Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I am aware of the WHO report referred to by the Deputy. My Department provided information and observations on an early draft of that report. The report emphasises the need for reform of our health services and acknowledges that the Government is the first in the history of the State to commit to the principle of a universal, single tier health service which guarantees access to medical care based on need, not income. The first concrete manifestation of that will be seen this year by extending GP care without fees to the younger and older in our society. We remain committed to the goal of universal health care and to driving forward reforms in other areas such as extending GP care without fees to other groups, further widening discretion for medical card based on medical need as well as income, improving the management of chronic diseases, establishing activity-based funding, establishing hospital groups, and making health insurance more affordable. These initiatives are important reforms in their own right that will drive efficiencies and bring benefits in advance of moving to a system of universal health care. This Government's commitment to major reform is long overdue with the report noting that reform "was largely ignored in the pre-crisis period".

With regard to the potential cost of a competitive universal insurance system, my Department is working with the ESRI, the Health Insurance Authority and others on a major costing exercise. This exercise will examine the cost implications of a change to a multi-payer, universal health insurance model, as proposed in the White Paper on UHI. The analysis will include a review of evidence of the effects on health care spending of alternative systems of financing and changes in financing methods and entitlements. It will also estimate the cost of UHI for individuals, households, employers and the Exchequer. I expect to have the initial results from this exercise in April, following which I will revert to the Government with a roadmap on the next steps to UHI.

The work of the WHO and others points to the fact that there is no magic prescription for all countries when it comes to health service reform. At different points in their development, some health services may be charged with control of excessive costs while others - arguably including our own - will need to focus on responsive and equitable access.

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