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

The Government has embarked on a multi-annual programme of health reform, the aim of which is to deliver universal health care, as defined by the World Health Organization, where everyone can access the health services they need, which are of sufficient quality to be effective, while ensuring that the use of these services does not expose them to financial hardship.

In April 2014, the White Paper on Universal Health Insurance was published. Following its publication, the Department of Health initiated a major costing project, involving the ESRI, the Health Insurance Authority and others to examine the cost implications of a change to the particular UHI model proposed in the White Paper. The reports detailing the estimated cost of this UHI model were published on 18 November 2015. Having considered the findings, I concluded that the high costs associated with the White Paper model of UHI are not affordable and that further research and cost modelling on the best means to achieve universal health care was needed.

The next phase of research will 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 work will be carried out under the auspices of the joint Department of Health-ESRI three-year research programme on health reform. Both the research undertaken to date and that planned in the next phase of the costing exercise will assist the next Government in its decisions on the best long-term approach to achieving the shared goal of universal health care.

I should add that when I assumed the office of Minister for Health, I concluded that while progress had and was being made on health reform, the original timeline for implementation of universal health insurance, UHI, was too ambitious. I also emphasised my commitment to progressing health reform and my determination to push ahead with four key building blocks, namely, the Healthy Ireland strategy and the public health agenda; building sufficient capacity to satisfy unmet demand; the expansion and development of primary and social care; and reforming structures, information and communications technology and financial systems with key initiatives, such as the phased extension of GP care without fees, the establishment of hospital groups and community health organisations, the implementation of activity-based funding and the improved management of chronic diseases. These all are major milestones on the road to universal health care and have the potential to drive performance improvement and deliver significant benefits in terms of timely access to high-quality care.

Additional information not given on the floor of the House

Already GP care without fees has been successfully introduced for children under the age of six years and all people aged 70 years and over. This has resulted in approximately 800,000 people now being eligible for GP care without fees and without being obliged to undergo a means test. The under-sixes service includes age-based preventive checks focused on health and well-being and the prevention of disease including asthma and diabetes. In budget 2016, the Government made financial provision for the extension of GP care without fees to all children aged six to 11 years. It is envisaged this third phase will bring the total number of those eligible for universal GP care without the obligation to be assessed by a means test to approximately 1.2 million people. The progress made in recent years in introducing universal health care, together with the improvement in public finances, provides a very good basis upon which to plan the next phase of improvement in our health services.

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