Mr. Stephen Mulvany:

It has not always done that. There have been many decades when we would have been behind that. I mentioned the €3 billion or €4 billion that we spend on social care and to what extent that is equally reported with other countries. With some of these measures, one is often measuring total spend on health. We are well down the league with regard to publicly funded healthcare expenditure versus total healthcare expenditure. Part of the question is whether we spend too much on health for what we get back.

I refer to two of the most expensive things in a healthcare sector. The same OECD data - data have to be used carefully - says that we have significantly fewer doctors per 1,000 population than the OECD average. We rank somewhere around 26 out of 34 on that. We have significantly fewer hospital beds, which is the single most expensive resource in any healthcare system. We rank 24 out of 34 on that. We also have the lowest increase over an eight year period which puts us at 31. That is using the same OECD data. I am not saying that means we do not get sufficient resources. We get more than €15 billion but I am saying that one cannot simply rely on OECD figures to provide the answer. Again when one looks at the hospitals, the OECD figures say that Ireland had a consistent bed occupancy of 94%. We are well ahead of the 77% OECD average. The doctors will tell one that at more than 85% bed occupancy on a consistent basis, one is demonstrating a system that is under stress. That is in the Department's capacity review document and that is a recipe for both efficiency, cost, and potential quality issues. That is all OECD data. Is it consistent? I do not know. It is not simple to settle that question. I agree with Deputy Durkan that it is something that a proper body, such as the ESRI, if it is not doing it already, should seek to answer. Having tried for a number of years, I can tell members it is not a straight forward thing to do.