Economic outlook: A medium-term review of the Irish health and social care system

Ireland’s growing and ageing population is projected to significantly increase demand for a range of health and social care services in the coming years. Responding to these increasing demands, several plans and measures are in place to address the growing capacity requirements. While it is somewhat unclear how successful these measures will be in meeting the totality of future health and social care needs, there is an ongoing concern about the fiscal sustainability of the health and social care system. While Ireland’s population is relatively young, approximately one-quarter of current government expenditure was allocated to health and social care in 2025, one of the highest proportions among European countries. Even within this budget, access to some healthcare services remains curtailed, with long waits for a range of services, and the majority of the population continues to pay out of pocket for primary care services. 

The international literature identifies a range of potential policy options to ensure the fiscal sustainability of healthcare systems in light of changing demographic trends. These include saving for future expenditure requirements, exploring alternative financing mechanisms, 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 driving efficiency gains, in particular within the hospital setting. Other policy options, such as seeking alternative financing mechanisms (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. Increased consideration could be given to policies which positively impact population health, both as a means of improving the quality of life of the population and reducing demand for health and social care services. 

In addition to its impact on the health and social care system, demographic change will also have implications for other areas of government expenditure, including pensions. Demographic changes are occurring alongside a range of other major challenges, including an uncertain geopolitical environment, digitalisation (including rapid development in artificial intelligence), climate change and decarbonisation. These challenges also bring potential opportunities for the economy and society as a whole, and specifically for the healthcare system. However, a cross-government and agency approach is required to harness all potential benefits, to ensure the fiscal sustainability of the healthcare system and the economy at large over the medium term.