THE PERCEPTION of the quality of public services tends to be low in Ireland relative to other European countries, according to a study by the Economic and Social Research Institute.
The research is based on 2007 Europe-wide surveys of perceptions of public services in education, health, transport, care for the elderly and pensions.
The data showed that only public education received a high rating by EU standards, while the rating given to the health services was one of the lowest among the 15 western European countries.
The least well-off give the lowest-quality ratings to Ireland’s public services, in four of the five areas surveyed. Education was the exception.
The report, by ESRI researcher Dr Dorothy Watson, acknowledges the challenges of maintaining and improving the quality of public services in the context of reduced Government revenues and greater demands on services in recessionary times.
It notes, however, that according to the international evidence “spending on services and measures of quality are rather weak”. The paper concludes that “how the service is delivered is as important as how much is spent”.
This is particularly the case with education, according to the study. “There is no clear link between spending on education and the measured performance of pupils: Finland, Austria and Portugal spend roughly the same share of GDP on education, but pupil performance at age 15 is very different.”
The research uses the European Quality of Life Survey and is based on responses obtained in 2007, the end of an extended period of high public expenditure growth in Ireland.
Dr Watson’s paper will be delivered at an ESRI conference today on issues related to Ireland’s ongoing economic crisis.
A separate study from the research institute says there is insufficient evidence to support the introduction of pay-for-performance schemes in the Irish healthcare system.
The study, by Dr Anne Nolan, Jacqueline O’Reilly, Dr Samantha Smith and Dr Aoife Brick, concludes that pay-for-performance should not be considered “at least until the many complexities in financial incentives in the current system are resolved”.
The report says that in the context of the current economic climate, securing greater value for money in healthcare is crucial.
It says that pay-for-performance, in which GPs, hospitals and other providers are paid based on their achievement of defined quality and efficiency targets, is seen as a possible way to increase efficiency and value for money. It argues that pay-for-performance schemes are being increasingly adopted internationally and that the current programme for government includes commitments to reform the way in which GPs and staff in public hospitals are paid.
However, the authors maintain that many of the pay-for-performance schemes currently in place have not yet been properly evaluated, particularly in terms of their cost-effectiveness.
They argue that even where appropriate evaluation has been conducted, there is no clear evidence that pay-for-performance has improved quality and efficiency in healthcare.