Mary Harney (Dublin Mid West, Independent)

The current legislation governing eligibility for health and personal social services has been in place since 1970. The 1970 Health Act contains the now outdated concept of undue hardship as the basis for providing full eligibility for people who cannot arrange health care for themselves. It is time to move to more modern concepts for the basis of public health care such as'financial, medical or social need.

Since 1970 there have been many developments in services with a growing emphasis on the delivery of care in community health rather than institutional settings. For example, both in respect of public and privately funded services, the area of chronic disease management in the community is being given a higher profile than before. To support this change, and better care for all patients, we must develop both the eligibility rules for public benefits and the minimum benefits regulations for health insurance. Both of these, together, should be aligned towards the objective of better primary care and much better and more cost effective chronic disease management.

It is important that people have clarity about what they can expect in public benefits and from health insurance policies, and that both these support best health care and outcomes for everyone. The review of eligibility therefore dovetails with the development of minimum benefits for private health insurance. Work in this area is at an advanced stage and I hope to bring proposals to the Government as soon as possible in the coming months.

See this speech in context