asked the Minister for Health if he proposes to reduce the allocation to the health boards for 1985 by £1.4 million in lieu of the charges for use of equipment for private patients by consultants in public hospitals.
Ceisteanna—Questions. Oral Answers. - Health Boards Allocation.
16.
The non-capital allocation which has been approved for health boards and voluntary hospitals for 1985 reflects in appropriate cases the estimated financial benefit of a charge for the use by consultants of public facilities in the treatment of their private patients.
I asked the Minister whether he had instructed the health boards to collect £1.4 million from the consultants in lieu of charges for the use of equipment for private patients.
On 5 February last a letter was sent to the health agencies specifying the amount to be collected from consultants in their employment and asking them to include in their action plan for budget management, 1985 details of the arrangements to collect the moneys. I am asking the agencies to pursue this matter in the ordinary course of events. Individual levies were notified to each of the agencies.
Do the levies amount to £1.4 million, as outlined by the Minister, and would he not accept that this charge, if collected, will be passed on to the patient so that he, and not the consultant, will be paying? The equipment has been paid for already by the patients as taxpayers and through their health contributions. Would the Minister accept also that, if implemented, this levy will result in patients in categories (1) and (2) opting for public hospital services, and that in that way a large number of patients will be transferred into an already overcrowded public service? Did the Minister not meet with the medical organisations on a number of occasions in an effort to negotiate this charge with them and, having failed in that respect, has now instructed the health boards to collect the money? In effect this is asking the health boards to enter into confrontation with the consultants at a time when we should all be grateful that the health boards and all their staffs have ensured that the health services will continue despite reduced allocations. A serious confrontation would be detrimental to the interest of patients.
I do not envisage any such confrontation. I have indicated that the levy — and the use of that word is for want of a better term — is on the basis that a reasonable contribution would be made by medical consultants for the use of public facilities in respect of the treatment of their private patients. In a number of hospitals — for instance, in the voluntary hospitals in the Dublin area — the consultants pay over to the hospitals anything from 15 to 33 per cent of their income for the use of facilities for private patients. That has been the practice for a number of years. I am reflecting that procedure by introducing it into those areas where it has not been the practice. The amount concerned is relatively low.
It is £1.4 million.
I do not envisage people transferring to the public services as a consequence of that change.
Can the Minister give a breakdown for each health board area?
A detailed discussion on a proposal such as this, one that embraces a very wide topic, is not in order for Question Time. The Chair has discretion in such matters.
It is a very serious national matter.
Yes, and that is why I am ruling that it is not suitable for teasing out by way of question and answer at Question Time.
That is why we should have discussion on it.
But not at Question Time.
Does the Minister recall that in reply to a question here last week he stated that more than £400,000 would be collected by way of this new procedure, but how is it proposed to collect the other £1 million? Also, can he indicate whether the direction from his Department to the health boards is in conflict with the common contract? The Minister has not answered the other question I asked, that was, whether after he had tried to reach agreement with the consultants but failed he then proceeded to issue the direction to the health boards.
I have ruled out of order an in-depth discussion of the matter.
The sum of £423,000 was in respect of all the health boards while the balance, £977,000, was in respect of the voluntary hospitals.
Will the voluntary hospitals be retaining the moneys collected in this way?
Yes.
Is the direction to the boards not in conflict with the common contract?
The additional contributions from this source are reflected in the budgets of the hospital concerned.
As this is totally new, is it not in breach of the common contract?
I would not like to examine that common contract. It is quite a can of worms but the proposal is not in breach of it.
The Minister cannot know that yet.