Irish patients spend longer waiting for emergency treatment in hospital than any others in Europe, according to a new report.

Ease of access to the Irish healthcare system is the worst of the 36 countries surveyed, with longer waiting times for minor operations and CT scans, the report found.

Overall, the Irish system ranks 21st in the 2016 Euro Health Consumer Index, the same as in the previous year. The index is led by the Netherlands and Switzerland, and those ranked above Ireland include lower-income countries such as Macedonia, Croatia and Slovenia.

The report analyses the performance of national healthcare systems across 48 indicators, including patient rights, access to care, treatment outcomes, range of services and use of pharmaceuticals.

Compiled by the private Swedish firm Health Consumer Powerhouse, it relies on a combination of statistics, patient polls and research.

Ireland scores particularly badly on access to health services, based on feedback provided by patient organisations. Waiting times are found to be “frequently more than three hours” more often here than anywhere else in Europe.

The Irish health service is also fifth-worst – after Greece, Romania, Bulgaria and Hungary – on a composite “bang for your buck” measure included in the report.

Target

The report notes that after its 2015 edition was published, the Irish Department of Health and the Health Service Executive set a target of no patient having to wait longer than 18 months for a specialist appointment.

“Even if and when that target is reached, it will still be the worst waiting time situation in Europe,” it says. “The fact that Ireland has the highest percentage of population purchasing duplicate healthcare insurance – over 40 per cent, down from 52 per cent three years ago – also presents a problem. Should this be regarded as an extreme case of dissatisfaction with the public system, or simply as a technical solution for progressive taxation?”

The report praises the “very dedicated effort” in the Irish health service to cut rates of antibiotic-resistant infections. This had led to a “real improvement” in rates from 40-45 per cent in 2008 to less than 20 per cent now.

Ireland ranks second-worst for respiratory cases but is praised for its tobacco control measures and for access to new medicines.

The report says Ireland is one of four countries where free abortion rights do not exist, though it acknowledges new legislation allows for abortion “in extreme circumstances and subject to external verdict”.

“It has been well known for centuries that stigmatising or banning abortion results in tragedies such as the female dentist [Savita Halappanavar], who died in a Galway hospital because doctors did not dare/want to perform an abortion on her [already dying] foetus.”