The cost of developing high-quality health services free at the point of need could be as high as €1.6 billion, according to a new report by the union-backed Nevin Economic Research Institute (NERI). Although this would require significant extra taxation, much of the outlay for families would be offset by reductions in health insurance costs, it says.

The study, Equality in Irish healthcare: Time for a new deal, says it will be impossible to win public support for higher taxes without “a root and branch reform of the service.” But it warns against a “big bang” approach, saying that new innovations should be introduced incrementally.

“Rather than seek a big bang approach to reform, it would seem better to achieve progress in particular areas with new innovations and pilots building up to a critical mass effect, where people see the benefits of a unitary public health service that does not compromise patient safety and offers equal access to everyone on the basis of need and not ability to pay,” it says.

Earlier this year Fórsa head of health Éamonn Donnelly said people would accept the need to pay a little more tax in exchange for free, high quality health services.

The NERI report, authored by Paul Goldrick-Kelly and Tom Healy, points to a “systemic problem” of disparities in access to healthcare and the scope of provision based on wealth.

“Those at the bottom are more likely to be covered by a State-funded medical card with those at the upper end enjoying private medical insurance. A large group in the middle relies on limited entitlements to State care and out-of-pocket expenditure,” it says.

The report looks at the costs associated with SláinteCare, the ten-year plan for the introduction of quality healthcare free at the point on need, which has been backed by all the main political parties.

Read Equality in Irish healthcare: Time for a new deal.