James Reilly (Dublin North, Fine Gael) | Oireachtas source

It is not fair and I am committed to addressing it by charging a realistic amount for this service.

The recently published money follows the patient policy paper proposes the introduction of a new model of funding for public hospital care.

It involves changing from the current inefficient system of block grant budgets to a new approach where hospitals are paid for the actual level of activity they undertake. This will be facilitated through the introduction of a prospective case-based payment system using diagnosis related groups. The changes will effectively mean that hospitals will be funded on the basis of the quantity and quality of the services they deliver to patients and not the size of last year's budget. This move is in line with the recommendations of a value for money and policy review which previously examined this issue. It means if there are no patients, there will be no payment.

With regard to the national clinical programmes, it is in the interests of all patients, public and private, that effective clinical pathways are in place throughout the health system. National clinical guidelines will help to improve further the quality, safety and cost effectiveness of health care throughout Ireland. In the public health system, the HSE continues to work on national clinical programmes to improve and standardise patient care throughout the system. The stroke programme has saved one life a week since its introduction and pre-empted the necessity for three patients a week to go into long-term care. We also have a new early warning score card which will make a huge difference throughout the system. We are the first country to put it in place nationally. It will mean doctors and nurses in Tralee will operate on the same value set as doctors and nurses in Letterkenny, Beaumont Hospital or St. James's Hospital.

As I stated earlier, the Government is embarking on a major reform programme for the health system, the aim of which is to deliver a single-tier health service, supported by universal health insurance where access is based on need, not on income. I have already outlined the number of important stepping stones which are under way to pave the way for the introduction of universal health insurance.

Contrary to the claims made by the Opposition, I believe we are taking the right steps to achieve a sustainable and robust private health insurance market. The risk equalisation legislation is a key element of this. Taken with the actions on addressing costs in the market, I am determined to ensure that private health insurance remains affordable. My concern is to ensure the private health insurance market is ready to form a key building block for universal health insurance. In the meantime, the Government will work intensively to ensure a well-functioning insurance system for our people. I urge insurers to take all appropriate means to address their costs and to keep premium rises to the absolute minimum. There is much room for improvement.

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