asked the Minister for Health if his attention has been drawn to the practice in some hospitals of requesting payment of large sums of money in advance for treatment, and in some cases essential treatment; and the difficulties and distress that this can create for patients; if he will request hospitals, in the interests of patients, to desist from this practice; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Hospital Charging Practice.
15.
I presume the Deputy is referring to charges made under the Health (Out-Patient Charges) Regulations, 1987, and the Health (In-Patient Charges) Regulations, 1987.
In the case of scheduled attendance for out-patient services, health boards and hospitals are acting quite responsibly and in accordance with the advice contained in the relevant circular issued by my Department on 24 April 1987 in giving those attending prior indication of whether they will be liable for a charge and, in the case of in-patient services, what the level of the charge is likely to be. Such arrangements allow for the persons knowing in advance their liability and being able to plan accordingly. More particularly, they give persons who may be unable, because of financial constraints, to meet the costs involved, an opportunity to have their position assessed prior to entering hospital. The Deputy can be assured that, in accordance with long established practice, those in need of treatment will always receive it.
It is possible that people misunderstand the intention of the letters which issue from hospitals notifying individuals of their date for appointment-admission and the level of charges for which they are liable. Should there be any confusion in this regard a person should immediately contact the secretary-manager of the appropriate hospital for clarification.
The question does not refer to hospital charges. I thought the wording of the question was quite clear. It refers to the practice in some hospitals of requesting payment of large sums of money in advance for treatment, in some cases, essential treatment, and the distress this can cause. I have a specific case in mind of a person who had a serious operation for cancer. Two days later that person was referred to a private hospital for a CAT scan because there was a two to three months waiting list in public hospitals for the CAT scan to which the person was entitled free of charge. Having been brought to the hospital by ambulance the person concerned was asked for the money up front. Would the Minister not agree that that was an extremely distressing situation and will he undertake to instruct hospitals, whether they be private hospitals charging fees or hospitals providing public services, that this is not an acceptable method of operation?
The Deputy should send the details of this case to the Department.
The question is clear.
There is some confusion over a letter which issued from Beaumont Hospital.
This has nothing to do with letters; it is about people.
We are not aware of any cases where large sums of money have been demanded prior to treatment.
Will the Minister indicate that it is unacceptable that procedures of this kind should operate, that a patient who had only two days previously had a serious operation for cancer should get a demand for £360 while lying on a stretcher in a hallway, before the hospital would carry out the CAT scan?
I agree with the Deputy that that would be unacceptable and I would like him to send the details of this case to the Department so that it can be fully examined.
In relation to the Minister's reply, it is hard to read between the lines. He referred to two letters from Beaumont which are confusing. I know of a case of an elderly patient who was advised to take treatement for arthritis and who was concerned that she had to have the £110 up front before she could go to hospital. Is the Minister assuring us that it is not necessary to produce the money in advance and that the early notices do not mean that you must have the money ready in advance but simply indicate that the charges will be payable at some stage?
The letter which is causing some concern and which is separate from the one Deputy De Rossa is referring to was issued by Beaumont Hospital. That letter has caused some confusion but the matter has now been clarified. We were in touch with Beaumont Hospital in relation to that letter.
Can the Minister clarify the matter for me?
The arrangement made between the hospital and a particular patient would be one of sensitivity. We will bring the points raised by the Deputy to the attention of the hospitals involved.
Arising from the Minister's initial response and accepting that the intent of Deputy De Rossa's question is quite different, I am greatly concerned that the message the Minister is putting across to the House today is that it is an objective of the Government to dissuade people from seeking necessary medical assistance in out-patient departments and that that was one of the objectives of introducing the in-patient and out-patient charges last year. Is the Minister satisfied that there are not people who are dissuaded from availing of necessary medical attention and that people are not dying at home because of these charges that he introduced last year?
I do not agree with Deputy Howlin. The charges were introduced to encourage people to avail of their general practitioners in relation to minor ailments and it has been successful to the extent that the more urgent cases are being treated in the casualty departments. I want to make it clear that people with medical cards are exempt. We also introduced in 1987, through the VHI, a very attractive scheme covering members for in-patient and out-patient facilities. I would not agree that anybody has died as a result of these charges being introduced. That is an irresponsible allegation which should be withdrawn.
Will the Minister assure us that he will write to hospital administrations advising them that it is unacceptable to demand money up front before providing services?
I would prefer to get the details from the Deputy in relation to the allegations he is making. A case has been brought to our attention by way of a letter from Beaumont Hospital. We have been in touch with that hospital and are pursuing the matter with them. If the Deputy gives us specific details of the case he has in mind, we will have it examined.