Seanad debates

Tuesday, 23 June 2015

Commencement Matters

Universal Health Insurance

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

The Government is committed to a major reform programme for the health service, the aim of which is to deliver a single tier health service where access is based on need, not ability to pay. This is the most fundamental reform of the health service since the foundation of the State and it is imperative that we get it right. The White Paper on universal health insurance was published on 2 April 2014 and provides detailed information on the model of universal health care for Ireland. Under the White Paper model, everyone will be insured for a standard package of health services and have his or her choice of health insurer from a mix of private health insurers and a publicly owned health insurer.

A major costing exercise, involving my Department, the ESRI and others, is ongoing. The purpose of the exercise is to examine the cost implications of a change to a multi-payer, universal health insurance model as proposed in the White Paper. Draft results from the initial costing exercise were presented to me at the end of May and are now informing deliberations on the next steps, including the necessity for further research and cost modelling. Ultimately, this is a major 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 using bottom-up costing techniques. The draft results from the initial phase, as well as the plans for the next phase of research, will now inform discussions with the Taoiseach and the Cabinet sub-committee on health on the best long-term approach to achieving universal health care and on the development of a roadmap for health care reform.

The Senator also asked about timeframes for the introduction of universal health care. When I became Minister for Health, I reviewed progress to date and concluded that it would not be possible to introduce a full UHI system by 2019, as envisaged in the White Paper. However, I remain steadfastly committed to implementing important reforms as set out in the programme for Government and I am pushing ahead with key building blocks for universal health care as quickly as possible, including the phased extension of GP care without fees; implementation of key financial reforms, including activity-based funding; the establishment of hospital groups on a statutory footing; and measures to make health insurance more affordable. Just this month we have seen significant progress with the extension of free GP care to children under six years of age. Starting on 1 July, over 400,000 children under six years will benefit from a new enhanced service under the new under-six GP contract. This will involve health checks focused on well being and the prevention of disease. The contract also covers an agreed cycle of care for children diagnosed with asthma.

In parallel, during August GP care without fees will be extended to all people aged 70 years and over. This service will benefit about 36,000 people and be provided under the existing GMS contract. Talks with GPs on the new contract to replace the existing core contract will begin shortly. The provision of universal GP access through greater public investment in primary care services is a critical reform in resolving inequities and rebalancing our services towards earlier prevention. The introduction of universal GP access for the youngest and oldest members of our community, those who need to see their GP most often, is an important step in the phased implementation of these reforms.


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