At Regency Airport Hotel – Meeting

On 2nd March, the FairCare health policy of Fine Gael was outlined by Dr James Reilly,who spoke eloquently and convincingly on this new policy. It is based on insurance for all and the consequences of money following the patient were made clear to all. Hospitals would only get paid for what they do and there would be a financial incentive to move patients out of hospitals into the community. Treatment of mental health problems will be moved into the mainstream. A cornerstone is the evolution of free GP care within phase 3 of the implementation. The template of the Dutch system of private health care was used. The cost is 6.5% of first €30,000 in income and there is risk equalisation as a core principal which stops cherry picking of patients. The state will insure those on low incomes and the higher incomes will pay more. the Dutch spend €60 billion on 17 million people and Ireland spends €20 billion (public and private) on 4.2 million people. Dr Reilly wants to develop lots of Primary Care centres with GPs, nurses, physios, occupational therapists, pharmacy and imaging including ultrasound and X-rays. I am not too sure about this element because of potential conflicts of interests in investor owner facilities involving doctors. Implicit in this model is the necessity for electronic medical records with the problems of confidentiality that follows.

Who are those two guys with Bill?

Enda Kenny spoke of putting people at the heart of health care and making each person equally valuable to medical institutions. The strain of a dual syatem would be removed and citizens would have equal access to medical services within the state. The methods of the task force on waiting lists in Northern ireland will be used address the elimination of waiting lists and those in gthe way will be moved sideways.

Dr Reilly is also a fan of a regular national body test. I never give a blank imprematur to this type of activity without examing the cost benefit in advance. Fine Gael can offer free checks to people but it is usually the worried well who take up these offers. He will also institute a greater emphysis on chronic disease management in primary care where tasks would be delegated to the lowest ranking competent person. For example, not a consultant doing blood pressure checks. Health screening for example – coloscopy will be offered but I hope it will not be done by another disease specific quango. Dr Reilly also cited the need to find the undiagnosed diabetics in the community and treat them before they run into trouble.

I am heartened by the potential of this plan to improve the health service here over the course of a Kenny government.