Alex White (Dublin South, Labour) | Oireachtas source

The Government is committed to introducing, on a phased basis, a universal GP service without fees within its first term of office, as set out in the programme for Government and the future health strategy framework. This policy constitutes a fundamental element in the Government’s health reform programme. This is the first Government in the history of this State to commit itself to implementing a universal GP service for the entire population.

It has become clear that the legal and administrative framework required to provide a robust basis for eligibility for a GP service based on having a particular medical condition is likely to be overly complex and bureaucratic. Relatively complex primary legislation would be required to provide a GP service to a person on the basis of him or her having a particular illness. The assessment system for such an approach would have to be robust, objective and auditable to have the confidence of this House as well as the general public. This legislation would have to address how a person could be certified as having such an illness, and who could do this, and how to select the diagnostic basis for medical conditions. There would also be a need for secondary legislation to give full effect to this approach for each condition. While it would not be impossible to achieve this, it would take several months more to finalise the primary legislation, followed then by the preparation of statutory instruments. This would entail putting in place a cumbersome legal and administrative infrastructure to deal with what is only a temporary first phase on the way to universal GP service to the entire population.

However, the Government is firmly committed to introducing a universal service within this term. The Cabinet committee on health has discussed the issues relating to the roll-out of the universal GP service. In doing so, it has considered the delay in the initial step and the importance of weighing the balance between, on the one hand, resolving the legal issues but with a further delay and, on the other, the need to bring forward an important programme for Government commitment with the minimum of further delay.

It has been agreed that a number of alternative options should be set out with regard to the phased implementation of a universal GP service without fees. The Minister and I have updated the Taoiseach on this matter and we expect to report back to the Cabinet committee in the near future. As part of this work, consideration is being given to the approaches, timing and financial implications of the phased implementation of this universal health service.

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