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Minister Reilly publishes “The Path to Universal Healthcare: White Paper on Universal Health Insurance”

2nd April 2014 - Susan Moss

The Minister for Health, James Reilly, T.D. today 2 April published “The Path to Universal Healthcare: White Paper on Universal Health Insurance”.

The fundamental objective of the Government’s health reform programme is to bring to an end the existing unfair, unequal and inefficient two tier health system and deliver a single-tier health service, supported by universal health insurance, where access is based on need, not ability to pay.
Speaking at the launch Minister Reilly said “the publication of this White Paper is a key further step on the road to implementing Universal Health Insurance. This document sets out in significant detail Government plans around the introduction of Universal Health Insurance. It will lead to the most radical reform of our health services in decades and will result in a fairer, more effective health service. The publication will be followed by extensive consultation around the implementation of UHI and I would welcome the widest possible involvement by the public and by the stakeholders in ensuring that these major changes are put in place in the best possible way for the benefit of all our citizens.”

Broad outline of contents of White Paper

The White Paper outlines the key elements of the new UHI system and how it will work. The areas covered include

· the model of UHI for Ireland, including the design of the new system,
· the process for determining the future basket of health services, including the package of services that will be covered under UHI, and
· the funding mechanisms for UHI.

The White Paper identifies those key building blocks, already underway, that will deliver efficiencies and pave the way for the introduction of UHI. Critically, the key steps on the road ahead for full implementation of UHI by 2019 are also set out.

The publication of the White Paper at this stage demonstrates the Government’s resolve to deliver on health reform commitments set out in the Programme for Government.

Cost-effective UHI System

The Minister for Health is committed to implementing the most cost effective system of UHI possible which will be fully compliant with Government expenditure targets. Over the coming twelve months, the Department of Health will undertake a major costing exercise to ensure that a full and comprehensive analysis of the estimated costs involved is available. In addition, the Minister is committed to showing demonstrable evidence of lower costs and improved productivity as a result of initiatives to be introduced over the coming years. These include providing community-based models of care, full implementation of an efficient Money Follows the Patient funding system and introduction of value-for-money contracting arrangements with healthcare providers.
Communications and Consultation on the White Paper

The importance of engaging with the public on this major policy reform of the health service is critical. The Minister is keen to ensure that the public is fully aware and supportive of the changes proposed. Accordingly, he will undertake a series of media engagements at regional level to ensure that there is clarity about the implications of UHI for individuals.

The publication today of the White Paper also marks the beginning of a major consultation process with a call for submissions from the public and key stakeholders on the overall policy direction. The Minister is urging all those wishing to make their views known to participate in this process.

The consultation process will last eight weeks (until Wednesday, 28th May).More detail of the process is set out on the Department’s website at

Consultation on the Future Basket of Services, including in relation to those services that will be covered by UHI.

A separate consultation process on the shape and composition of the future basket of health services, in particular those services that will be covered by UHI, will also be undertaken. The Oireachtas Joint Committee on Health and Children will play an active role in the consultation the values system that should underpin future decisions on the provision of services. An Expert Commission will develop detailed and costed options in relation to services to be provided under UHI.

Key elements of the UHI system set out in the White Paper

Under UHI –

· everyone will be insured and have a choice of health insurer;
· everyone will have equal access to a standard package of services, based on need and not on ability to pay;
· the State will pay or subsidise the cost of UHI premiums for those who qualify;
· various protections will apply in the case of those purchasing UHI policies, including open enrolment, lifetime cover and community rating;
· health insurers may not sell insurance that provides faster access to services covered by UHI, and
· healthcare providers supplying care under UHI may not sell faster access to services covered by UHI.

Next Steps

The Minister is committed to having all the necessary legislative and organisational groundwork on UHI completed within this Government’s term of office. Once all the necessary groundwork is in place, UHI will roll out on a phased basis with a view to full implementation by 2019.

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