ANALYSIS:A FG-Labour coalition would introduce some form of universal cover
IT’S NOT uncommon for young northerners studying or working in the Republic to defer going to see a doctor until they return home at the weekend. That’s because there’s free GP care for all in the North, as there is elsewhere in the UK.
If it can be done in the North, it can be done in the Republic. This was the Labour Party’s message yesterday when it launched its health manifesto, promising free primary care for everyone in the country within four years if in government after the election.
It acknowledges free primary care for all would lead to about two million extra GP visits a year but it would be ready for those by recruiting an extra 35 GPs a year from abroad and 100 additional practice nurses to deal with the increased workload.
Drawing on a report from an expert group on health service funding published last year, it estimates the cost of the reform, if GPs were paid a maximum of €45 by the State for seeing patients who don’t have medical cards, at €389 million.
The idea is a good one, as it’s well known people who delay seeing their family doctor because of the cost often end up having to be treated in hospital where care costs are much higher.
The changes would come in over four years. Free GP care would be extended first to those on long-term illness schemes, then to people on treatments such as chemotherapy. By year three there would be subsidised GP care for all and in year four there would be a free-for-all system.
Can we afford to provide free GP care for all in the current climate? While some might argue we can’t afford not to do it, Labour says the costs would be met from savings made on drugs and procurement, ending tax relief on GPs’ fees, and payroll savings including savings on pay to hospital consultants. But is this realistic? After all, consultants signed up to the Croke Park agreement which protects them from further pay cuts. And in the past it has taken years to negotiate new terms and conditions with them.
By 2016, if Labour is in government, it also promises a system of universal health insurance cover for hospital care, bringing an end to the two-tier system. Under its new system it would be compulsory for everyone to have health insurance, with the State paying for those on lowest incomes and subsidising payments for those on middle incomes.
Overall the hospital system would still be funded with a mix of taxation and insurance, with taxes going into a separate hospital insurance fund to cover ambulance services and emergency department care, and insurance policies covering the other half of hospital care costs.
Labour says the hospital cover element of its plan would cost €371 million a year, if hospitals become as efficient as is the norm in other European countries. If they remain as inefficient as they were in 2009, it could cost an extra €7.4 billion which could render the plan unattainable.
Given how long it has taken for change to occur in our health system to date, Labour may be overly ambitious in hoping to have universal hospital cover and a system under which money follows the patient in place by 2016. Fine Gael, in its health plan published last Sunday, said it would take it 10 years to introduce universal health insurance cover.
Fine Gael, though, was vaguer on its costings and on when free GP care for all would commence, but essentially both parties want the same end result. Fine Gael’s reforms are based on the Dutch system; Labour’s are closer to the German model.
Either way, if the parties form the next coalition, efforts will undoubtedly be made to put some form of universal healthcare system in place, either at primary care or hospital level or at both.