I understand the Deputy is referring to my response to his recent parliamentary question concerning the extension of medical card coverage to all persons under 18 years of age. As the Deputy is aware, the health strategy includes a commitment to the extension of medical card coverage to persons on low incomes and to give priority to families with children and particularly children with a disability. I have already stated to the House that the Government is committed to achieving this aim and that the timing of the introduction of the extension will be decided having regard to the prevailing budgetary position.
A key goal of the national health strategy, Quality and Fairness: A Health System for You, is the development of an accessible, efficient and responsive health system. The strategy has set out a significant programme of development and reform for the next decade designed to achieve this goal. To date significant progress has been achieved in the implementation of the strategy with work having commenced on over 85% of the 121 actions set out in the strategy action plan. I provided the Deputy with a detailed progress report in this regard in my response to his parliamentary question of 22 June last, No. 59, which included a report on measures to tackle inequalities, reduction in waiting times for hospital treatment, the funding of additional acute beds and the implementation of the primary care strategy. A national health strategy progress report was published for 2002 and I intend to publish the 2003 progress report in the next few weeks.
The recent in-depth reviews of the Irish health system — the Prospectus audit of structures and functions in the health system and the report of the Brennan commission on financial management and controls in the health service — identified structural reform as the most important change required to establish the organisational improvements needed to strengthen the capacity of the health system to meet the challenges of implementing the health strategy. Implementation of this programme is now well under way and will result in the establishment of a health service executive with responsibility for the delivery of a unitary health care service designed to respond efficiently and effectively to patient and client needs.
