New health card system advised

An independent expert group has recommended a primary care card for all citizens, to replace medical cards and GP-visit cards, with a system of graduated eligibility for GP services and prescription charges.

Minister for Health Mary Harney today unveiled a report on resource allocation and financing in the health sector, which was chaired by Prof Frances Ruane of the Economic and Social Research Institute (ESRI).

Ms Harney said she favoured the "tiered" approach to primary care cards recommended by the report. She said she would take the report to Government for decision in the autumn, "hopefully September".

Asked if she fully endorsed all the recommendations in the report, Ms Harney said: "I’m open-minded about all of them, yes."

One of the report’s recommendations - that tax reliefs on medical expenses and private insurance be replaced with more targeted subsidies - was not supported by the Department of Finance.

Citizens with a "standard" primary care card would pay €40 per GP visit and the State would pay 20 per cent of their drug fees.

Households with incomes in the lowest 50 per cent and those with high risk of chronic illness would receive "standard plus" cards. They would pay €30 to visit the GP and the State would cover 40 per cent of their drug costs.

“Enhanced” cards would be similar to the current GP-visit cards. They would be given to households with incomes in the lowest 40 per cent and those with chronic illness needing treatment. The State would pay 60 per cent of their drug fees and they would pay €20 to see the doctor.

Meanwhile, "comprehensive" cards, similar to the existing medical card, would give patients access to health care services without a fee. The cards would be given to households with incomes in the lowest 30 per cent and those in the “High Tech” drug scheme.

The report favours a "flatter" organisational structure within the Health Service Executive.

The Irish Patients Association said it did not see a problem with a proposed tiered system but said it wanted to ensure low-income families would not be left worse off. “Where changes are going to be made each area needs to be risk assessed, that it’s not going to have negative impact on current entitlements to patients,” chairman Stephen McMahon said.