New 'Sláintecare' plan aims to end two-tier health service

The new plan aims to introduce free GP for all and phase out private healthcare within public hospitals

New 'Sláintecare' plan aims to end two-tier health service

Roisin Shortall. Photo:

The government is launching a new 10-year-plan for Ireland’s health system this morning.

The Oireachtas Future of Healthcare Committee has secured all-party agreement for the plan – which will require investment of approximately €5.8bn over the next decade.

The report – provisionally dubbed 'Sláintecare' by members of the government group – aims to radically transform the health service and establish a universal, single-tiered service, delivered on medical need and not on ability to pay.

On Newstalk Breakfast this morning, Social Democrats co-leader Róisin Shortall – the chair of the committee – said the plan is based on a shift away from the acute hospital sector towards primary and social care.

Free GP care for all

The report has recommended free GP for all, a phasing out of private healthcare within public hospitals and cuts to the cost of medication for patients. 

“The first thing is that we want to encourage people to access most of their care locally in the community,” she said. “That means expanding the capacity of primary and social care and we are very much front-loading that element of it.”

“We are calling the system Sláintecare and we are also proposing the introduction of a new health card called a Cárta Sláinte.”

“That card will give people an entitlement to access universal health care locally in their community; GP care, reduced costs medication, [...] free GP care - but primary care as well which again is standard across Europe.”

The committee has been working on the plan for the best part of 11 months after hearing over 160 different submissions from health experts from home and abroad.

The plan commits to reducing waiting times to a maximum of 12 weeks for inpatient procedures, 10 weeks for outpatient appointments and ten days for a diagnostic test. 

It will also see the HSE transformed into “a more strategic “national centre” carrying out national level functions” while regional bodies are established to ensure timely access to integrated care.

A ten-year-plan

File photo, Minister for the Health Simon Harris, 23-02017. Image: Sam Boal/RollingNews

The Minister for Health Simon Harris said he hope the new plan will end "political tinkering" with the health service, adding that it can provide direction for the future of health care in Ireland.

"I think the Irish health service has really suffered from constant political tinkering with the health service," he said. "We need once and for all to have a plan for the next decade."

"I would like now to take time to consider the report, I think it deserves that; it deserves a number of weeks of consideration."

"I expect there will be quite a substantive debate in the Dáil - I presume next month - and I look forward to participating in that."


Health service investment

Deputy Shortall said the cost of the plan has been broken down into two elements - with the funding coming mainly from general taxation.

The cost of providing the required package of care at community and hospital level has been calculated at €2.8bn over a ten-year period.

The second package of investment will go towards a special transition fund to address the chronic under-investment in health care over the austerity years – and will cost €3bn over six years.

Deputy Shortall welcomed the political support behind the plan, adding that there is “no other show in town if you like” in terms of health policy.

“I also think it is important to bear in mind that there will significant savings for families in this,” she said. “It is estimated that as a result of the entitlements on the proposed health card that we are talking about that there will be savings of €285 per year, per person.”

“We are talking about how Ireland can move towards a new system that is comparable to all the kind of public health systems that all of our European neighbours enjoy – and how we can do that in a reasonable phased period of time that is affordable.”

Cross-party support

While the plan has strong political support it is likely to face opposition from certain sectors within the health service.

Question marks remain over the effect the plan will have on general practice – and how GPs might be compensated on the loss of their private practices if free GP care is made available to all.

Separately, the Private Hospitals Association (PHA) has called the report a “missed opportunity” to provide a public-private partnership that could provide progress for patients over the short term.

PHA chief executive, Simon Nugent said the report ignores the private system, “even though it operates alongside [the public system] with a similar spread of services across the country.” 

He said it is in the government’s best interests to “stimulate more private sector investment as well as public capital in health infrastructure.”

“It is disappointing that the Committee did not decide to partner the public and private systems of healthcare for patients to make real progress quickly for those waiting longest for treatment," he said.

“In the appropriate policy environment, private providers stand willing to invest in additional beds, operating theatres and other facilities to care for public and private patients."

Fundamentally about the patient

Deputy Shortall said there is always opposition to reform in any sphere adding, “I think the health service has been very much dogged by different interests and vested interests so it has held back the system.”

She said the current two-tier system mean people who are entitled to public care have to wait very long periods of time to access it – while a large number of people view the public system as “so inadequate” they feel like they have no other choice but to take up private health insurance.

Dr Michael Harty TD – a member of the committee – said the new Taoiseach and the Minister for Health must implement the report’s recommendations within the next six months.

“Undoubtedly, some aspects of this plan will raise eyebrows in the medical profession,” he said. “I would say to consultants and doctors that they need to read the entire document and not just the area that is of particular interest to them because the plan is fundamentally about the patient.”

He said the plan will see a marked drop in private health insurance as the public system improves and it becomes clear that holding a private insurance policy provides no extra benefits within the public system.

You can listen back to Deputy Shortall's appearance on Newstalk Breakfast here: