Varadkar delaying controversial health insurance policy
Timescale for controversial shake-up is 'too ambitious'
Published 05/08/2014 | 02:30
HEALTH Minister Leo Varadkar is to delay the introduction of the Government’s controversial plan to reform the health insurance system and end the two-tier service.
Varadkar to delay universal health insurance plans
A universal health insurance system was a major part of his predecessor James Reilly’s reform agenda.
But its planned introduction by 2019 is now deemed “too ambitious” by the recently-appointed health minister.
After the 2011 election, Fine Gael and Labour agreed to introduce Universal Health Insurance (UHI) by 2019 – a scheme that would force everybody to have a health insurance policy.
However, writing in today’s Irish Independent Mr Varadkar says the introduction of the radical scheme within the next five years is “too ambitious”. He is also putting off the abolition of the HSE until the new organisational and funding structures for hospitals are “bedded down”.
The minister intends to continue the rollout of free GP care to build up public confidence in the overall reform proposals.
Universal Health Insurance was the key plank of the Government's health reforms.
The basic principle of UHI is that everybody will have equal access to primary, hospital and acute medical care, regardless of income.
But accident-prone former Health Minister Dr James Reilly ran into repeated difficulties in explaining how the policy would work and how much it would cost.
Finance Minister Michael Noonan and Public Spending Minister Brendan Howlin have expressed serious concerns about the cost of UHI and the financial implications for the State.
The Department of Public Expenditure claimed the plan could add €5bn to healthcare costs, as Dr Reilly was modelling his proposals on the experience in the Netherlands.
In a bitter battle between the two government departments, it was suggested the standard package of universal health insurance could cost up to €1,672, which the State would pay in full or subsidise for some. But Mr Varadkar was appointed by Taoiseach Enda Kenny to clear up the various controversies and re-evaluate his predecessor's stalled policy programme. The new Health Minister says free GP care remains a priority, but he is separating universal health care from Universal Health Insurance.
"Universal GP Care and Primary Care are the first two parts of the Government's plan for Universal Health Care - the third part is Universal Health Insurance. Personally, I think we need to get Universal GP and Primary Care right and show people that it works before trying to bring Universal Health Insurance into the hospital system. That's why I think the original timetable to have Universal Health Insurance in place by 2019 is too ambitious," he says.
Mr Varadkar is not ditching all the policies of his predecessor. He says he remains committed to the 'money follows the patient' funding model, where hospitals get money based on the numbers of patients they treat.
"The HSE should remain in place at least until all of this has bedded down," he says.
Mr Varadkar is proceeding with free GP care for children under six and pensioners over 70, followed by other groups in the population. He is warning the rollout to the entire population may take "longer than originally planned", although he says it is definitely going to happen.
Mr Varadkar says everyone registered with a GP for the first time will be issued with a unique health identification number.
"This personal number will apply right across the health service, with benefits for both patients and service providers," he says.
The minister says he aims to tackle the low morale in the health service, which he says is not just about pay cuts. But he says he wants to stem the losses of staff in the public health system to jobs overseas and the private sector.
Mr Varadkar praises the staff in the health service who he describes as "phenomenal", having produced better results with less workers and less money.
He says he cannot reverse the pay cuts outside of the planned negotiations with public sector unions at the end of the Haddington Road Agreement. He suggests there are some actions he can undertake to "raise morale and restore confidence and trust".
"It's important that we make careers and jobs in the health service attractive again," he says.
The minister repeats his commitment to drive down the cost of private health insurance and the cost of drugs.
He also says his "most immediate challenge" is negotiating what he describes as a "realistic and adequate budget" for health for 2015.
Mr Howlin argued in recent weeks that the health budget had not actually been cut over the past three years.
Mr Varadkar has spent the past month meeting with officials and examining how his new department operates.
The Fine Gael TD is regarded as a potential future leader of the party but the health portfolio is a major test of his ambitions.
Mr Kenny's decision to put such a high-profile minister into the portfolio was viewed as a major gamble, as it would ensure the health service remains firmly in the spotlight.