Ireland’s growing and ageing population will challenge the financial sustainability of the Irish health and social care system

A new report by the Economic and Social Research Institute (ESRI) notes that Ireland's growing and ageing population will continue to increase pressure on health and social care services and public finances in the coming decades, requiring continued action to ensure the long-term sustainability of the system. Economic outlook: A medium-term review of the Irish health and social care system brings together evidence on projected demand, capacity and expenditure requirements, and considers how the system can respond to ensure its sustainability.

While Ireland’s population is relatively young, approximately one-quarter of current government expenditure was allocated to health and social care in 2025 (approximately €26 billion), one of the highest proportions among European countries. Expenditure requirements are expected to increase significantly in the coming years.

There are a number of potential policy options to ensure the financial sustainability of a health system, including saving for future expenditure requirements, exploring alternative funding sources, reallocating or increasing public expenditure, improving efficiency and maximising population health.

In this context, a number of measures are ongoing in Ireland, including saving for the future through the Future Ireland Fund and seeking efficiency gains, in particular within the hospital setting. Other policy options, such as seeking alternative funding sources (generally from private sources) and continuing to increase the allocation of public expenditure to healthcare, are likely to be less viable in the Irish context. A shift to more private spending, for example, would likely reduce access to healthcare and would conflict with existing Irish health policy (Sláintecare), which aims to reduce out-of-pocket payments on healthcare services.

Increased consideration could be given to policies which positively impact population health.

The challenges to the financial sustainability of the health and social care system need to be considered in the context of other long-term challenges including an uncertain geopolitical environment, increasing demands on the pension system, climate change, and increased digitalisation and AI.

Commenting on the findings, report author Sheelah Connolly said: “Ireland has begun to plan for higher health and social care demand, but demographic change will require sustained action. Expanding capacity needs to be accompanied by increased efficiencies and a stronger emphasis on preventing ill health.”