Dr. Maev-Ann Wren:

The Chairman's first question was about the costing of Sláintecare. The development of the model came from previous work the ESRI did which was costing a previous proposal for universal health insurance based on the 2014 White Paper. When we developed the model, we did it very much with a view to being able to cost future such reform proposals. Having said that, we still have to develop the expenditure phase. The committee is very conscious of time and delay but realistically it will be at least another year before we have the expenditure phase fully developed. It will probably be somewhat longer than that but then the ESRI should be very well placed to cost reforms like Sláintecare. Based on our earlier work looking at the cost of universal health insurance, we have some forthcoming work looking at the cost of free GP care alone on various assumptions. It is possible with the data and knowledge available to us to look at discrete components of the reform in that way. What the Chairman said about visiting rates and their pertinence to cost is very much on point. We based the work we did recently on the Healthy Ireland survey, which uses four-week recall and includes phone consultations and separately records practice nurse visits. We feel we have a much better base now so in our recent costing, we looked at both the 12-month recall and four-week recall periods for GP visiting.