Ireland

Original Editor -Michael Adams created the original content for this page.

Top Contributors - Didzis Rozenbergs, Elaine Lonnemann and Michael Adams    


Patient Access to Physiotherapy or Physical Therapy Services / Entry Point

In general, if you wish to access physiotherapy services as a public patient, you need a referral from your family doctor (GP), public health nurse or hospital. You can also refer yourself to a community physiotherapist.

You will have to pay for physiotherapy services if you attend a physiotherapist in a private capacity however, you may be able to claim tax relief for medical expenses incurred by you whether you, your spouse, your dependent child or a dependent relative attend a physiotherapist privately.[1]

There is direct access to physiotherapy in Ireland. The physiotherapy services are determined by the profession and the physiotherapist determines the clinical intervention of physiotherapy him/herself. Physiotherapy is available both public and private physiotherapy centres.[2]

In the Republic of Ireland the titles of physiotherapist and physical therapist cannot be used interchangeably because a group calling themselves ‘physical therapists’ are not physical therapists/physiotherapists as defined by WCPT. These physical therapists are not eligible for membership of the Irish Society of Chartered Physiotherapists and are not permitted to work in the National Public Health Service in the Republic of Ireland.[3]

Therapist Preparation

      Degree/Credentialing

Education matters are the responsibility of the Irish Society's Standing committee of Education Committee and specialist working parties all of whom report to the Council of the Irish Society which is the decision making body. Additionally it has an Accreditation committee which evaluates the educational programmes and ensures that they meet the standards set by the Irish Society of Chartered Physiotherapists. Physiotherapy education in Ireland is a four-year honours degree course. All graduates have access to Masters Degrees and Doctorates.[2] 

Also contact the Schools of Physiotherapy for their student information booklet which gives full details of entry requirements:


University College Dublin
School of Physiotherapy
Bachelor of Physiotherapy
National University of Ireland
Admissions Office, Belfield, Dublin 4
Phone: (01) 269 3244 Fax: (01) 269 4409
http://www.ucd.ie/


Trinity College Dublin
School of Physiotherapy
B.Sc. (Hons) Physiotherapy
Admissions Office, Trinity College, Dublin 2
Phone (01) 608 1532
http://www.tcd.ie/


Royal College of Surgeons in Ireland
Department of Physiotherapy
B.Sc. (Physiotherapy)
Admissions Office, RCSI, St Stephen's Green, Dublin 2
Phone (01) 402 2156
http://www.rcsi.ie/


University of Limerick
Department of Physiotherapy
School of Health Sciences
College of Science
University of Limerick, Limerick
Phone (061) 234232
http://www.physiotherapy.ul.ie/ 

[4]

      Specialization

Physiotherapists can gain advanced knowledge by applying to special training organized by ISCP (The Irish Society of Chartered Physiotherapists) or by applying to Postgraduate Diploma training organized by universitie.[5][6]

Professional Associations

ISCP logo.jpg


The Irish Society of Chartered Physiotherapists is the professional body representing over 3000 members in Ireland. The Society was founded in 1983 following a number of developments in the profession including the establishment of a university degree qualification. Over the years there has been an increasing public demand for the services of the Chartered Physiotherapist and it is the role of the Society to ensure that this demand is met by the highest standards of care.[7]

ISCP

Information about the Patient Community

Total population: 4515000. 

Life expectancy at birth m/f (years): 77/82
Probability of dying between 15 and 60 years m/f (per 1 000 population): 97/57
Total expenditure on health per capita (Intl $, 2009): 4,005 [8]

Infant mortality rate (probability of dying between birth and age 1 per 1000 live births): 3

Under-five mortality rate (probability of dying by age 5 per 1000 live births): 4

Deaths due to tuberculosis among HIV-negative people (per 100 000 population): 0.49 [0.43-0.58] [9]

SDR all causes, all ages, per 100000 - 591
SDR, diseases of circulatory system, all ages per 100000 - 192
SDR, external cause injury and poison, all ages per 100000 - 41
SDR, malignant neoplasms, all ages per 100000 - 182 [10]

Social/Cultural Influences

Significant differences in death rates between social classes were highlighted in the Institute of Public Health’s Inequalities in Mortality report. Overall the findings showed that between 1989 and 1998:

  • The death rate for all causes in the lowest occupational class was 100 to 200% higher than the rate in the highest occupational class.
  • Differences in mortality rates were even greater for some causes of death.

When it comes to health and illness, significant inequalities between socio-economic groups were revealed in an Institute of Public Health all-Ireland report on social capital and perceived health which found that:

  • People with no formal education qualifications were half as likely as those with third-level education to say they had excellent or very good health.
  • Those who were unemployed were a third less likely than those in employment to have a high general mental health score.
  • People with the lowest incomes were half as likely as those with the highest incomes to be very satisfied with their health or to have a very good quality of life.

More recently marked social gradients in self-rated health across the island were documented in a large survey of patients of general practices on the island of Ireland. This study found that household income levels were strongly linked to health with similar steep gradients in both Ireland and Northern Ireland.

In addition to worrying differences in death rates highlighted by the all-Ireland mortality report, recent analyses of the EU Survey on Income and Living Conditions in Ireland revealed significant inequalities in health and illness between socio-economic groups in 2004:

  • 85% of those who were ‘non-poor’ reported good or very good health, whereas this was true of only 66% of those experiencing income poverty.
  • Almost half (47%) of those who were consistently poor (i.e. in income poverty and experiencing deprivation) and 38% of those who were income poor reported having a chronic illness, compared with 23% of the general population.
  • 11% of men in the highest income decile had a chronic illness. This rose to 20% for those in the middle of the income range, and to 42% for those in the second lowest decile.

The health of some socially excluded groups is even more severely affected. Travellers in Ireland live on average 10 to 12 years less than the general population. Homeless people are vulnerable to ill health and premature death. In 2006 for instance, 55 homeless people who had been in contact with Simon Communities services died prematurely.[1]

Delivery of Care

There are a high number of doctors per head of population in Ireland. GP’s are responsible for general health, prescribing drugs, treating serious illnesses, and providing preventive healthcare and health education and you cannot attend an Irish hospital without a referral from your doctor, unless your case is an emergency. Medical cardholders are sent a list of ‘approved’ doctors and can register with any doctor on the list. If you are treated by anyone other than an ‘approved’ state funded doctor, you will have to pay the fees yourself. To register with a doctor, you make a contract between the two of you. You can change to a different doctor, but beware of the reason you give for your change, as many Irish doctors are reluctant to take on patients who have had a disagreement with their previous doctor.

Most of the doctors in the country operate from a single or two-man practice. If you register with a doctor in a group practice, you can be treated by one of the other doctors in the practice, when your own doctor is absent.

There are not many state hospitals in Ireland, but they do contain the latest technology and staff are highly qualified.

There are four classes of hospital; the general hospital located in major towns provides in and outpatient care and emergency treatment. Areas that are more rural are served by district or regional hospitals, which offer maternity care and general care but they do not have emergency facilities; district hospitals offer less facilities than regional hospitals. Specialist hospitals are mostly based around the capital, Dublin and specialise in certain kinds of illness or disease.

You may specify the hospital at which you wish to be treated, but there is no guarantee that your choice will be met.

Hospital accommodation consists of wards containing six beds. Some of the wards are mixed sex wards. There are also private and semi private rooms available containing up to four beds, but these are usually reserved for intensive cases or patients who are prepared to pay.
Ireland has several small walk-in medi-centres, where you can receive treatment regardless of whether you are registered or not and you do not need an appointment. Most towns and cities have ‘after-hours clinics’ which operate outside of normal surgery hours and deal with minor complaints.
Emergency wards are located in all main hospitals and are open 24 hours a day. There may be a charge for ambulance transportation.[2]

Type of Health System

Healthcare in Ireland is free and you do not need to contribute to the Irish social security system to receive treatment. Indigenous citizens qualify by birth. Citizens from the European Economic Area (EEA), which consists of all EU member states and Norway, Liechtenstein and Iceland, qualify because Ireland has a reciprocal health agreement with all EEA member states. Foreigners from outside of the EEA must be able to show that they qualify for ordinary residence and will remain resident in the country for at least a year by producing an residence or work permit, proof of property ownership or a valid rental agreement, or in the case of students, proof of college registration. All foreigners from outside of the EU must also show evidence of an Irish bank. If you qualify for ordinary residence, your dependant family members must also qualify in order to receive free healthcare. Citizens do not fall into the above group will have to pay for all medical treatment, although emergency treatment may be given free depending on necessity.[2]

Payment System

The insurance cover for physiotherapy is paid both through the national health care system and privately the patient.[2]

In the public service treatment is free following referral from a consultant or a GP. You will have to go on a waiting list.

There is no standard fee in private practice due to competition authority. For example, fees can be dictated by:

  • the location of practice;
  • whether it is an initial or follow-up visit;
  • the duration of treatment;
  • the prescription and supply of specialist materials e.g. orthotics (customised insoles used in the treatment of biomechanical malalignment).[4]

Ireland has two recognised private health insurers, the Voluntary Health Insurance known as VHI (www.vhi.ie) and BUPA (www.bupaireland.ie). If you have private health insurance from your home country, it may be transferable to one of the recognised Irish insurers without penalty. VHI and BUPA premiums are gauged according to a community rating. All members contribute the same amount and premiums do not rise with age. Therefore young people over the age of 21 (with VHI) and 18 (with BUPA) pay more than they would if they subscribed to a risk based system.

Private health patients can choose the hospital of their choice, depending on the level of their insurance cover.[2]

Resources

WCPT Country Profile for Ireland

References

  1. 1.0 1.1 http://www.citizensinformation.ie/en/health/care_in_your_community/physiotherapy_services.html
  2. 2.0 2.1 2.2 2.3 2.4 2.5 http://www.physio-europe.org/index.php?action=15&subaction=details&member=30
  3. http://www.wcpt.org/node/30236
  4. 4.0 4.1 http://www.iscp.ie/about-us/faq.html
  5. http://www.iscp.ie/news/41-upcoming-events/361-find-a-physio.html
  6. http://www.iscp.ie/news/36-upcoming-events/340-find-a-physio.html
  7. http://www.iscp.ie/about-us.html
  8. http://www.who.int/countries/irl/en/
  9. http://apps.who.int/ghodata/?vid=10800&theme=country
  10. http://www.euro.who.int/en/where-we-work/member-states/ireland/selected-basic-statistics