FG proposes health plan based on Dutch model


A UNIVERSAL health insurance scheme based on that used in the Netherlands would be fully introduced into Ireland within four years of a Fine Gael government being formed, party leader Enda Kenny has said.

The party's proposals to reform the healthcare system will be outlined in a document to be launched by Mr Kenny and Fine Gael's health spokesman James Reilly this month.

It will be the party's first major policy document since the 2007 general election.

The new policy has emerged from the work of an internal party commission on health chaired by former party leader Alan Dukes. It examined different models being used throughout Europe.

The commission recommended the Dutch model, and also proposed a four-year framework for its introduction into Ireland.

Mr Kenny, in an interview with The Irish Times, said the Dutch system was ranked number one in Europe compared to Ireland, which was ranked number 15. There were no waiting lists in the Netherlands and there was free access to GPs.

He said while Fine Gael supported universal health insurance in the past it had never fully defined a model and had never sold it properly. The Labour Party has long supported the introduction of universal health coverage.

"Holland spends almost exactly the same as Ireland for its health services though it has over double our population. There are no waiting lists. There are lists of consultants who are waiting for people to see and hospitals always available for them to do their business. It's an absolutely efficient and professional system."

The Fine Gael commission has recommended a three-phase introduction of the new system that would see it fully operational after four years.

The first phase would involve a substantial reduction in waiting lists. This would take place over two years and copy the changes made in Northern Ireland in the way it managed hospitals and their waiting lists. The Government would also set non-negotiable targets for hospitals.

The new system would also facilitate tax incentives to GPs to encourage them to build facilities to carry out some of the diagnostic and aftercare work that is currently being undertaken by hospitals. This would lead to a reduction in costs and free up hospital beds.

The second phase would change the basis of payments to doctors and hospitals. Under the "money follows the patient" (MFTP) concept doctors and hospitals would only be paid for the number of patients they treat.

"MFTP will be introduced by, at the latest, the third year of a Fine Gael government," states the briefing note.

During this phase universal health insurance will be made available for free for under-18s and over-70s. Under the final phase, in the fourth year of operation, a single-tier health service will be set up with mandatory insurance for every citizen of the State.

The State will subsidise the less well-off up to 100 per cent of the premium. Private insurance companies will compete in offering a basic healthcare package with community rating and a "sophisticated" risk equalisation element.

"Under this system if you want to retain your private health insurance, like VHI or Quinn, you can have that," said Mr Kenny.

"But that's only going to mean more convivial and more luxurious surroundings in whatever the facility will be. It will not mean that you get your medical attention any more quickly than somebody who is coming down the line. The waiting lists are gone and you have a system that operates whenever you need it."

He said Ireland was ranked 24th for value for money compared to the Dutch system, which was ranked second. The Dutch system paid far less per patient but delivered a much higher quality of healthcare.