Evidence from the European Social Survey conducted in 2016 shows that, compared to other European countries, Irish respondents show relatively high levels of satisfaction with the education system but relatively low levels of satisfaction with health care. The public evaluation of the Irish health service is negatively viewed across all income groups. However, satisfaction levels with both education and health services are higher for respondents who respond that they are ‘living comfortably on present income’ compared to those who are ‘finding it difficult on present income’.
European Social Survey: Level of Satisfaction with the state of education and health care services
The European Social Survey is a cross-national survey that has been administered across Europe since 2002. Face-to-face interviews with people aged 15 or over are conducted every two years, investigating the public’s attitudes and values on a wide range of topics, including satisfaction with public policies and services. Measuring public satisfaction is important because members of the public are beneficiaries and actors in health and education systems and their feedback bring legitimacy and accountability in the policymaking process. Moreover, assessing levels of public satisfaction can be a useful input in evaluating the quality of services and responsiveness of policies in meeting the needs of the population.
Table 1 outlines two specific questions included in the European Social Survey relating to levels of satisfaction in health and education services in Ireland. Participants were asked to rate their levels of satisfaction on a range of 0 to 10, with 0 signifying ‘Extremely Bad’ and 10 ‘Extremely Good’.
Table 1: European Social Survey – State of health and education in Ireland
Source: European Social Survey (2018)
European Levels of Public Satisfaction in Education and Health
Figure 1 shows the mean values of satisfaction in education and health care for ESS participating countries. In 2016, the seven countries with the highest mean values of satisfaction in education included Finland (7.8); Norway (7.2); Switzerland (7.1); Estonia (6.6); Belgium (6.5); the Netherlands (6.5) and Ireland (6.5). Spain had the lowest mean value of satisfaction in education at 4.6 in 2016.
In terms of health care, Belgium had the highest mean value of satisfaction at 7.4 and was followed by Switzerland (7.2); Finland (7.2); Austria (7.2); and Norway (7.1). Ireland had the third lowest mean level of satisfaction in health at 4 in 2016.
Figure 1: Mean levels of satisfaction with education and health services – ESS participating countries, 2016
Source: ESS (2018)
From this sample of ESS participating countries, Ireland presents as having the largest gap in the levels of satisfaction between education and health care services, with better evaluations of the education system and worse views of health care services. This data suggests that the education system in Ireland is performing better in terms of access, the quality of services provided and responsiveness to meeting the needs of the population. While there are many explanations for this difference between these two policy areas, studies suggest that levels of public satisfaction with health care systems is considerably reduced when people encounter financial barriers to accessing services (i.e. health insurance and co-payment costs).
Figure 2 shows mean value of satisfaction levels relating to education and health care services between the years 2002-2016. Public satisfaction with health care services has remained consistently poor with a mean value of around 4 throughout the period. While the level of satisfaction with education services has varied during these years, it has been consistently higher compared to health: with a mean value of 6.5 in 2016.
Figure 2: Mean levels of satisfaction with health and education services in Ireland, 2002-2016
Source: ESS (2018)
Figure 3 compares the level of satisfaction in education and health care services between the United Kingdom and Ireland. The red line represents the mid-point on the scale. Here we also examine how satisfaction levels vary according to respondents’ subjective assessments of their household incomes. In the case of the UK, the mean values of satisfaction in health and education services are very close to each other and are above this red line, signifying that they are closer to the ‘Extremely Good’ point of the scale. The mean levels of satisfaction with education and health care services is higher for subjective income groups who are ‘living comfortably on present income’ at around the point 6 in this 11-point scale, compared to those who are finding it difficult on present income (point 5).
Figure 3: Comparison of satisfaction levels in Education and Health care services between United Kingdom and Ireland, 2016
Source: ESS (2018)
In the Irish case, the mean values of satisfaction across all subjective income groups are below the red line for health care, indicating that the state of the health service is perceived to be closer to the ‘Extremely bad’ point on the scale. Those respondents in Ireland who believe they are “Living comfortably on present income” are the least dissatisfied with the health care services: with a mean value of satisfaction of 4.4. However, the mean level of satisfaction for those who are finding it “very difficult on present income” is lower at just 3.4.
By contrast, the mean levels of satisfaction with education are above the mid-point, indicating that the average satisfaction for all groups is closer to the positive end of the scale – ‘Extremely good’. However, as with Health, levels of satisfaction are higher among respondents who are ‘living comfortably on present income’, compared to those who are ‘finding it difficult on present income’.
From this analysis of ESS data, it is evident that there is a significant gap in the public evaluation of education and health service delivery in Ireland across all subjective income groups. In 2016, the gaps in public levels of satisfaction between those ‘living comfortably’ and those finding it ‘very difficult on present income’ was considerably higher in Ireland when compared to the UK.
European Social Survey Cumulative File, ESS 1-8 (2018). Data file edition 1.0. NSD – Norwegian Centre for Research Data, Norway – Data Archive and distributor of ESS data for ESS ERIC. doi:10.21338/NSD-ESS-CUMULATIVE.