Wait times here for A&E are the worst in Europe
Ireland's healthcare system last year ranked below that of lower-income countries Macedonia and Slovenia - despite a big increase in spending.
Ireland ranks 21st out of 35 countries and our hospital waiting lists continue to be among the worst in Europe, according to the Euro Health Consumer Index.
The top countries, based on a comparison of key areas, are the Netherlands, Switzerland, Norway, Belgium and Iceland.
A&E waiting times in Ireland are again the worst in Europe, followed by Poland, Greece and the UK, the report, published today, reveals.
The report expressed surprise at the low ambitions of the HSE and referred to the "target of no more than 18 months' (!) wait for a specialist appointment".
It warned that "even and if and when that target is reached, it will still be the worst waiting-time situation in Europe".
Hospital waiting lists climbed to record levels last year, with more than 530,000 waiting, and will increase again this month due to the trolley crisis.
The report also casts doubt on the validity of official HSE statistics and said "as a matter of principle" it uses patient organisation feedback to score Ireland on accessibility.
There is also a poor score when it comes to cost efficiency, as Ireland's healthcare system is the fifth worst country when it comes to "bang for buck".
Only Greece, Hungary, Bulgaria and Romania emerge with worse rankings for value for money.
Ireland's per-capita spend on drugs is also still among the highest in Europe - ranking in eighth place behind countries like Switzerland, France and Sweden. And when it comes to cancer survival rates, the Europe-wide comparison, which refers to 2012, showed Ireland again in eighth place.
Ireland is mid-way in the league table for infant mortality but is one of the countries which has seen a big reduction in rates of the superbug MRSA.
The report notes: "Ireland no longer has a total ban on abortion...The requirement that a woman wishing an abortion becomes subject to judgment on if the pregnancy should be regarded as a serious health hazard, including suicide risk, is a very minor step indeed towards abortion as a women's right."
The report said European healthcare is steadily improving: infant mortality as well as survival rates of heart disease, stroke and cancer are all moving in the right direction.