Politicians agree on universal healthcare for all

The provision of universal healthcare for all and the abolition of private practice in the country’s public hospitals – to ensure equal access to public hospital services for public and private patients – is the basic recommendation of the Oireachtas Healthcare Report. Maureen Browne reports.

Maureen Browne
Maureen Browne

The 187 page report – to which all the political parties have signed up – sets out a strategy for the Irish healthcare services for the next ten years.

It envisages universal healthcare being introduced over a period of between two and six years.

The Oireachtas report figures that universal healthcare can be provided for an additional investment of between €6.8 – €7.6 bn over ten years.

It states that free primary and hospital care for everyone will cost an additional €380 – €465 million a year over the ten year implementation period.   There will also be transitional and legacy funding arrangements to a total of €3 billion over six years, to boost reinvestment into ”one off system changing measures, training capacity and capital expenditure.”

The Oireachtas report says that private work should be phased out from public hospitals between year 2 and year 6 of this plan and the private patient income currently received by public hospitals replaced by the state over the same period. 

If this is implemented in Year 2, it would suggest that the hospitals stand to lose a minimum €5.6 bn over the ten year lifetime of the plan – the very least they could have been expected to earn from private patient charges, if as is highly unlikely they were pegged at their present rate.

It is difficult to see how the state can take out €5.6 bn from the health service, invest less than €8 bn and then extend free services to nearly half the people of the country, who up to now were more or less paying for these services for themselves.

The report leaves the whole question of bed capacity up to the review group which is at present examining this area.

It suggests that as much diagnoses and treatment as possible be carried out in primary care,

It acknowledges the challenges of recruitment and retention saying we need “ new approaches to recruitment as well as new approaches to retaining staff, thereby creating a system where all professions are enabled to fully utilise their capacity and expertise in delivering safe, high quality care.”

On waiting lists it proposes that legislation be introduced by next spring for the following waiting time policies, to be implemented on a phased basis by 2023.

  • No-one should wait more than 12 weeks for an inpatient procedure, 10 weeks for an outpatient appointment and 10 days for a diagnostic test.
  • Individual waiting lists are published by facility, by specialty.
  • Introduce a maximum wait time in EDs, working towards a four hour target.
  • Hospitals that breach guarantees are held accountable through a range of measures including sanctions on senior staff, but not to the detriment of healthcare delivery.”