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2. Key Health Challenges for 2008 – 2011

 

Corporate Plan 2008-2011 Menu

Introduction

Internationally the environment in which health and social services operate has changed rapidly over the past decade, exerting many pressures on health systems across the world. Significant developments in technology, matched by radically different expectations within the population and changing lifestyles, have all contributed to these pressures

In Ireland, the past decade has particularly been a time of rapid change in Irish society. This change has taken place against the backdrop of significant demographic change and economic growth and has resulted in increased expectations of public services. It is also marked by unprecedented improvements in health status and life expectancy. In taking on the role of delivering a world class health service, there are many challenges that we have to address.

Our People

A key factor in the demand for health and personal social services over the coming years will be the structure of the population and how that is expected to change. Key demographic issues include:

  • Our population is at an all time high since 1864. There are now 4,339,000 people living in the Republic of Ireland (10.8% increase in last five years). The Irish population is estimated to be in excess of five million by 2025.
  • Between 1996 and 2006, Ireland had the largest population growth rate in the EU at nearly 17%.
  • Over the last 10 years births have increased on average, by over a thousand births per year. There were over 70,000 babies born in 2007.
  • Across the EU, Ireland continues to have the highest proportion of children in the population, which has implications for the provision of childcare services.
  • Older people account for 11% of the overall population. It is predicted that by 2011 the number of those aged over 65 years will have increased to 16%, rising to 40% by 2016. A larger and older population places greater demands upon the health system now and in the future. A significant challenge will be to ensure that these people enjoy their extra years of life as healthy and disability free as possible.

Health Status of Our Population

We will continue to work to improve the overall Health and Wellbeing of the population. To facilitate this objective, there is a constant focus on how to integrate service delivery to achieve maximum health and social gain. Many factors outside of our control also impact on the health status of our population and must be taken into account. It is internationally accepted that the wider determinants of health will continue to have the greatest impact on health.

Key health status issues include:

  • The death rate for Ireland continues to fall steadily. In 2006 just over a third of all deaths were due to circulatory diseases, 29% of all deaths were from cancer, 14% were from respiratory diseases and deaths from injury and poisoning, including road traffic accidents, accounted for 5%.
  • In 2005, life expectancy at birth was estimated at 81.8 yrs for Irish women and 77.1 yrs for Irish men.
  • Almost 394,000 persons in Ireland are reported as having a long lasting health problem or disability.
    • 58% of persons with a disability are aged 50 yrs or older, and
    • Approximately one-third of people aged over 65 with a disability, live alone.
  • Worldwide, there is an increasing incidence and prevalence of chronic illnesses; these include diabetes, heart failure, kidney disease, some cancers, chronic obstructive pulmonary disease, dementia, asthma, arthritis and a range of disabling neurological conditions. The incidence of such diseases increases with age and many older people are living with more than one chronic illness.
  • Success in treating what were previously fatal diseases, such as heart disease, respiratory diseases and some cancers is also a factor that has led to the increase in chronic illnesses. Ireland has achieved major success in heart health status in the past 15 years, with a 40% reduction in deaths from heart disease.
  • An analysis of the Irish Hospital Inpatient Enquiry (HIPE) System shows that only 5% of inpatients account for over 35% of all inpatient bed days.
  • In 2006 some 409 deaths were identified as suicide. Deliberate self-harm is also a significant problem. Over 11,000 cases of deliberate self-harm are seen in the emergency departments of our hospitals annually.
  • There is concern as to the number of road deaths, particularly young men aged 15-24 who accounted for almost a third of all such deaths in 2006.
  • Ireland now has one of the highest alcohol consumption rates in the EU. Patterns of alcohol misuse among young people in Ireland are particularly a cause for concern.
  • Illicit drug use causes health problems, social problems, family disruption and economic deprivation. The pattern of increasing illicit drug use, particularly of cocaine, poses a challenge and highlights the need for services to be delivered in primary health care settings by multidisciplinary teams.
  • The problem of obesity is at epidemic proportions among adults and children in Ireland and looks set to continue growing at a rate of 1% every year. Approximately 39% of Irish adults are overweight and 18% are obese.

Key Health Challenges

While there are many challenges facing the health services, those prioritised for action in the 3 years 2008 to 2011 are:

  • The integration of services across the service spectrum from disease prevention through primary and community care to hospital care, to allow the service user to be managed at the most appropriate level for their care needs.
  • The prevention and management of chronic diseases.
  • Cancer prevention and provision of quality assured treatment services.
  • Promotion of mental health and provision of support and interventions for those with mental health problems.
  • Promotion of patient self care and provision of information for service users.
  • Control of health care acquired infections (HCAI).
  • Supporting people with disabilities to achieve their full potential, including living as independently as possible.
  • Enhancing the quality of life of older persons, supporting them in their homes and communities and, where this is not possible, providing them with access to appropriate residential accommodation.
  • Promoting and protecting the health and well being of children and families.