A package of measures aimed at boosting A&E funding while trying to reduce the number of people visiting these departments was unveiled in the €11 billion health spending estimates for 2005, by the Minister for Health, Ms Harney.
The Minister has two measures to reduce the number of people attending A&E units, extending free GP care and making visits to A&E departments more expensive.
A new class of medical card, the doctor card, has been created which will entitle an estimated 200,000 people to free GP care but not free medicines.
Announcing the decision, Ms Harney said she decided to do this because with the money available she could either provide 70,000 "full" medical cards or offer free access to a family doctor to a much higher number.
She said no one on these new cards would have to pay more than €85 per month on medicines. The new cards would come into place early in the new year. She also announced an extra 30,000 normal medical cards as a result of widening the income eligibility thresholds by 7.5 per cent, effective from January 1st, 2005.
The income allowance for parents of two children will be increased by 20 per cent and the allowance for third and final children rises by 30 per cent.
She said the Government's stated policy remains to extend eligibility for medical cards rather than to achieve a certain percentage of the population.
Ms Harney also said that the parents of children with chronic illness who hold a medical card will no longer have to re-apply every year.
Along with making GP more accessible, the Minister has raised the cost of attending A&E units, without a reference from their GP, to €55.
As part of the Government's wish to end the subsidy for private beds in public hospitals, private health insurers will face a 25 per cent rise in the cost of private beds, which is likely to lead to an increase in the cost of health insurance premiums next year.
The Minister said this combination of increased charges would raise an estimated €50 million per annum. Allied to this is a ten-point €70 million plan to improve accident and emergency services which includes the development of minor injury units. One person will be appointed to oversee A&E services nationwide.
Ms Harney said 100 high dependency patients would be transferred to nursing homes and the Department will start negotiation with the private sector to provide step-down facilities.
The plan includes home support for 500 additional older and the provision of additional out-of-hours GP services. Ms Harney said there were parts of Dublin without such a service.
Spending on disability services will rise by €205 million to €2 billion next year with an extra 1,000 staff due to be recruited to extend services.
Ms Harney said the additional funding would provide for 270 additional residential places, 400 days places and 90 extra respite places.
The Department will spend €50 million on fully opening all the recently built medical units which were not "fully operational" while 300 extra acute hospital beds will be provided.
She said the National Treatment Purchase fund would receive an additional €20 million bringing its allowance for the year to €64 million.
The cost of running the GMS service will rise by 12 per cent or €142 million next year. However, part of this funding increase will be off-set by the increase in the current drugs threshold from €78 to €85 per month - saving the Government €7.5 million.Under this scheme the patiet has to pay the first €85 of the cost of a prescription with the remainder reimbursed by the Government.
Health spending is rising from €950 million to €10.5 billion, an increase of 9.9 per cent.
