asked the Minister for Health whether the estimated cost of hospitalisation includes out-patient services costs; and if he will state what proportion these latter costs represent.
Ceisteanna—Questions. Oral Answers. - Hospitalisation Costs.
21.
The average in-patient cost as at present computed includes the cost of out-patient services. This can vary from hospital to hospital and to isolate it in precise terms would involve a considerable amount of investigation, but it is estimated in some Dublin hospitals that the portion of expenditure attributable to out-patient services is in the region of 7 per cent.
What is the percentage?
It is 7 per cent.
In the light of this information would the Minister not think that the figure of £14 per day for in-patient service is misleading?
It is very hard to say. One of the things that disappoint me most about hospital accountancy is that I find in no country is it regarded as really possible to separate out-patient services costs. If one could do that, it would be easier to estimate the efficiency of a hospital operation for the in-patients, and it would be easier to calculate on a cost benefit basis how much to expand the out-patient services and in particular to establish hostels for patients awaiting observation. Nursing costs would be less. Nevertheless, we will do our utmost to examine the whole of this business to see whether we can get some useful information.
In the light of what he has said, will the Minister not agree that there is need for an investigation into the costing systems of hospitals?
I agree with the Deputy.
Is it not true that not only here but in England also you do not get the separation of costs which would provide the sort of information the Minister is talking about? For instance, if you want separate costs for pathology you will not get them even in British hospitals.
That is right. I have read the main study by the Department of Health and Security in England which is a large volume on the provision of measures to ensure efficiency in the running of hospitals. It is an immensely long document and I was very disappointed to find that, whatever else you could recommend, it was terribly difficult to separate these costings at a cost which would not be absolutely prohibitive.