Another decade before 'free GP care for all' promise phased in
Patients suffered one of the worst days of hospital trolley overcrowding yesterday as the Health Minister signalled the promise to extend free GP care for all has now been pushed out for another decade.
Minister Simon Harris was outlining a set of long-term proposals for another overhaul of the health service.
But as he was speaking, the HSE reported that 67 more patients were waiting for a hospital bed across the country compared to the same day last year.
Nationally, 565 patients were lying on trolleys with 50 crammed into the emergency department of University Hospital Limerick.
He said that it would take 10 years to achieve free GP care for all - a promise originally made in 2011.
Over that time there is a need to invest in staff, buildings, diagnostics and training while the expansion of eligibility for primary care services would have to be done on a "phased and prioritised basis".
However, Mr Harris did not provide any costings for his proposals at the Committee on the Future of Healthcare, which is to produce a plan for the service next month.
The plan also failed to provide specific proposals to address the shortage of key staff, including doctors and nurses, which is leading to closed theatres and spiralling waiting lists for surgery.
Mr Harris conceded he was "acutely conscious of the challenging staffing environment".
The need to secure and retain staff is important when assessing both "pay and tax rates", he suggested.
"But it also means we must enhance the attractiveness of the work environment with ongoing learning and career opportunity," he said, without providing any more detail.
He wants to see hospital consultants who currently earn a public salary, and can top-up their income with fees for treating each private patient, agree to annual remuneration.
This would cover public and private work.
This would aim to counter the perverse incentive doctors have to treat more private patients.
Any such change would involve a renegotiation of the consultants' contracts.
There are currently 400 consultants posts unfilled as more doctors snub jobs in Irish hospitals due to pay and conditions.
Mr Harris said the public and private mix of medicine will continue - but he gave no signal of any cuts in tax relief for private insurance.
Responding to calls by some committee members to axe private medicine in public hospitals, he said this would cut their income by €700m.
He also outlined medium and long-term plans to dismantle the HSE.
This will include joining up hospital groups and the nine community health organisations which currently cater for areas such as GP services, mental health care and nursing homes.
Both hospitals and community care were under the one umbrella until 2014 when they were split. But just two years on he plans to reunite them.
The monolith of the HSE would be replaced by regional bodies, although part of it would be retained to provide a national service in areas such as cancer care.
In the medium-term, Mr Harris said he wants to change how the HSE at top executive-level functions.
There was no analysis of the Department of Health, whose civil servants contributed to the minister's presentation.