Universal health care timetable ‘too ambitious’, admits Health Minister.

Varadkar admits the cost to families was a consideration in decision to delay implementation of the plan

The decision to push back the introduction of universal health insurance (UHI) was influenced by fear of imposing a fresh financial burden on families, Health Minister Leo Varadkar has admitted.

He said he had been given the crisis-hit Cabinet post in order to “aid the Government’s re-election”, and insisted he could not say when the flagship UHI insurance reform would now come in.

However, James Reilly, the former health minister, refused to say whether he endorsed his successor’s move to abandon the planned 2019 introduction of the scheme.

With opposition critics accusing the Government of overloading people with new taxes, Mr Varadkar said estimates that a family of two adults and two children would have to pay €3,600 a year for UHI, fed into the postponement.

“That’s certainly a consideration, if you make everyone have a requirement for health insurance it’s going to cost,” Mr Varadkar told RTÉ, as he branded Dr Reilly’s UHI timetable as “too ambitious”.

Slowing down the roll- out of UHI was the first major decision of the new health minister, and Mr Varadkar said Taoiseach Enda Kenny gave him the role to enhance Fine Gael’s chances in the election.

Mr Varadkar said he was given one of the “toughest jobs” in Cabinet because Mr Kenny thought he “would do a good job of it and in that way aid the Government’s re-election”.

Mr Varadkar said he hoped UHI would begin during a second Fine Gael- led Coalition term but, in what some saw as a sideswipe against Dr Reilly, he, added: “I think we made mistakes in the past by putting dates on things and then not delivering.”

He also said he would be happy to “delegate” some of the policy areas of the health portfolio to Dr Reilly, who is now children’s minister.

Dr Reilly would not be drawn on whether he backed the postponement of UHI, with his spokesperson saying: “It is up to each Government minister to establish the priorities of their department.”

Mr Varadkar insisted it was still realistic to expect free GP care for the under- sixes and over-70s to begin by the end of the year, despite negotiations with the Irish Medical Organisation still on-going.

He denied this reform would disproportionately benefit the well-off, saying it would bring 500,000 people into free GP care.

Former Labour junior health minister Róisín Shortall blamed a “lack of political will” for the delay in free GP care for all and called on Mr Varadkar to reconsider ways of funding the reform.

Ms Shortall also expressed concern that not enough clarity had been brought to the issue of restoring medical cards.

Health budget

-The health system needs a €650m extra cash injection next year if it is to ensure patient safety, Health Minister Leo Varadkar has said.

The minister threw the figure in the direction of Finance Minister Michael Noonan and Public Expenditure Minister Brendan Howlin, pointedly noting that it is in line with what both men received while they held the health portfolios in the mid-1990s.

Speaking on RTÉ Radio, Mr Varadkar admitted the health service was facing severe financial problems and would “certainly” be “€450-€500m” over-budget by the end of 2014.

However, despite the need for Government to keep reducing spending levels, he said the long-term problem could only be solved if “realistic” budgets were given to health — with a budget 2015 windfall top of his agenda.

While slashing the health budget led to a damaging private falling out between Mr Howlin and ex-health minister James Reilly last year, which culminated in the medical cards fiasco, Mr Varadkar said he believes Mr Howlin and Mr Noonan “understand health” as they secured 11% and 5% increases to their budgets while holding the high-pressure role.

He said there was a “broad understanding across Government” that the service could not take any further cuts, adding that when reductions were forced through last autumn “nobody won — the fiscal hawks didn’t get the savings they wanted”.

- Fiachra Ó Cionnaith

Public policy

- Leo Varadkar has insisted there will be no “silly turf war” with his predecessor, James Reilly, over public health policy — but has made it clear the area will “remain” in his own department.

In the aftermath of the Cabinet reshuffle last month, Government officials strongly indicated that a number of public health policies would move with Dr Reilly after he was switched to the Department of Children and Youth Affairs.

The reported move — related to anti-smoking and obesity campaigns — was widely seen as an attempt to allow the departing health minister to continue to have an input in the policies, which he has repeatedly spoken out over, as his stock was falling within Cabinet.

However, in recent weeks there has been a clear rowing back on the issue from Mr Varadkar, while sources close to Dr Reilly have suggested the move was never on the agenda.

When asked about the policy switch yesterday, Mr Varadkar tried to diffuse the situation, saying “one thing I can guarantee is there’s going to be no silly turf war over this”.

However, despite describing his predecessor as a “real crusader” on the issues and that he welcomed his input, he added: “Public health is a section of the Department of Health, and that’s going to remain.”

- Fiachra Ó Cionnaith

HSE reform

- Plans to abolish the HSE have been effectively shelved by Health Minister Leo Varadkar due to concerns its removal could damage ongoing hospital and community care reforms.

The senior Cabinet member made the announcement yesterday, contradicting promises made by predecessor James Reilly and the coalition’s Programme for Government.

Under the Health Service Executive Governance Act passed in July 2012, the HSE was due to be removed by January 2015 to help improve patient care and make spending in the service more transparent.

The legislation was to see the HSE’s board and chief executive replaced by a director general and six directorates to make accountability clearer in the system.

Crucially, from January 2015, control of health spending was to revert back to the Department of Health — meaning the health minister of the day would be responsible for how funds were used, not HSE officials.

Dr Reilly was a supporter of the move, which received public backing due to a number of HSE controversies, saying it would be a major step towards a single-tier health service.

However, Mr Varadkar said he will not implement the policy, as it could damage the ongoing establishment of hospital groups and community care reforms.

While suggesting the abolition could still happen at an unspecified future date, he said the HSE “should remain in place at least until all of this has bedded down”.

- Fiachra Ó Cionnaith