Thursday, 16 April 2015
Ceisteanna - Questions - Priority Questions
General Practitioner Services
1. To ask the Minister for Health his plans to implement his proposals for free general practitioner care for all children under six years of age; the projected annual cost of this plan; and if he will make a statement on the matter. [14852/15]
Will the Minister of State outline how she intends to implement the proposals for free general practitioner, GP, care for all children under the age of six and the projected annual cost of this plan?
I thank the Deputy for tabling this question. It is a significant announcement by the Government and in the future will be seen to be so. The announcement last week that agreement had been reached between the Department of Health, the Health Service Executive, HSE, and the Irish Medical Organisation on terms for the delivery of free GP care for all children aged under six years represents the first step in the phased introduction of a universal GP service without fees. This development underlines the Government's commitment to enhancing primary care and keeping people well in the community. It marks a shift towards promoting health and well-being and away from the old "illness model" of care.
The commencement of the service during the summer will make a real difference to the lives of the youngest in society. It is a major step forward in improving access, the quality and affordability of health care. Under the new arrangements, an additional 270,000 children under six years of age will benefit from GP care free at the point of service. All children under six years will benefit from the new enhanced service under the proposed GP contract. This will involve age-based health checks focused on well-being and the prevention of disease. These assessments will be carried out when a child is aged two years and again at age five, in accordance with an agreed protocol. The contract will also include an agreed cycle of care for children diagnosed with asthma. Under this cycle of care, GPs will carry out an annual review of each child diagnosed with asthma, not just the two health checks, as was said in the House last night.
It is estimated that in a full year the additional cost of the universal under-six service, including the preventive wellness checks and arrangements for the management of asthma in general practice, will be approximately €67 million. As the service is based on the “choice of doctor” principle, the next step is for the contract to be issued to GPs in order that they can decide whether to sign it. Contracts will be issued to doctors in the next few weeks.
The service should be ready to commence by early July. It will be preceded by a public information campaign and simple online arrangements for parents or guardians to register their children for the service. This registration can be completed by their GP in the surgery.
In the context of the announcement having taken place eventually and given that there is concrete evidence of some effort to roll out the commitments made in the programme for Government, will a Supplementary Estimate be required for this measure? If not, it could be interpreted that there has been a withdrawal of funding from other areas or that the funding will come from savings that have not yet been identified. Perhaps the Minister of State might clarify the matter. There appears to be an underspend in the mental health area, for example, and other key areas. If no Supplementary Estimate is required for this measure, is the funding coming from savings that have been identified but not yet published or from moneys that have not been spent?
I have said publicly that the money for the scheme will not be taken from other areas of the health service. In the budget for this year we estimated that it would cost approximately €37 million. The additional funding, for which we had to secure agreement from the Department of Public Expenditure and Reform, was signed off on by the Minister for Public Expenditure and Reform, Deputy Brendan Howlin. It will not be taken from any other budgetary area. We have not underspent in the area of mental health. Incidentally, we are still examining how we will spend the additional €35 million allocated for mental health services this year and have not yet made a decision on the matter. We are looking at different ways of providing services because clearly there is a blockage in delivering them. However, the funding for this scheme will not be taken from any other stream.
We need further elaboration on this issue. As the Minister of State said, only €37 million was identified as the figure that would be required to fund free access to GPs for children under six years of age. We now discover that the anticipated cost for the year will be approximately €67 million. Is the Minister of State hoping or envisaging that only some GPs will take up the contract in an effort to find savings in the scheme? Clearly, the money will have to be found somewhere because it was not identified in the original Estimates. There must either be a Supplementary Estimate, savings accruing in some other area or there will not be a full drawdown of the full €67 million identified as the cost of the scheme over a 12 month period.
If there is a need for a Supplementary Estimate towards the end of the year, there will be a Supplementary Estimate introduced. We are determined that not only will the scheme be taken up by everybody, to the advantage of every child in the country, but also that it will be funded in the way we have proposed. A Supplementary Estimate might be required towards the end of the year. At present, one is not required. However, the funding will not come from any other health area.