Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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781. To ask the Minister for Health the estimated cost of providing universal free primary care, including GP care; and if she will make a statement on the matter. [35673/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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Over the last number of years, several pieces of detailed policy analysis have been undertaken to assess various aspects of expanding eligibility for near or full universal access to primary care and other care sectors and the associated additional costs for the Exchequer. These include the Expert Group Report on Resource Allocation and Financing of the Irish Health System (2010), the White Paper on Universal Health Insurance (2014) and associated costings, and the Committee on the Future of Healthcare Sláintecare Report (2018).

The Sláintecare vision for the future of health services in Ireland is of a universal health service for all commonly referred to as Universal Health Coverage (UHC). The World Health Organisation (WHO) defines Universal health coverage (UHC) as meaning that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation and palliative care.

It may not be possible for a health system to afford to pay for all available health care benefits for everyone, even under universal coverage aspirations. However, what is key to sustainable UHC implementation is that the health services people need are available to them as needed and that access is affordable.

Over the last 3 years, there has been a significant focus on improving access to, and the affordability of, healthcare services. Significant progress has been made in expanding eligibility and reducing the cost to patients. A range of affordability measures have been introduced such as a reduction in the monthly deductible for prescribed medicines, removal of public inpatient charges, a free contraceptive scheme and an expansion of free access to GP care via the GP Visit Card.

The Department recognises that, in order to achieve the goal of universal healthcare in line with the commitments made in Sláintecare, we must first review existing eligibility arrangements and see how they align with current population needs identifying gaps in the eligibility framework.

It is in this context that the Department has commenced a long-term project to review Ireland’s current eligibility policies, with a focus on services delivered at primary and community care level.

Regarding the provision of GP care without charges for all, please note that eligibility for a GP visit card for those aged between 8 and 69 years of age is primarily based on a qualifying financial threshold. All children under 8 years of age and persons aged 70 years and older, as well as persons in receipt of Carer's Benefit or Allowance, are automatically eligible for a GP visit card.

The 2023 ESRI report Extending Eligibility for General Practitioner Care in Ireland: Cost Implications, and other previous reports, have estimated the cost of universal GP care without charges. However, these reports were able only to estimate costs based on the current model, while implementing a general practice model that provides for GP care without charges for all would require significant change to that model, as the existing model is based on the mixed delivery of GP services to both private and GMS patients.

It is not possible to definitively calculate the cost of universal free GP care given the changes that would be necessary to the current general practice system and the range variables that would have to be accounted for. Additionally, the fees payable to GPs could only be determined following agreement with general practice, represented by the IMO, on the scope and content of the service to be provided. A strategic review of General Practice is currently underway, which amongst other things, aims to identify the challenges facing general practice in ensuring the delivery of a sustainable general practice service within the community and to identify the measures necessary to address those challenges in the context of delivering on the principles of Sláintecare. The review will be finished in the coming months, and I plan to publish it after that. This is an important step in making sure general practice in Ireland is future proofed.