Health Minister Stephen Donnelly predicts it will take three to five years to fully reform public health services to eliminate the need for private health insurance.
Comprehensive reforms are planned in the next few years to provide free health care services as needed.However, almost half of the population relies on insurance to avoid waiting listaccording to ESRI, there is still a long way to go.
Mr Donnelly toldReforms need to provide accessibility for patients, which means ending spiraling waiting lists; affordability, which means lowering costs such as prescription fees; and quality, which means improving standards of care.
For many, affordability also means the promise of getting treatment without relying on expensive health insurance.
Under Sláintecare, Mr Donnelly said, many changes needed to happen before insurance disappeared here.
“For people to say ‘if I’m sick, my GP needs to get me a diagnosis or specialist care’, we certainly need to go a long way in three to five years,” he said.
About 900,000 people are on the hospital waiting list, which he described as “unacceptable”.
Some reforms have already begun. More than 120,000 people had been scanned through their GP by the end of last year, under a pandemic measure that will continue.
However, Mr Donnelly said overall recruitment was a huge challenge.
That was evident last week when the first in a possible series of strikes by medical scientists occurred over pay.
Their salaries are lower than the rest of the lab staff, and graduates work as lab assistants during their studies and take a pay cut when they start working as scientists.
Junior doctors, non-consultant hospital doctors (NCHD), are also voting for strike action, saying they routinely work 80-hour weeks in violation of European law.
“Their working lives need to make very significant changes and improvements,” Mr Donnelly said. “I think the questions NCHD raises are absolutely valid.”
Despite these concerns, he insists that with the substantial increase in funding, a big step has been taken towards safe staffing levels, which are now equivalent to 134,000 full-time employees. He noted that compared to the beginning of 2020, the health services sector increased staff (net) by 14,284. These include 4,100 nurses and midwives, and 1,300 doctors and dentists.
As part of the move towards better community care, 2,300 health and social care professionals, such as audiologists, speech and language therapists and physiotherapists, were also recruited.
At the local level, the focus is on the creation of six regional health districts to replace hospital groups and HSE community organizations. The delay in these changes was the focus of the top resignation of the Sláintecare team last year. They are now expected to be “fully operational” in 2024.
“At the same time, what we want to keep is a leaner but still strong central organisation for the HSE,” Mr Donnelly said, adding that Covid-19 vaccination was a good example of why central power was still needed.
On a crowded shelf next to Mr. Donnelly’s desk are copies of the Cancer Strategy (2017-2026) and Sharing Vision for Mental Health (2020) and other plans launched to great fanfare.
Looking ahead to an era when Covid-19 is no longer dominant, he said: “Strategies have to be funded.” The plan is to fund existing strategies rather than commission new ones where possible. “We have a very clear plan on how to get there, it’s about implementation.”