Health system failing on waiting times and treatment of patients, OECD warns

There's also potential for it to worsen given the likely increase in demand pressures from an ageing population, the Organisation for Economic Co-operation and Development (OECD), a global body working with more than 100 countries, signalled.

Households that cannot afford private health insurance have poor access and face high costs, with the lack of universal coverage for primary healthcare a contributing factor, the Paris-based body added in its latest assessment of the Irish economy.

"The health system already struggles to meet the needs of the population," the OECD report said. "Citizen satisfaction with healthcare was lower than in most OECD countries in 2016 and has fallen since 2007.

"The reduction in satisfaction coincides with falling public health expenditure through the crisis.

"Furthermore, there are inequalities in the health system, with the gap in health status between high and low-income individuals greater than in the average OECD country."

The report said that unlike most OECD countries, Ireland does not have universal coverage for primary healthcare.

"While roughly half the population have private health insurance, health insurance premia are high and co-payments are applied on a broad range of services, including primary care," the think-tank said.

"Consequently, health costs can be prohibitively high for a group of the population with earnings that are below average but who are ineligible for free services."

Access to healthcare is impeded by "hospital congestion", the OECD added, saying that those without insurance may find it difficult to get adequate care, as private patients get seen faster within the public system in some cases.

"Furthermore, medical consultants in public hospitals may focus disproportionately on those with insurance as they are paid on a fee per service basis for treating such patients.

"This two-tiered system of care is a factor behind the high inequalities in health status."

The report said that a path to providing universal coverage should be laid out.

The report, launched by OECD secretary general José Angel Gurría in Dublin yesterday, had high praise for Ireland and its recovery.

It said living standards are high, that the economic recovery has broadened to domestic demand, and that the economy is projected to continue expanding over the next years, albeit at a more sustained pace of under 3pc.

But as well as criticisms of the health system, the report noted that Ireland under-performs in housing and getting people into work.

The OECD said a longer-term solution to deal with the shortage of housing is required, adding that at present some unnecessary housing regulations in urban areas reduce the density of housing development and raise the cost for developers.

"There are also well-located swathes of land that are under-utilised and should be rezoned for residential purposes," the report said.

"To promote the efficient use of such land, a broad-based land tax should be introduced."

The report - launched on International Women's Day - noted that Ireland exhibits weak labour force participation by women.

"In response, the Government is introducing a new childcare subsidy. However, the comparatively steep withdrawal of some means-tested benefits means that the participation tax rate will remain high for many women."

On the financial sector, the body said that while non-performing loans have fallen by around 60pc from their peak, the stock remains high.

"This reflects judicial inefficiencies relating to the repossession of collateral and limited progress in improving the regulatory framework for writing off non-performing loans."

It said stronger incentives for banks to reduce them should be introduced.