Below is a selection documents related to government strategy for and independent policy research evaluating the implementation of universal healthcare in Ireland. The international links section contains a selection of documents pertaining to the international knowledgebase for the implementation of universal health coverage.
Project Ireland 2014: National Planning Framework
The Irish government published their long-term development and investment framework in February 2018. In the area of health, the framework calls for consideration to be given to ‘the location, number, profile and needs of the population to ensure access to the most appropriate care’ and that the health service of the future should ‘facilitate the transition of people across services, providing multi-disciplinary care at the lowest level of complexity close to where people live … [while] improving access to primary and community care services, including mental health, disability services, palliative care, services for older people, social inclusion and addiction support’.
Health Service Capacity Review
In January 2018 the Department of Health published a capacity review of the evolving Irish healthcare landscape covering the period 2017 to 2031. The review assesses current levels of activity and utilisation of services, and drivers of demand in order to identify future demand and capacity requirements across the health service from now until 2031.
Press Release: New Year’s Day to see families across the country get help with the cost of medication
In line with Sláintecare recommendations, starting 1 January 2018 drugs charges for Medical Card holders will be reduced from €2.50 to €2 per item and there will be a reduction in the monthly cap from €25 to €20.
Lack of 'effective' care causing almost 4,000 early deaths each year
“A lack of timely and effective healthcare is causing the early deaths of 3,800 people in Ireland annually from conditions such as heart disease, stroke and cancer, an EU report has warned.”
Opening Statement by Minister Harris at the Joint Committee on Health on 22 November 2017
Minister Harris spoke to the Health Committee on the topic of Sláintecare. In addition to providing the Department’s update on progress on Sláintecare, the Minister said: “This is the first time in our history that we have achieved consensus at a political level on the future direction of our health system. These opportunities don’t come around too often and I am determined to harness this political consensus and to work with colleagues across the political spectrum and with all stakeholders to move forward on a programme of health reform that will ultimately benefit the health of our citizens and our society.”
Department of Health trying to ‘capture’ healthcare reforms
“Ms Shortall, chair of the committee which drew up the Sláintecare report outlining a 10-year plan for healthcare, said the Government “must not let departmental interests slow this down and block progress”.
Dáil debate on Committee on the Future of Healthcare Report (Sláintecare)
Committee Chair Róisín Shortall said: “Sláintecare was and is a once in a lifetime opportunity to do something of real importance in this country and should be grasped with both hands by Government. We have a cross-party consensus on health policy for the first time which is key to making progress. For the first time we can take the politics out of health and end the situation that has existed for so long where health was used as a political football, to score points against each other. Sláintecare gives us the opportunity to do this as it is a fully costed, phased plan. It deals with the issues that go to the heart of the problems within our health service, namely the dysfunction that arises as a consequence of Ireland's two-tier system. That system is inequitable, very inefficient and is a huge barrier to people being able to live a life free from illness and worry over what will happen in the event of their developing an illness.” Read full debate at the link.
The National Patient Experience Survey
Conducted by the Health Information and Quality Authority (HIQA), the Health Service Executive (HSE) and the Department of Health, the National Patient Experience Survey is a nationwide survey that offers patients the opportunity to describe their experiences of public acute healthcare in Ireland. The HSE has committed using this information to make improvements to the quality of care delivered in Irish hospitals. The Department
of Health will use the information gathered to inform the development of policy in relation to acute healthcare. And the survey will be used to develop HIQA’s approach to the monitoring of hospitals.
A Future Together: Building a Better GP and Primary Care Service
“Reform of primary care in Ireland has been on the agenda for several years. The current system is seen as fragmented, poorly developed and unfair. To achieve reform requires a decisive shift towards general practice. For such a shift to occur the State needs changes in its contractual arrangements with General Practitioners (GPs). Such changes will then facilitate wider changes in primary and community care services.”
On 1 June 2016, the Dáil agreed to establish a Special Committee -- the Committee on the Future of Healthcare - to achieve cross-party consensus on a single long-term vision for healthcare and the direction of health policy in Ireland.
For information about the Oireachtas Select Committee on Future of Healthcare, please refer to these resources:
- Full committee description
- Minister for Health, Simon Harris', speech on Tuesday May 26, 2016 announcing the Oireachtas Select Committee on Future of Healthcare.
- Dr Sara Burke, the co-ordinator of the Pathways project presented to the Oireachtas select committee on 5thOctober, 2016 on the topic of inequality in healthcare in Ireland (video link).
- Dr Josep Figueras, Director of the European Observatory on Health Systems and Policies, presented to the Oireachtas select committee on 12 October 2016 (video link)
Wren, M and Connolly, S. (2016). Challenges in Achieving Universal Healthcare in Ireland.
The report from the Economic and Social Research Institute reviews the recent policy debate on Irish healthcare reform, examines how universality is defined in healthcare, the rationale for its adoption and approaches to financing universal healthcare.
Connolly, S, and Wren, M. (2016). The 2011 proposal for Universal Health Insurance in Ireland: Potential implications for healthcare expenditure.
In this article from Health Policy, the authors find that the 2011 Universal Health Insurance plan was too costly and was therefore abandoned by the government as a viable option for Ireland.
Department of the Taoiseach. (2016). A Programme for a Partnership Government.
The 2016 Programme for Government outlines a number of priorities for healthcare and the health service. Amongst many important priorities, the government is committing to lowering waiting lists, increasing the health budget, enhancing primary care, extending free GP care to all children under the age of 18, enhancing preventive dental care and emergency care.
Cost of healthcare further impoverishing the poor. Irish Medical Times. 12 October 2016.
The article describes the work of the Future Healthcare Committee and the challenges the health system face in moving toward universal healthcare in Ireland.
Department of Health. (2015). Progress on the first year of our three-year Statement of Strategy 2015 – 2017: Annual report.
The Annual Report provides updates on a number of health deliverables, including steps toward universal healthcare, set forth by the Department of Health in their three-year strategy.
Department of Health (2015). Profile table of priority areas, actions and deliverables for the period 2015 and 2017.
The table outlines Minister for Health and the Department of Health’s priorities of the health service over the period 2015-2017. The first progress report on these is in the Annual Report just above.
Economic and Social Research Institute. (2015). An Examination of the Potential Costs of Universal Health Insurance in Ireland.
The report was commissioned by the Department of Health upon Publication of the White Paper on Universal Health Insurance (UHI) in April 2014. These costings contributed to the decision not to progress with the model of UHI as promised in the 2011 Programme for Government.
Universal healthcare was promised but has not been delivered. The Irish Independent. 21 September 2015.
The article from the Independent details the lack of progress toward the Irish government’s 2011 goal of moving toward universalism in the healthcare system as well as the shift in language from universal health insurance to universal healthcare.
Department of Health/Crowe Horwath (2014). Thematic Analysis of Submissions in Response to a Public Consultation on the White Paper for Universal Health Insurance.
The report is a collection and analysis of all public submissions to the government in response to the 2014 White Paper on Universal Health Insurance. It details input from the relevant stakeholders in the broad healthcare system in Ireland, including health service organisations, health insurers, healthcare providers, health policy researchers, advocacy organisations, pharmaceutical companies, and more.
Department of Health (2014). Lynch & Varadkar announce ten key actions for Medical Card System
The press release announces actions in response to the Expert Panel on Medical Need for Medical Card Eligibility.
Department of Health (2014). The Pathway to Universal Healthcare: White Paper on Universal Health Insurance.
The White Paper details the 2011 government commitment to the introduction of a single-tier, multi-payer model of healthcare covering both hospital and primary care through universal health insurance. The plan for UHI has since been abandoned.
Department of Health. (2013). The Path to Universal Healthcare – Preliminary Paper on Universal Health Insurance
Department of Health. (2012). Future Health: A Strategic Framework for Reform of the Health Service 2012 - 2015. Dublin.
The plan for substantial and fundamental reform of Ireland’s health service, detailing the building blocks to reach the goal, of the time, to introduce a single-tier, universal health insurance supported health service
Government of Ireland. (2011). Government for National Recovery 2011-2016 Dublin, Fine Gael/Labour Party
The Fine Gael/Labour programme for Government published as they entered government in March 2011. The programme commits to the introduction of universal health insurance and the abolishment of the two tier two-tier system of unequal access to healthcare.
The State of Health in the EU: Ireland Country Health Profile 2017 https://ec.europa.eu/health/sites/health/files/state/docs/chp_ir_english.pdf
The Ireland report in the series of the concise and policy-relevant overview of health and health systems in the EU Member States, emphasising the particular characteristics and challenges in each country. Designed to support Member States in their evidence-based policy making with the ultimate goal of ensuring that all EU citizens have access to fast, safe and effective healthcare.
State of Health in the EU: Companion Report 2017
First in a new series of biennial reports to accompany the State of Health in the EU country profiles. This companion focusses promoting good health and preventing avoidable chronic diseases while ensuring effectiveness, accessibility and resilience of all health systems in the EU.
Thomson, S, Evetovits, T, Cylus, J , and Jakab, M. (2016). Monitoring Financial Protection to Assess Progress Towards Universal Health Coverage in Europe.
The article explains why financial protection (shielding patients from financial hardships when they utilise health services) matters, review ways of measuring it, and ways reporting on it can contribute to the formulation of health policy.
World Bank. (2016). Universal Health Coverage. The hub for all World Bank resources on the topic of universal health coverage.
The hub for all World Bank resources on the topic of universal health coverage.
WHO. (2015). Fact Sheet no 395: Universal health coverage.
WHO’s site for basic information about universal health coverage.
The World Bank. (2014). Universal Health Coverage for Inclusive and Sustainable Development. A Synthesis of 11 Country Case Studies.
A multi-country study to share varied experiences from countries at different stages of adopting and implementing universal health coverage. Synthesizes experiences from 11 countries—Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam—in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways.
2013 & Earlier
The World Bank (2013). Global conference on universal health coverage for inclusive and sustainable growth: a global synthesis report.
The paper synthesises findings from eleven country cases on UHC including a framework for analysis, emerging lessons from country experiences, global lessons in the political economy and policy process, global lessons in health financing strategy, global lessons in health service delivery and human resources for health, lessons for countries in the four UHC groups, and a future course of action, interspersed with case studies from various countries
WHO. (2013). World Health Report 2013: Research for universal health coverage.
Report focuses on the importance of research in advancing progress towards universal health coverage. In addition, it identifies the benefits of increased investment in health research by low- and middle-income countries using case studies from around the world, and proposes ways to further strengthen this type of research.
United Nations. (2012). United Nations General Assembly. Adopting consensus text, General Assembly encourages member states to plan, pursue transition of national healthcare systems towards universal coverage. GA/11326
Notes from 12 December 2012 plenary meeting of the UN General Assembly where a resolution was adopted urging governments to move towards providing all people with access to affordable, quality healthcare services
WHO. (2010). The World Health Report: Health System Financing and the Path to Universal Coverage.
In this report, the World Health Organization maps out what countries can do to modify their financing systems with the goal of moving toward universal coverage. It provides an action agenda for working toward universal health coverage for countries at all stages of development.
WHO. (2005). World Health Organization 58th World Health Assembly Resolution WHA58.33 Sustainable Health Financing, Universal Coverage and Social Health Insurance
This WHO resolution urges countries to take steps in a variety venues including healthcare financing, infrastructure, human resources, and more, to facilitate the transition and full implementation of universal health coverage.