Enda Kenny (Mayo, Fine Gael) | Oireachtas source

Universal health insurance will not be introduced in the lifetime of this Government. On taking office, the Minister for Health reflected very carefully on the timeframes set out for health reform. He pointed out last July that he determined that while good progress had been made in implementing health reform, the original timeframe for full implementation of universal health insurance was too ambitious. He pointed out that notwithstanding this, the Government remains committed to its major programme of health reform and plans to continue to press ahead with those main foundations for universal health care. This include the phased extension of GP care without fees; implementing a number of key financial reforms, including activity-based funding; the establishment of hospital groups; and improved chronic care management. Hospital groups, primary care centres and the GP card system for children aged under six and people aged over 70 are part of the foundation necessary for universal health insurance in addition to the requirement for people to take out private health insurance based on age limits. This is all under way. The Government recently allocated €75 million for home care packages and the fair deal scheme in order to reduce the waiting list from 18 weeks to approximately five weeks. This seems to be working well. Obviously, we hope this is managed in the best interests of the patients.

The integrated care agency is part of the Government's commitment to reform of the health service. Future Health referred to the agency as the health care commissioning agency and this agency will be charged with driving performance improvement in health services through value-based purchasing. The Minister is reviewing how best to develop the structure that is required to replace the HSE - I know Deputy Martin's party now has a different view - including the question of a health care commissioning agency. Future Health set the broad direction of travel for reforming the health system and made it clear that an incremental, phased approach to implementation was taking place. This is just one of number of structural changes envisaged under Future Health. Others include hospital groups, community health care organisations, a health care pricing office and the commencement of activity-based funding. The Minister intends to build on these as part of the wider structural reform agenda. However, the complexity and scale of the issues to be addressed require detailed preparatory policy work to provide the basis for legislative proposals. The next incremental step in that process will be to develop policy on a health care commissioning model in an Irish context.

In respect of the review of home care, the HSE is progressing a range of measures to improve the position overall. Providers are monitored through service-level agreements with the HSE. They are supervised through local and regular operational meetings and the review of care plans for individual patients. The HSE is undertaking a full review of home care services with a view to improving services generally. This includes national quality guidelines, which will apply to all home support services, including those procured by the HSE from external providers.

If I have left anything out, I will respond to Deputy Martin.

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