Primary care card proposed in report

A PRIMARY care card for everyone who registers with a GP is proposed in a report launched yesterday by Health Minister Mary Harney.

The report by an independent expert group recommends the introduction of a stepped GP and drug payments to replace the medical card system.

Ms Harney said she preferred the tiered payments system that takes account of individual income and health-care needs.

“I very much support the tiered approach based on income. That is what we have done with the Fair Deal for long-term care and I believe in the foreseeable future that is the only realistic way to be able to reallocate and reorganise resources,” she said.

“We are currently preparing legislation in Department of Health around eligibility and this will very much inform that legislation,” she pointed out.

“What we need is something that is fair and I think what the group has recommended is certainly fair. I believe it is achievable and the way forward.”

The report that recommends money following the patient’s best health, said the new graduated form of eligibility, was needed to better address the burden of chronic disease management.

The group did not recommend a change from the mainly tax-based financing of health care to universal/ social health insurance.

It stated it was more concerned with how the mechanisms for collecting and managing funds were structured.

It wanted to see a shift away from hospital to primary, community and continuing care with the Health Service Executive having an integrated role as purchaser and provider of healthcare.

Chair of the group, Prof Frances Ruane from the Economic and Social Research Institute (ESRI), said their aim was to advance the Irish health system to a level where limited resources were clearly targeted to achieve the best possible health for the population and the best outcomes for all patients, irrespective of their means.

Ms Harney, who said she would bring the report to Government in September, said the way health services were funded was the next major step in health reform.

“The priorities we set and the incentives we create, will mean more care in the community, improved services for patients and more transparency in how money is used,” she said.

Ms Harney said some of the group’s recommendations could be implemented quickly while others would require more fundamental changes over three to five years.

The report said a project should be established to immediately explore how a structure of entitlements to primary and community care services and drugs could be implemented.

The report also proposes using the National Treatment Purchase Fund (NTPF) as a model for the way resources are allocated.

Chairman of the Irish Patient’s Association, Stephen McMahon, urged caution in transferring the role of the NTPF to the Health Service Executive because of their distinct duties to patients.


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