Is there a need for an increased role in private financing in European Health Systems? The changing role for individuals in health financing. 7th European Health Forum, Gastein, 7th October 2004 Michael Kelly,Secretary General, Department of Health and Children, Ireland

Ireland : Some Facts Population 4 million Health Budget 10 billion Employees 100,000 GMS 30% Population PHI 50% Population

The Restructured Irish Health System Minister for Health and Children Board of HIQA Director of HIQA Board of HSE Chief Executive OfficerDept of Health & Children Secretary General Regional Directors of the Primary, community and continuing care pillar Director of the National Hospitals Office Director of the National Shared Services Centre Formal accountability Ongoing liaison

National Treatment Purchase Fund - Progress 2002 – 1920 people treated 2003 – 9752 people treated 2004 – 19,000 treated & off waiting list to end Sept – target of 12,000 for 2004 will be exceeded 80% now wait 12 months at outset) 37% wait 3 – 6 mths and 43% wait 6 – 12 mths Longest waiters have been treated Patient Satisfaction rate of %

Why Public Private Partnerships (PPPs)? Accelerated delivery of priority economic infrastructure Value for money over life time of the project Quality public services

Private Health Insurance in Ireland Three Pillars of Current System Community Rating –Non discriminatory –Premium rates not linked to risk factors Open Enrolment –Cover must be offered to all Lifetime cover –Continuity of cover irrespective of onset of illness or claims record

Social Determinants and the Role of the Individual The Determinants of Health

Conclusion There is every reason to consider increased Private Financing Individuals can play an increasing role in funding health care If they have all the information they need for informed decision making We need to ensure equity is respected