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Dáil Éireann debate -
Tuesday, 14 Jun 1988

Vol. 382 No. 1

Ceisteanna — Questions Oral Answers - Private Hospitals Subsidisation.

20.

asked the Minister for Health if he approves of ordinary VHI subscribers having to subsidise patients in luxury private hospitals.

I presume that the Deputy is referring to the new high technology hospitals which are particularly catered for by VHI Plans D and E. In fact the board's policy, and mine, is that all plans should be self-financing within the broad framework of community rating which avoids loading subscriptions for increasing age or for poor health status.

Will the Minister agree that the VHI subscribers who qualify for facilities in the high-tech hospitals, Blackrock Clinic and the Mater Private Hospital, are not providing self-financing and that they are being financed by the ordinary VHI subscriber?

No, people who subscribe to plans A, B and C are entitled to use the high-tech hospitals for certain procedures. If they use them for other than certain specified procedures they do not receive the full payment of the costs but a percentage of that payment.

Is the Minister aware of the concern being expressed by senior people in the medical profession about the amount of money being absorbed by the high-tech hospitals, the effect it is having on the stability of the VHI and on the cost to the ordinary VHI subscribers?

Certainly we would all be concerned at the high cost of health care, particularly the high cost of health care in the high technology hospitals but, as I pointed out, there are special plans, D and E, which are self-financing for the two high-tech hospitals.

They are not self-financing.

Patients who are in plans A, B and C are entitled to use those hospitals but they do not have the full cost of their treatment and maintenance paid for them.

Is it not true that when the former Minister was considering plans D and E and the question of self-financing, a certain figure was laid down as being the required number of subscribers to attain the self-financing level? Will the Minister agree that that number of subscribers was never attained and that there is a huge element of subsidisation involved now?

My understanding is that they are self-financing with the proviso I have outlined in regard to patients in plans A, B and C.

In relation to the question of subsidisation of patients in luxury private hospitals, I would like to ask the Minister to give his views on the subsidisation by PAYE taxpayers of patients in such luxury hospitals who are covered by VHI plans. That service is subsidised by tax refunds.

It is the right of individuals to use such hospitals if they so wish. No public moneys were expended on either hospital in the provision of the hospital buildings or in the provision of any of the equipment there.

Is the Minister not aware that the special premiums for these luxury hospitals are tax deductible by those who pay them? Is that not a subsidy by the taxpayers of those private luxury hospitals?

The question of tax relief on premiums paid for any insurance is a budgetary matter.

We now move to questions nominated for priority.

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