Billy Kelleher (Cork North Central, Fianna Fail)
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70. To ask the Minister for Health why two fundamental health commitments in the 2011 programme for Government, namely the undertakings on universal health insurance and the introduction of free general practitioner care for the entire population, were not met; and if he will make a statement on the matter. [3926/16]

Leo Varadkar (Dublin West, Fine Gael)
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The Government has embarked upon a major multi annual programme of health reform, the aim of which is to deliver universal healthcare, where all people can access the health services they need, 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 the 18 November 2015. Having considered the findings, I concluded that the high costs associated with the White Paper model of UHI are not acceptable and decided that further research and cost modelling in relation to the best means to achieve universal healthcare are 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 in deciding on the best long-term approach to achieving the goal of universal healthcare.

I should add that when I assumed the Office of Minister for Health, I concluded that, whilst progress had and was being made in relation to the programme of health reform, the original timeline for implementation of UHI was too ambitious. However, I also emphasised both my commitment to progressing health reform and my determination to push ahead with four key building blocks: Healthy Ireland and the public health agenda, building sufficient capacity to satisfy unmet demand, the expansion and development of primary and social care and reforming structures, ICT and financial systems with key initiatives such as the phased extension of GP care without fees, the establishment of Hospital Groups and Community Healthcare Organisations, the implementation of activity-based funding and the improved management of chronic diseases. These are all major milestones on the road to universal healthcare and have the potential to drive performance improvement and deliver significant benefits in terms of timely access to high quality care.

Already GP care without fees has been successfully introduced for children under the age of 6 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, without having to undergo a means test. The under 6s service includes age-based preventive checks focused on health and wellbeing and the prevention of disease, including the asthma and diabetes of care.

In Budget 2016, the Government made financial provision for the extension of GP care without fees to all children aged 6 to 11 years. It is envisaged that this third phase will bring the total number of those eligible for universal GP care, without having 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.