Universal Health Insurance (UHI) will not be in place in Ireland before 2021 despite the Government’s pledge to introduce it by 2016, the recent EGM of the NAGP heard. Former special advisor to the former Minister for Health Mary Harney, Oliver O’Connor said it would take two terms of Government to introduce UHI because it was so complex.

Complex changes required at every level

Mr O’Connor noted that the building blocks for UHI were to be in place by 2015/16, but pointed out that there were highly complex inter-related changes required at every level from payment systems and hospitals to primary care providers and insurers.

The independent health finance and public policy consultant said 2021 was the earliest that all of these changes could realistically be achieved.
Speaking on the topic of health reform at the recent NAGP meeting in Portlaoise, Mr O’Connor noted that the number of GPs with GMS contracts was up 7.7% since 2008, although health spending overall was down 10% and HSE staff had been cut by 10,000.

FEMPI cuts aim to make savings of €38m

The number of GMS patients was up 37% since 2008 and payments per GMS patient were down 26% since 2008 and with the new FEMPI cuts, these payments would be down by 33%, said Mr O’Connor.

Free GP care to cost over €600m

He said free GP care for the whole population would cost €633m at the post-FEMPI average capitation/practice support rate per patient – if the policy were implemented with this capitation rate.

Mr O’Connor argued that general practice should embrace measures that demonstrated, where possible, the value of this part of medicine.

“As pointed out today, not everything valuable that GPs do for patients can be costed, but some things can be and it only helps GPs and taxpayers if we identify what works and what delivers real value and best clinical outcomes,” he said.