The defining issue of the next general election will be the state of the health services, the Fine Gael leader said yesterday at the launch of his party's document on how to reform the system.
"Health is likely to be the single biggest issue in the general election," Mr John Bruton said, adding that this was the area of Irish society where injustice was most marked.
The document, "Restoring Trust - A Health Plan for the Nation", proposed a targeted extension of the medical card scheme, doubling income limits for qualification immediately, and extending free family-doctor services to a number of groups.
Children up to 18 years of age would qualify, and beyond that those in full-time education, all senior citizens, and those in the lower 60 per cent of income groups. Special provision would be made, he said, for those with chronic disabilities, and asthma would be included in the long-term illness scheme.
The Fine Gael spokesman on health, Mr Gay Mitchell, said 31 per cent of the population, was eligible for the medical scheme. These proposals would bring that figure up to 40 per cent, which was below the threshold where it would be necessary to renegotiate with doctors involved in the scheme.
Mr Mitchell said Fine Gael was proposing a detailed reform of the health services, including services for the elderly and those with mental illness.
"We also intend to change how the system is governed and provide for a new enforceable convenant of patients' rights and responsibilities.
"In today's Ireland, if you can pay you will live longer and in less pain, while those on low incomes must suffer on. This is unjust, unacceptable and untenable. We must end this double standard. There must be a comprehensive, modern and high-quality service available to all, based on fair criteria, not on the size of a person's bank account," said Mr Mitchell.
The party proposes reform of hospital management contracts with new and specific performance-measurement criteria. Fine Gael would create an office of Health Ombudsman.
In total, said Mr Mitchell, the extra cost of their proposals would be £990 million, including an extra u£300 million spent on primary healthcare, and £500 million on secondary care annually, which would be targeted with the aim of creating a more effective and fairer health service.
The party would spend £190 million to meet private insurance costs currently borne by taxpayers individually.
Addressing the issue of staff shortages in the health services, the plan says there may be a need for a loyalty bonus to medical staff to enable the service to get over its current crisis.
It also pointed out the need to remove disincentives to working in Dublin and said a "Dublin weighting" payment for crucial healthcare staff should be considered. "This could take the form of assistance with housing or with housing being provided near hospital sites or similar measures."
The plan also proposed a White Paper on health policy which would focus on strategic objectives which should be included in a new Health Act which provides for "specific and measurable" strategic objectives to govern resource allocation for the next 10 years.