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Health Insurance

Dáil Éireann Debate, Tuesday - 1 May 2012

Tuesday, 1 May 2012

Ceisteanna (592, 593, 594)

Ciara Conway

Ceist:

668 Deputy Ciara Conway asked the Minister for Health the position regarding the progress of universal health insurance; if he will provide details on the model being adopted; and if he will make a statement on the matter. [21969/12]

Amharc ar fhreagra

Ciara Conway

Ceist:

669 Deputy Ciara Conway asked the Minister for Health if universal health insurance is introduced and citizens do not pay at point of access, if they will they be able to recoup expenses from the State for medications and whether these will be covered under the scheme; and if he will make a statement on the matter. [21970/12]

Amharc ar fhreagra

Caoimhghín Ó Caoláin

Ceist:

674 Deputy Caoimhghín Ó Caoláin asked the Minister for Health the action he has taken on a month by month basis, to progress the provision of universal health care since his coming in to office; and if he will make a statement on the matter. [22003/12]

Amharc ar fhreagra

Freagraí scríofa

I propose to answer Questions Nos. 668, 669 and 674 together.

The Government is committed to fundamental reform of the healthcare system with the objective of delivering a single tier health system, supported by universal health insurance, where access is based on need, not income. Every citizen will have a choice of insurer and will have equal access to a comprehensive range of curative services. A new Insurance Fund will subsidise or pay insurance premia for those who qualify for a subsidy.

There are a number of key initiatives in the reform programme which will play a critical role in improving our health service in advance of the introduction of universal health insurance. Significant work has already been undertaken to progress these. They include:

the strengthening of the primary care sector to deliver universal primary care with the removal of cost as a barrier. The Government has established a Universal Primary Care Project Team to oversee the introduction of universal primary care. In addition, the Government has given its approval to the preparation of Heads of a Bill to progress the phased introduction of free GP care in line with the commitment in the Programme for Government. It is envisaged that the first phase in the Programme will provide for the extension of access to GP services without fees to persons with illnesses or disabilities to be prescribed by regulations under the new legislation.

reform of the acute hospital sector, including the establishment of the Special Delivery Unit (SDU) which has been tasked with unblocking access to acute services by improving the flow of patients through the system. An important part of the Programme for Government is the establishment of independent not-for-profit trusts. As a first step, non-statutory hospital groups will be set up which will have a single clinical governance model, one budget and one employment ceiling. I clearly set out my policy on the formation of hospital groups in my letter of 28 March 2012 to the Chairman of the HSE as a Direction under Section 10 of the Health Act 2004. In this letter I stated that I intend to revert to my colleagues in Government to agree the arrangements for, and make up of, hospital groups where they are not already in existence. Preliminary work in this regard is already underway within the Special Delivery Unit. The hospital groups will be established on the clear understanding that the groupings and their governance arrangements will be reviewed prior to 2015 to ensure an appropriate environment for the introduction of UHI.

the introduction of the more transparent and efficient "Money Follows the Patient" funding mechanism for acute hospitals. A number of initiatives are already underway including a patient level costing project and a pilot initiative in relation to prospective funding of certain elective orthopaedic procedures, at selected sites.

In February, I established an Implementation Group on Universal Health Insurance. The Group is tasked with helping to develop detailed implementation plans for universal health insurance and to actively drive implementation of various elements of the health reform programme. The Group held its first meeting on 1 March 2012 and a second meeting took place on 4 April 2012. A project team comprised of senior Department of Health officials has also been established to support the work of the Implementation Group.

The initial work of the Group will focus on overseeing reform work in relation to the following work streams:—

Hospital Financing (e.g. Money-follows-the-patient, Hospital Care Purchase Agency),

Hospital Structures (e.g. Hospital Trusts),

Regulation of the Hospital Sector (e.g. Patient Safety Authority, Licensing),

Health Insurance Market (e.g. Risk Equalisation, Minimum Benefits),

Overarching UHI Design (e.g. detailed design of the UHI system, including the legislative framework and the package of services to be covered).

In certain respects, we are fortunate in being at the early stages of the reform process in that it enables us to learn from and use the experiences of other countries to inform, develop and advance implementation proposals. To that end, during 2011 my officials undertook a study visit to the Netherlands to examine the Dutch health insurance model and also hosted a seminar which was attended by international experts. In addition, the Implementation Group on UHI comprises both those with executive responsibilities within the health service and external expertise, including international experts working with the World Health Organisation and the European Observatory on Health Systems and Policies. However, I should point out that, ultimately, this Government's reform proposals will be designed to meet the needs of the Irish system and to ensure the best outcomes for Irish patients.

The reform programme is a complex and major undertaking that requires careful sequencing over a number of years. The Implementation Group will continue in existence throughout the health reform process and will oversee different elements of the reforms as they are being put in place. It is also intended that it will consult widely as part of the reform implementation process.

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