The Government is committed to fundamental reform of the health care system that will deliver 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.
There are a number of key stepping stones that will play a critical role in paving the way for 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. 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 will assist in developing detailed implementation plans for universal health insurance and driving implementation of various elements of the health reform programme. 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),
Private 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).
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.