Dr. Josep Figueras:

Yes. As the committee can see there is a lot of data in my presentation. I will start by discussing whether Ireland is getting value for money. What do the indicators look like in comparison and how much is being spent? One of my slides shows the percentage of health care expenditure against GDP. It is typical of most presentations on the subject so it will be no surprise that Ireland's health care expenditure as a percentage of GDP is so low. I got one of my research fellows to update all our figures and data for this meeting so the slides I have given to the committee contain the most recent data from the WHO, the OECD, EUROSTAT and so on. The available data is from 2014 and 2015. I will be very happy if the Chairman wants me to give a detailed analysis of expenditure trends. I have the figures here so we can go back to that.

Life expectancy is the other main indicator but I have other indicators such as preventable mortality and avoidable mortality, which we can come back to later if the committee wishes. Life expectancy in Ireland is above the average in OECD countries. The committee will see the data for women on the left and the data for men on the right. I looked at these figures with a colleague and it is interesting to see that healthy life years in Ireland are higher than in other countries. Ireland is above the average.

If the committee looks at the data for healthy life years, it will see that life expectancy is broken down into healthy life years and life with activity limitations. That is how that is measured. It is quite high, which is a really interesting element. I have more data on a form of benchmarking that looks at issues of life expectancy and risk factors. It will remind the committee that Ireland has challenges with regard to obesity. It is a reminder because the committee knows this very well. Despite this challenge, Ireland was the first country to introduce a novel tobacco ban. Many countries followed Ireland and used its example and research. Ireland still has challenges with regard to tobacco and alcohol.

I am very familiar with the Healthy Ireland strategy. One of the elements I would like to talk about later on is how that relates to other health policies and approaches in Europe. In terms of cardiovascular diseases, Ireland has made huge, amazing improvements that explain improvements in the life expectancy figures. There is a mixed picture but one that shows Ireland is going in the right direction. Researchers never manage to get the data for amenable mortality right. It is an indicator that is meant to look at mortality that would be amenable for health care services. There is amenable and preventable mortality. It is terribly difficult to disentangle mortality that can be addressed through the health system from mortality that is addressed by determinants. This data is an attempt to do that. As the committee can see from the slide, there has been a measured improvement.

The green pertains to 2014 and the pale pink to 2000. One can see the huge improvements. Ireland is fairly low down the ranking in terms of amenable mortality for both males and males. A lower ranking is more positive. With females, interestingly, the ranking is a bit higher. We ought to be very cautious about how we interpret some of these data. Let us not attach too much importance to them. They help to give a sense of what is occurring, however. Ireland's health services are doing pretty well if we take the data as an indicator of their impact.

I will return to the issue of preventable mortality. Is it satisfactory for me to give an overview and then refer to the options?