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Dáil Éireann debate -
Tuesday, 6 Dec 1983

Vol. 346 No. 6

Ceisteanna—Questions. Oral Answers. - Private Hospitals.

7.

asked the Minister for Health whether his attention has been drawn to a report (details supplied) that he intends to introduce legislation affecting private hospitals; and whether he will make a statement on the Government's intentions in this regard.

To ensure that our hospital services are structured in a planned and orderly manner, there is an obvious need for statutory control over the establishment and development of private hospital facilities. I am at present drawing up proposals for submission to Government regarding such legislation.

Can the Minister say what precisely there is about the existing private hospitals which he finds unplanned or disorderly and why he considers it necessary to interfere at all in their operation?

To give a short answer, I do not wish the VHI to finish up in the same way as the PMPA.

Are the Minister's intentions entirely related to that? Perhaps I might ask the whole question in the same breath. Are they related also to ensuring proper medical and nursing standards in those hospitals?

There is a double-barrelled reason for it. We have an enormous proliferation of hospitals of all kinds and all varieties of bed occupancy costing approximately £650 million per year. We are spending now £13 million a week on hospital institutions and many people have very bright ideas about setting up yet another private hospital and then availing of VHI — who, I assure the House, are entirely solvent and in very good hands, lest my earlier comment be misconstrued. The existing system of voluntary medical insurance must be protected and must not be exploited. That applies to domestic entrepreneurs in the medical field or to international entrepreneurs. We have had proposals in that regard from America and we have resisted those proposals, or at least I have.

Is the Minister going to nationalise private hospitals?

With that in mind I propose to introduce a system of registration and approval of individual hospitals by the Department of Health.

Is this nationalisation?

Order, please. The question on the Order Paper.

Is it nationalisation?

A Deputy

It is long overdue.

Question No. 7 asks whether it is proposed to introduce legislation to deal with private hospitals. That cannot possibly be taken as an opportunity for discussing the workings of private hospitals, the necessity for private hospitals etc. That could go on for weeks.

It was not I who broadened the question.

I am speaking to everybody whom the cap may fit.

Arising out of the parts of the Minister's reply which were in order, could I ask him if he would state briefly the criteria on which he proposes to permit, or presumably impliedly also to refuse, registration to existing private hospitals?

I am sorry, I must rule that question out of order.

I think I am getting a whiff of ideological soup from the Minister's kitchen and I could not let this pass.

The Deputy will have to get a stomach-full of Standing Orders. That is what is ruling here, not soup from any kitchen.

On this question I have tried to elicit from the Minister in an orderly way what exactly is behind his or his Government's intentions, assuming they are shared collectively, in regard to legislation on private hospitals. The Minister has replied that he intends to legislate to prevent——

The Deputy will have an opportunity of discussing that if and when legislation is introduced.

A great deal of agony would be saved if legislation were preceded with open discussion rather than the other way round.

The Deputy will find an opportunity on the Estimate for the Department of Health and many other opportunities of discussing it. This is not one of them.

I wish to raise this matter on the Adjournment.

The Chair will communicate with Deputy Kelly.

Is the Minister opposed to private hospitals? He has refused the building of private hospitals at Beaumont and Tallaght.

That does not arise on the question. It deals with legislation only.

Arising out of the Minister's reply and the inference that people are anxious to establish private hospitals for the purpose of monetary gain, does the Minister feel, as the health boards are availing of the services of these hospitals and passing patients from their own institutions into these hospitals, that those in charge of these private hospitals and nursing-homes have a charitable function at the back of their minds as well as a financial one?

If legislation is introduced the Deputy can talk about that. I cannot allow a point to be raised by one Deputy and not allow a point to be raised by another Deputy.

I would like clarification on a point. The Minister in answering the question made a certain inference. Is he to be allowed off scot free without comment from our side of the House on that inference or are we entitled to ask him to clarify an inference such as he made?

If the Chair were to accept that logic we could be chasing hares on one question here for a good day.

(Interruptions.)

Question 8, Deputy Gregory-Independent. Deputy Kelly has given me notice that he intends to raise the matter on the Adjournment.

On a point of order, on what basis, Sir, did you rule out my supplementary question to the Minister?

I was asked so many supplementary questions. I ruled it out because it was not in order and because the Chair has absolute discretion on whether supplementary questions are in order or will be allowed and how many will be allowed. A discussion at Question Time on private hospitals versus public hospitals or the necessity for private hospitals, which is a huge question, is not suitable.

I asked a supplementary question——

This question is being hustled out of the House.

It is not being hustled. The others were in order.

I asked at one of the Minister's rejoinders if he would explain his apprehensions about VHI. With all due respect to a friend and colleague, it is wrong to leave that out.

I have ruled. Question No. 8

I understood you to rule my supplementary question out of order on the basis that it was not related to the question.

That it was widening the question enormously.

If I remember the question, all I asked the Minister was if he was opposed to private hospitals, and the question specifies to ask if the Minister will make a statement on the Government's intentions.

That will arise very much if and when a Bill is introduced but not on the question.

I think it is an appropriate supplementary question to ask the Minister.

The Chair respectfully disagrees with the Deputy.

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