Health care in Ireland is delivered through public and private healthcare. The public health care system is governed by the Health Act 2004, which established a new body to be responsible for providing health and personal social services to everyone living in Ireland – the Health Service Executive. The new national health service came into being officially on 1 January 2005; however the new structures are currently in the process of being established as the reform programme continues. In addition to the public-sector, there is also a large private healthcare market. In 2019 Ireland spent €3,513 per capita on health, close to the European Union average, of this spending approximately 79% was government expenditure. In 2017 spending was the seventh highest in the OECD: $5,500 per head. Overcrowding has been an issue at hospitals in Ireland, with over 118,000 patients having to wait for a bed in 2019. Healthcare system All persons resident in Ireland are entitled to receive health care through the public health care system, which is managed by the Health Service Executive and funded by general taxation and subsidised fees for service. All maternity services and child care up to the age of six years are provided free of charge. Emergency care is provided at a cost of €100 for a visit to an Emergency Department (ED), if one has not attended a GP first. The Medical Card – which entitles holders to free hospital care, GP visits, dental services, optical services, aural services, prescription drugs and medical appliances – is available to those receiving welfare payments, low earners, many retirees, and in certain other cases. The only medical conditions carrying automatic entitlement to a card are having thalidomide syndrome, having a surgical symphysiotomy, and children with cancer. Many political parties support extending the availability of the Medical Card to eventually cover every resident in Ireland – they currently cover 31.9% of the population. Those on slightly higher incomes are eligible for a 'GP Visit Card' which entitles the holder to free general practitioner visits. Persons over 70 years who are not entitled to a medical GP visit card can instead receive an annual cash grant of €400 up to a certain income. People who are not entitled to a Medical Card (i.e. 68.1% of the population) must pay fees for certain health care services. There is a €100 charge for those who attend an emergency department