asked the Minister for Health whether any arrangements, by way of pooled capitation payments or otherwise, have been made by him under the Health Acts to provide for the remuneration of medical and surgical staffs in voluntary general hospitals; and if such arrangements have been made by way of a pool, if he will state the amount of the capitation rate paid into the pool, and the grades covered by the arrangement; whether it applies to whole-time or part-time posts; whether the cost is charged on the Vote for his Department or on the local health authorities; and the total amount of the pool in each of the years 1956, 1957 and 1958.
Ceisteanna—Questions. Oral Answers. - Voluntary General Hospitals: Remuneration of Medical and Surgical Staff.
43.
I presume the question relates to all voluntary hospitals other than the specialist maternity hospitals.
Following upon negotiations with representatives of the medical staffs of the Voluntary Hospitals, arrangements were made for the remuneration of visiting medical staffs who provide institutional services under the Health Acts.
In respect of services provided for in-patients in a teaching hospital, health authorities pay to the hospitals a capitation charge of £1 Os. 8d. a day. This includes a sum of 2s. 8d. which, under the arrangements referred to, is transferred in each hospital to a pool for subsequent distribution amongst certain of the visiting medical staff on a basis fixed by themselves. The supplement paid to the non-teaching hospitals is 1s. 8d. a day.
The "pool", as mentioned, is divided between certain of the parttime visiting medical staffs of the hospitals. Full-time staffs, paid on a salary basis, and anaesthetists, radiologists and pathologists are not remunerated from the "pool" but are paid by the hospitals from their revenues, derived as to more than 50% from payments by local authorities for "eligible" patients and as to more than 25% from the Hospitals Trust Fund as "deficit" payments.
In respect of specialist services for out-patients at approved specialist clinics, the arrangements provide generally for the payment by health authorities to the hospitals of a fee of £4 4s. Od. per session of 3 hours. Radiological and Pathological sessions are paid for at the rate of 4½ guineas per session of 3 hours. These fees are for the remuneration of the specialists who provide the services.
The sums paid to the hospitals under the foregoing arrangements are paid in the first instance from local authority funds. Fifty per cent. of the amount involved is subsequently recouped to the health authorities from the Vote for my Department.
The information readily available to me in regard to the amounts received by hospitals as contributions to the "pool" relates only to the hospitals which participate in the scheme of grants from the Hospitals Trust Funds towards revenue deficits. The aggregate amounts received by those hospitals in the year 1956 was £76,331. In 1957 it was £139,367. In 1958, it was £151,393. The figure for 1959 is not yet available to me.
Information as to the amounts paid by local authorities to voluntary hospitals for the remuneration of specialists conducting out-patient clinics for patients receiving specialist services under the Health Acts is available only in respect of financial years ending on 31st March. The aggregate amounts paid in respect of the years ended 31st March, 1957, 1958 and 1959 were £57,000, £68,900 and £74,800 respectively.