Slainte Care
Proposed Reform
In 2009 Fine Gael brought forward proposals r a system to abolish the basis of health care entitlement and replace it with universal health insurance. This would involve free GP Care for the entire population with state funding of insurance premium for medical card holders.
The Programme for Government contained a commitment to introduce a universal health insurance scheme with equal access to healthcare by 2016.The published government plan, outlined in the 2014 document “The Path to UHC – The White Paper”, foresaw introducing compulsory private health insurance based on managed competition between insurance companies to abolish the distinction between public and private patient status.
Key features of the policy entailed mandatory health insurance for every citizen under free choice of insurer as well as entitlement to the same package of care, covering primary and acute hospital services. Further, patients should be charged in turn insurance premium irrespective of age or risk profile and additionally have the right to change their insurance membership on an annual basis. Citizens who were unable to afford the amount of premium would have qualified for subsidies to cover the required premium payments by a National Insurance fund.
Cross-Party Approach
The plan for universal health insurance was abandoned in November 2015 due to projections that the envisaged system would be too costly and would still require the highest share of funds by general taxation. After the 2016 election, an all-party “Committee on the Future of Healthcare” sought to identify an appropriate approach for establishing universal healthcare in Ireland.
In May 2017 the committee published its final report entitled “Committee on the Future of Health, Sláintecare Report”.The intent of the Sláintecare reforms is to achieve a universal single-tier health and social care system, which provides equitable access to services based on need, and not ability to pay. The Sláintecare programme enjoys the support of all parties in the Oireachtas.
A universal healthcare system will provide population, promotive, preventative, primary, curative, rehabilitative and palliative health and social care services to the entire population of Ireland, ensuring timely access to quality, effective, integrated services on the basis of clinical need.
Slainte Care
The document proposed a ten-year plan for reforming the Irish health system towards universal healthcare. It covered Population health profile, Entitlements and Access to Healthcare, Integrated care, Funding and Implementation.
The report foresaw the provision of health cards called Carta Sláinte to every citizen, granting access to primary care free of charges at specified local entities preferably outside of hospitals. This system is planned to be funded by taxation, requiring an increase of public health spending and further infrastructure investment of approximately 3 billion Euros.
In December 2019, Minister for Health Simon Harris estimated that the reforms would be carried out by 2030 as a result of the government’s decision to only issue new contracts for public-only consultants. By 2030 he expected the government would have recruited an additional 1,000 consultants.
Reform Programme 1
Improving Safe, Timely Access to Care, and Promoting Health & Wellbeing
- Implement the Health Service Capacity Review (2018) including Healthy Living.
- Enhanced Community Care and Hospital Productivity
- Scale and mainstream Integration Innovation
- Streamline Care Pathways, from prevention to discharge
- Develop Elective Ambulatory Care Centres in Dublin, Cork, and Galway
- Implement a Multi-annual Waiting List Reduction Plan
- Implement the eHealth Programme
- Remove private care from public hospitals – implement the Sláintecare Consultant Contract.
Reform Programme 2:
Addressing Health Inequalities
- Develop a Population Health Approach for Service Planning and Funding Rollout Sláintecare Healthy Communities Programme
- Develop Regional Health Areas
- Implement Obesity Policy and Action Plan 2016 – 2025
On 1 March 2024, six new Regional Health Areas will be established. They are:
- HSE Dublin and North East North Dublin, Meath, Louth, Monaghan, Cavan
- HSE Dublin and Midlands Longford, Westmeath, Offaly, Laois, Kildare, Wicklow, and parts of Dublin
- HSE Dublin and South East Tipperary South, Waterford, Kilkenny, Carlow, Wexford, *Wicklow, part of South Dublin
- HSE South West Kerry and Cork
- HSE Mid West Limerick, Tipperary and Clare
- HSE West and North West Donegal, Sligo, Leitrim, Roscommon, Mayo, and Galway.