Private patients to be banned from queue-jumping in public hospitals
Queue-jumping by private patients in public hospitals should be phased out over five years, the final report of the Oireachtas committee drawing up a 10-year plan for the health service has recommended.
People with private health insurance who attend public hospitals will no longer get preferential treatment.
If they want faster access and their own room they will have to go to private hospitals.
The controversial proposal is part of a comprehensive blueprint from the all-party committee which signed off on its final report yesterday.
It will be published next week and will be a major challenge for the next taoiseach.
Hospital consultants will no longer be able to charge fees and it will mean a loss of €621m in income to public hospitals from insurance companies annually.
This will have to be replaced by additional public funding, starting in year two.
The committee is calling for the extension of free GP care to the entire population with an additional 500,000 annually over five years getting the benefit.
It acknowledges the need to increase the number of GPs in practice if this is not to create more waiting lists.
The committee wants the €80 a night for hospital care to be abolished along with a reduction of the €2.50 prescription levy to 50c.
The monthly drugs threshold payment should be cut from €120 to €100.
Nobody should wait more than 22 weeks for surgery and 10 weeks for an outpatient appointment. The maximum waiting time in a hospital emergency department should be no more than four hours.
Hospitals that breach the guarantees should be "held accountable", including sanctions on senior staff but "not to the detriment of healthcare delivery".
When it comes to funding the health service the committee, chaired by Social Democrat TD Róisín Shortall, it said a national health fund should be established.
Everyone will get a health card, or carta sláinte, which will entitle them to services based on need.
The money will come from general taxation and specific earmarked funds to be decided by the government of the day.
There needs to be €380m-465m a year to deliver the expanded entitlements.
Transitional and legacy funding should be around €3bn over six years.
There should be a reduction in the amount of tax relief paid out as more abandon their private health insurance.
An early recommendation to phase out tax relief for private health insurance was abandoned.
The committee calls for €119m to be allocated between years four to 10 to hire more hospital consultants.
This is based on the mid-scale salaries of consultants who currently only treat public patients.
The committee is adamant that the proposals should not be left to gather dust, like so many other reports have been in the past.
It says that the taoiseach needs to set up an implementation office in July.
It will work closely with the HSE and will be represented on management teams, reporting directly to the Health Minister. It should recruit a "lead executive" in change management.
The implementation office should be funded with around €10m for its duration.
The first implementation plan should be published at the end of 2017.
In her forward to the report, Deputy Shortall said that the aim of the recommendations is to consider how best to ensure that in the future everyone has access to "affordable, universal, single-tier healthcare in which patients are treated promptly on the basis of need rather than ability to pay".
The committee has been sitting since June.