HEALTH:UNIVERSAL HEALTH insurance will not be in place until the end of the new government's term in 2016, but the legislation and organisation change will be completed under the coalition's programme for government.
The Health Service Executive (HSE) is to be abolished, or in the terms of the programme “will cease to exist over time” and free GP care for all is to be in place by 2016. Those on the long-term illness schemes will have free care in the first year, costing €17 million, and those on the “high-tech” drugs scheme will have free care within two years, costing €15 million.
The only other reference in the health proposals to actual costs is the plan to ring-fence €35 million annually to develop community mental health teams. A commitment in mental healthcare is given that the parties will “endeavour” to stop the placement of children and adolescents in adult psychiatric wards.
A White Paper on how the health insurance scheme will be financed will be published “early” in the new administration’s term and the VHI will be kept in public ownership to retain a “public option” for the system.
Fine Gael and Labour have also promised to reopen discussions on further compensation for thalidomide victims. They will “seek a mechanism” to compensate women excluded on age grounds alone from the Lourdes Hospital redress scheme.
They plan to introduce a cervical vaccination programme for all girls in secondary school and will extend Breastcheck to women in the 65-69 age group. They also propose legislation to assume consent to organ donation unless specifically stated otherwise. The reverse is currently in place.
The HSE’s functions will either be returned to the Minister for Health or be taken over by the universal health insurance system. Public hospitals will be independent not-for-profit trusts. Public hospitals will be compensated for costs they bear that private hospitals do not, such as emergency departments.
All insurance providers will be obliged to offer everyone the same insurance package.
Under the plan to introduce free GP care for all by 2016, there will be preferment in the first two years for those in the long-term illness and high-tech drug schemes.
Access to “subsidised” care will be extended to all “in the next phase”, though this is not defined, nor is the “final phase”, when access to free fees will be extended to all. Like the system in the North, everyone will be obliged to register with a GP primary care team once the scheme is fully in place, and in the interim, more doctors, nurses and primary care professionals will be recruited.
Incentives will be offered to GPs to care more intensively for those with chronic illnesses, but their payment for medical card patients will be reduced, as will hospital consultants’ remuneration.
The parties will also establish an expert group to address the issues raised in the European Court of Human Rights case on abortion.
