Sir, – One expects more from a health system than merely keeping one alive. Relative mortality rates are very far indeed from adequate indicators of the merits of different systems. But if Brian O'Brien (Letters, April 8th and 12th) wants to draw any conclusion from the relative life expectancies of Northern Ireland and the Republic of Ireland, he needs to be more precise.
Demographers use “period life expectancy” to provide a snapshot of mortality rates at a point in time, which enables a comparison of how the number of deaths this cohort would experience at different ages in each of the jurisdictions on the assumption that mortality rates remained unchanged. The most recent CSO life tables are for 2015-17, and these can be compared with their Northern Irish equivalent.
In 2016, there were 32,709 male and 31,132 female births in the Republic; 109 boys would die in their first year of life using the Republic’s mortality rates, compared with 150 using the Northern Ireland rate. For girls, the numbers are 95 and 135 respectively.
By any historical or international standards this represents a very low rate of infant mortality, but perhaps hints at slightly superior neonatal treatment in the Republic. At the hypothetical cohort ages, its size falls slightly more slowly using the Republic’s mortality than that for Northern Ireland. By age 65, the difference is 974 males and 626 females, which is very small compared with the actual 2016 population aged 65 – 21,813 males and 21,716 females.
At older ages the difference begins to shrink – at age 75 for males and 79 for females. By age 90, the hypothetical cohort size is very slightly larger for males at Northern Ireland mortality rates than at Republic of Ireland rates (6,297 compared with 6,265), though it remains smaller for females (9,454 compared with 9,884).
Since elderly mortality rates are more likely to be affected by the quality of medical care than at younger ages, it might be argued that this shows the superior quality of Northern care.
But the differences are very small.
Comparison between the systems should depend on relative waiting times for elective surgery, opportunities for rehabilitative non-hospital care, fees for services, and the costs of administering the system, including the amounts spent by health insurance companies. – Yours, etc,
TIMOTHY KING,
Killiney,
Co Dublin.