Health: An extra 230,000 people will be entitled to free access to their GP from the beginning of next year under proposals announced in the Estimates yesterday. Eithne Donnellan, Health Correspondent, reports.
However, just 30,000 of these will become entitled to medical cards in the traditional sense. The remainder will get a new type of card, doctor-only cards, which will entitle them to free access to GP services only, and not to drugs if they are prescribed. These cards, which will be means-tested, are aimed at families on low incomes. Those whose income is 25 per cent over the new income guideline for medical cards will qualify. The general income guideline for current medical cards is being increased by 7.5 per cent.
The Minister for Health, Ms Harney, also promised 300 more acute hospital beds, which will be opened next year.
The Minister announced 10 initiatives costing €70 million to relieve pressure on accident and emergency departments, where every week patients have to spend days on trolleys waiting for beds. These initiatives include funds to transfer 100 high dependency patients from acute hospitals to private nursing homes; expanded home-care packages to support 500 additional older people at home; provision of more out-of-hours GP services to keep the need to attend A&E to a minimum; the development and expansion of minor injury units and chest pain clinics; three new acute medical assessment units at Tallaght, St Vincent's and Beaumont hospitals; and a new MRI scanner for Beaumont.
There will also be more money to ensure A&Es are kept clean. One person will be given responsibility for co-ordinating the initiatives.
Ms Harney said the additional resources will be given to hospitals "on the basis of outcomes and targets".
Furthermore, 1,000 extra staff, including nurses and therapists, are to be recruited to treat people with disabilities. Funding will also be provided for an additional 270 residential places, 400 new day places and 90 extra respite places for those with intellectual disability. A further 60 new places are to be provided for those with physical and sensory disabilities, who are currently in inappropriate settings.
Some 90 extra rehabilitative training places and 200,000 extra hours of home support and personal assistance is also to be provided for this group.
An extra €15 million is to be provided for mental health services. This will allow for the opening of an extra 14 beds at the Central Mental Hospital and the development of child and adolescent treatment services.
An extra €20 million will be given to the National Treatment Purchase Fund next year which buys private treatment for public patients waiting long periods for operations. Ms Harney said she would also be discussing with the fund how it might target long outpatient waiting times.
Some €50 million is also being made available to ensure idle healthcare facilities around the State are opened.
The overall health budget rises by 9.9 per cent to €11 billion for the first time. Some €450 million of the extra spending will go on staff pay.
Patients will also be charged more for certain health services next year. Some €50 million will be generated for hospitals by way of new charges.
These include an increase of €10 to €55 in the fee for attending A&E without a letter of referral from a GP and a €10 increase in the cost of inpatient beds. Patients who do not have medical cards will have to pay €55 a night for a maximum of 10 nights a year. Ms Harney said she wanted to reach a stage in the interests of "fairness and equity" where private health insurers would pay the economic cost of private beds in public hospitals.
She also said the potential of the private sector for providing capital facilities or services to the healthcare sector would be looked at. They could, she indicated, provide GP co-ops or facilities for the elderly.
There will also be an increase of €7 to €85 in the amount people must spend on drugs every month before being entitled to a refund under the Drugs Payments Scheme.
Ms Harney said the increased A&E charges were an attempt to get people to attend their GP rather than A&E, thus reducing pressure on casualty units. Recent research showed people found it cheaper to go to A&E than their GP.
Furthermore, she had extended medical card eligibility because she believed "no family on low income should have to worry about going to their GP or taking their children to the GP".
She said she had €60 million extra available to her next year for medical cards and if traditional type medical cards only were provided, she could have given out a maximum of 80,000. However, by providing doctor- only cards, free GP access could be given to many more people.
She also announced that parents with chronically ill children who have to apply to renew their medical cards every year will no longer have to do so.