asked the Minister for Local Government and Public Health if he is aware that Mr. Robert Lee, Monkstown, an insured worker, No. 506344, was taken ill on 7th August with acute appendicitis; that no hospital would admit him and that he entered a private nursing home and was operated on immediately; and whether there has been a refusal by the society to contribute to the cost of this worker's maintenance; and, if so, if he will state the reasons.
Ceisteanna — Questions. Oral Answers. - Insured Workers' Medical Expenses.
I have ascertained that the facts are as stated in the first part of the question. As regards the second part, it is not correct to state that no hospital would admit the patient. My information is that he requested that an operation be done at a particular hospital, and that there were no beds available at the hospital at the time. Acting on his doctor's advice he was taken by ambulance to a nursing home where one of the surgeons attached to the hospital in question performed the operation.
As regards the latter part of the question, the additional benefit scheme of the National Health Insurance Society provides for payment in respect of hospital benefit to hospitals which have entered into agreements with the society for the provision of the benefit in accordance with the terms of the scheme. The agreements entered into by the society do not extend to nursing homes and the society has no power to make any payment to the nursing home in the case in question.
My information is that the insured person could not get admission to any hospital. The Parliamentary Secretary's case apparently is that he could have got admission to one particular hospital. I would suggest to the Parliamentary Secretary that, even if the facts are as he says they are, he ought to be prepared to contribute the cost of the maintenance, because in the case of this worker there was no time to waste, and it is a well-known fact that very often there are no facilities for urgent cases available in hospitals. If the worker proves that he could not get into the particular hospital which the Parliamentary Secretary mentions, will he then make the contribution?
Payment can only be made to hospitals which have entered into an agreement with the society to afford medical treatment. Payment cannot be made to an institution which has never made such an agreement.
But if the Parliamentary Secretary's contention that the worker could have got into a particular hospital or institution is not well founded, will the cost then be paid?
That does not alter the position. The institution to which he went has not entered into an agreement with the society.
But he had failed to secure admission elsewhere.
Payment cannot be made to an institution which had not entered into an agreement.
I would suggest that the Parliamentary Secretary is only evading the issue.
Oh, no.
You have oversold insurance benefits and——
There is no evasion in it at all. The Deputy is all wrong.
Is it your contention that he could have got into the institution?
My contention is that the institution to which he went cannot be paid because that institution has not entered into an agreement with the society.
It is perfectly clear that he could not have got in anywhere else.
The point is that the home cannot be paid because no agreement had been entered into.
I would suggest to the Parliamentary Secretary that this is definite evasion.
The Deputy is merely repeating one supplementary.
The man might have died on the street while seeking admission to hospital.