Table 1 Key healthcare system differences
Northern IrelandRepublic of Ireland
Publicly funded (NHS)Mixed public/private funding
No charges for access to primary or hospital carePrimary healthcare free through the General Medical Services (GMS) scheme only to those judged less able to pay or aged over 70 years (32% of population registered in 2005)*
Individuals are registered for primary care in a specified general practice; practices are computerised, working within NHS GP contract with financial incentives for creating disease registers and monitoring quality of care; as regards care for patients with CHD, practitioners receive payments for performance relating to achievement of targets for recording and managing BP, cholesterol, smoking and prescription of aspirin, β blockers and ACE inhibitors.Individuals may access primary healthcare from more than one general practice; registration with a practice only required if in GMS scheme; limited use of computers in practice, few disease registers; no specific financial incentives for operating recall system to monitor patients’ care
Access to specialist care is through primary care except in emergencyAccess to specialist care is through primary care except in emergency, but enhanced access is available for higher income group
Prescriptions free to those who meet certain criteria, such as low income; nominal charge to othersFree prescriptions only available within GMS scheme; others pay full costs of medicines up to monthly limit of €90 per family