Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 204: To ask the Minister for Health in view of the complex and long-term programme of health reform, the steps he will take to ensure that cost does not continue to act as a barrier to care, particularly for that significant proportion of the population covered by neither medical or general practitioner visit card nor private insurance; and if he will make a statement on the matter. [24517/12]

James Reilly (Dublin North, Fine Gael)
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The Government is committed to fundamental reform of the health care system with the objective of delivering a single tier health system, supported by universal health insurance, where access is based on need, not income. Every citizen will have a choice of insurer and will have equal access to a comprehensive range of curative services. A new Insurance Fund will subsidise or pay insurance premiums for those who qualify for a subsidy.

There are a number of key stepping stones that will play a critical role in paving the way for the introduction of universal health insurance and significant work has already been undertaken to progress these. They include (i) the strengthening of the primary care sector with removal of cost as a barrier to access and (ii) reform of the acute hospital sector, including the work of the Special Delivery Unit in relation to unblocking access to acute services, the establishment of hospital groups and the introduction of the more transparent and efficient "money follows the patient" funding mechanism for acute hospitals. Once the key building blocks have been put in place, the health system will be ready for universal health insurance.

The reform programme is a complex and major undertaking that requires careful planning and sequencing. Detailed consideration must be given to the optimal structures for delivery of different services and to the critical inter-relationships between services as well as best practice in health care reform. Ongoing work on proposed new governance and administrative arrangements for the HSE represents an important first step in the process of delivering the reform agenda contained in the Programme for Government. The next steps, which will include measures to facilitate clearer and better integrated delivery and funding arrangements, are under consideration at present.