Old promises renewed in latest health reform plan

A pledge to introduce free GP care and universal health insurance by 2016 are among several old promises reiterated yesterday in the Government’s blueprint for radical health service reform.

Health Minister James Reilly conceded that “much of the stuff that’s in here [Future Health: A Strategic Framework For Reform of the Health Service 2012-2015] has all been announced before”. However, the actions were now specific and time-bound, he said, and the Government could be held to account.

The document promises the introduction of free GP care on a phased basis, the same promise made a year ago by then junior health minister Roisín Shortall. At the time, she said those on the long-term illness scheme would have free GP care from Mar 2012. Yesterday, new primary care minister Alex White said they did not have a specific date for the extension of the scheme, but the “aspiration” was early to middle of next year.

However he conceded the “free” care extended only to the GP consultation, not to any follow-up tests or treatments.

Under the universal system, insurance will be mandatory, and everyone will be insured for a standard package of primary and acute hospital services including acute mental health. Those who want additional benefits will pay for them.

People will have their choice of a health insurer, including a public option, and the cost of insurance will be based on ability to pay. The State will subsidise services or pay insurance premia for those who qualify.

Dr Reilly said the Government had always made it clear that people could buy enhanced cover when universal health was introduced. However, he said it “wouldn’t get them their colonoscopy any quicker or their hip or knee replacement any quicker, because that would be to defeat the egalitarian purpose of what we’re about, which is treating people on the basis of medical need”.

The document also outlines sweeping structural changes and the setting up of a number of new agencies, including the Child and Family Support Agency (2013); Patient Safety Agency (2013); the Healthcare Commissioning Agency (2014), which will take over the management of funds from the HSE; and the Health and Wellbeing Agency (2015).

Other structural reforms include grouping hospitals in different networks under a chief executive responsible for staff and budget. These new groups will be established on an administrative basis in 2013 and by the end of this year, the department will make recommendations on their composition.

The document also pledges reform of the Fair Deal nursing home scheme to allow more people live at home. Consideration will be given to extending the model to disability and mental health.