Health) from which Vote grants are now paid to the HSE. As a consequence, income previously accounted for as Appropriations-in-Aid in the HSE Vote is now collected directly by the HSE and shown in the HSE accounts but no longer incorporated in Vote terms. The 2014 estimate was also revised for comparison purposes. The allocation of this income of €1.043bn in 2014, €1.075bn in 2015, €1.061bn in 2016, €1.054bn in 2017 and €1.085bn in 2018 across the above HSE programmes is provisional.
(iii) Primary care and community health includes medical card services schemes, palliative care and social inclusion costs.
(iv) Access to care and private hospital expenditure has been recategorized from Health and Wellbeing, Other Operations, National & Support to Acute Division.
(v) In previous years, Health & Wellbeing and Other were separate headings. Due to restructuring of budgets in the HSE, these headings have now been combined into the category Health and Wellbeing, Other Operations, National & Support Services. The comparative years have been adjusted accordingly.
(vi) Covid Expenditure is included in Health and Wellbeing, Other Operations, National & Support Services.
(vii) From 2024, the methodology for distributing Appropriation-in-Aid across headings was updated. Income figures for each heading, sourced from the HSE Performance Report, are now used as the basis for allocation. Prior to 2024, total net expenditure was used to allocate A-in-A between headings.
The change in methodology has had a substantial impact across several headings. Care of Older People has been allocated €322 million of the Appropriation- in-Aid, while Primary Care & Community Health has been allocated €372 million. Meanwhile, the Acute Division’s allocation decreased to €709 million, and Care for Persons with Disabilities was reduced to €69 million.
If the previous year’s methodology had been applied in 2024, projected spending would have been: Care of Older People at €2.787 billion (up 10.8%) versus €3.109 billion under the new methodology; Care for Persons with Disabilities at €3.306 billion (up 13.5%) versus €3.138 billion; Mental Health at €1.400 billion (up 7.1%) versus €1.383 billion; Primary Care & Community Health at €6.435 billion (up 7.5%) versus €6.571 billion; and Acute Division at €10.550 billion (up 13.5%) versus €10.277 billion. The change in methodology had minimal impact on allocations for Health & Wellbeing, Other Operations, National & Support.

Source:
Revised Estimates for Public Services and HSE Reports on Capital Programme.

Note:
(i) Voted capital allocation, together with associated reporting functions, for Disability Services was transferred to the Office of the Minister for Children, Equality, Disability, Integration and Youth in 2023.

Source:
Table 6.1.

Note:
(i) See notes under Table 6.1.

Source:
System of Health Accounts, Central Statistics Office.

Source:
System of Health Accounts, Central Statistics Office.

Source:
System of Health Accounts, Central Statistics Office.

Source:
OECD, CSO.

Note:
(i) Total Current Health Expenditure is measured in Euro and has been deflated/inflated to real prices by using the CSO National Accounts series for net expenditure by central and local government on current goods and services (deflated in year 2014-2022, neither inflated nor deflated in 2023 and inflated in 2024).

Source:
OECD.

Notes:
(i) Data for Turkey, Latvia, Norway, US, Costa Rica, Spain, Japan, Slovak Republic, Finland, Belgium, Greece, Australia, Ireland and Mexico is estimated. Data for Chile, Colombia, Lithuania, Austria, New Zealand, Poland, Denmark, Korea, Slovenia, Sweden, Germany, Netherlands, Italy, France, Portugal, UK, Switzerland, Iceland, Canada, Czech Republic is provisional.
(ii) Per Capita Expenditure is expressed in US$ Purchasing Power Parities (US$PPPs).
(iii) GDP: Gross Domestic Product.
(iv) As PPPs are statistical constructs rather than precise measures, minor differences between countries should be interpreted with caution.
(v) Modified Gross National Income (GNI*): adjusted for retained earnings of re-domiciled firms and depreciation on foreign-owned domestic capital assets.

Source:
OECD.

Source:
Eurostat.