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

The Government is committed to a major programme of reform for the health service, the aim of which is to deliver a single-tier health service where access is based on need and not income. The White Paper on universal health insurance was published on 2 April 2014. Following its publication, a major costing exercise involving the Department of Health, the ESRI and others was initiated to examine the cost implications of a change to a multi-payer, universal health insurance, UHI, model, as proposed in the White Paper. Draft results from the initial phase of the costing exercise were presented to me at the end of May. These draft results are now informing deliberations on next steps, including the necessity for further research and cost modelling.

Ultimately, the UHI costing exercise is a major research project with a number of phases. The next phases in the costing exercise are likely to include deeper analysis of the key issue of unmet need and a more detailed comparative analysis of the relative costs and benefits of alternative funding models.

This will inform Government discussions on the best long-term approach to achieving universal health care. It is important that universal access does not result in shared but longer waiting lists for all, but instead results in more health care needs being met in a timely manner. For this reason additional analysis of unmet need and capacity is important as we implement changes on a phased basis.

Finally, I have already indicated that it will not be possible to introduce a full universal health insurance system by 2019, as envisaged in the White Paper. However, I emphasise my commitment to universal health care and to implementing key health reforms, as set out in the programme for Government and the White Paper. In particular, I have pushed ahead with critical building blocks for universal health care, including the phased extension of universal general practitioner care without fees, improved management of chronic disease in the community, implementation of financial reforms, including activity-based funding, and the establishment of the hospital groups. We have recently seen significant progress in the extension of GP care without fees to children under six years of age and we are also seeing the phased expansion of free GP care to all those aged 70 years and above from August. The introduction of universal GP access for the youngest and oldest in our society is an important step on the path to universal health care.

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