'Enormous' HSE should be broken up, says Varadkar
Health Minister Leo Varadkar has said the HSE is so enormous that it should be broken up.
Mr Varadkar revealed he is also looking to curtail the benefits enjoyed by patients with private health care in public hospitals, such as access to theatre, admission, a specialist opinion or diagnostics.
"Health insurance should get you a nicer room and other hotel-style benefits in a publicly funded hospital - but nothing else," he said.
The minister was speaking to reporters at the MacGill Summer School in Glenties, Co Donegal, last night.
The HSE "is absolutely enormous", he said, adding that it "doesn't work as a single organisation".
"It should be broken up to local hospital boards," he said.
"Hospitals should be funded for the work they do, and not just bloc grants, which really doesn't work."
In relation to staffing levels, he said: "there are 1,000 more people working in the health service than this time last year".
Plans are under way to recruit an additional 500 nurses this year.
The minister also revealed plans to refund some medical expenses such as eye and dental care through PRSI and give hospitals the freedom to appoint their own managers.
He also confirmed reports in yesterday's Irish Independent that he plans to extend the free GP care scheme to all children, up to the age of 18.
"That will be tax funded because I don't believe children should be means-tested under their parents' income," said Mr Varadkar.
"It doesn't happen for childcare or for education, it doesn't happen for child benefit, it shouldn't happen in health."
He said free access to primary care for adults who are not covered could be via two options.
The first is social insurance, using a reformed PRSI/USC system to refund medical expenses such as visits to GPs, the pharmacy, dentists and therapists, he said.
The second option is to introduce universal health insurance for primary care first and give people the option to pay for it through their PRSI or opt out in favour of a new or existing private health insurance policy that offers the same or better.
He acknowledged underfunding and shortcomings in current staff levels and capacity at hospitals.
Recommending more autonomy for hospitals, Mr Varadkarsaid: "Not all board members should be appointed by the minister."
Hospitals should also be able to recruit managers and specialists "outside the constraints of public sector rules", and to recruit their own general staff, he added.
Meanwhile, the minster said allegations that senior hospital staff had been receiving gifts from medical suppliers "is obviously entirely unacceptable anywhere" and not just in the health service and must be investigated by gardaí.