I raise this matter this evening because the draft regulations, as they stand, have very serious implications for the welfare of psychiatric patients and for the future of public and private psychiatric services. The draft regulations include one providing a minimum cover of 40 days psychiatric in-patient treatment per year be provided by any health insurer wishing to operate here.
There are considerable worries among the public and in the institutions involved in the provision of psychiatric care that this minimum will become the norm. I understand that preliminary discussions between many of these institutions and the Voluntary Health Insurance Board suggest that is likely to be the case. For example, the present cover provided for psychiatric in-patient treatment is 180 days per year, no different from that provided for physical in-patient treatment.
If one looks at the recommendations concerning patients suffering from substance abuse, like alcohol, drugs and so on, the position is even worse. At present the VHI cover is 90 days every five years but the draft regulations propose 40 days only within a lifetime. As we are all aware — and here I am sure the Minister of State will agree with me — neither alcohol dependence nor substance abuse is reducing here, if anything, the opposite is the case.
The introduction of a 40 day minimum limit constitutes a most serious discrimination against psychiatrically ill patients, no other type of patient is singled out for such a limit. It will result in approximately 30 per cent of patients currently being treated within the private psychiatric sector having to seek care from the already over-stretched and seriously strained public psychiatric services. The patients who will be most affected by these changes will include those who suffer from serious psychiatric illness, such as manic depression, schizophrenia, anorexia nervosa, psychiatric disorders associated with physical disease and with ageing, for example, Alzheimer's Disease.
In relation to those people suffering from substance abuse and alcohol dependence, these regulations will reduce the role of the psychiatric services from that of providing what they do at present, which is a valuable, professional, in-patient treatment and after care, to a very short term system of detoxification programmes and crisis management. In an era in which both alcohol and substance abuse are on the increase that is not acceptable.
The real impact of these changes in the draft regulations will be borne by the patients most seriously affected by psychiatric illness and, of course, by their families who are extremely worried. I understand that representatives of St. Patrick's Hospital and St. John of God's Hospital sought a direct meeting with the Minister because of their huge concerns but were informed that he was too busy to meet them. I appreciate that the Minister has a very busy schedule. I understand those hospital representatives met his departmental officials but, because of the level of care they provide, they feel they deserve a meeting with the Minister and I ask the Minister of State to bring that request to the Minister's attention.
I ask that the psychiatrically ill be treated no differently from patients suffering from physical illnesses. I also request that the present levels of VHI cover for psychiatric in-patient treatment should be the recommended minimum level for inclusion in the new regulations about to be signed by the Minister. If those regulations are implemented, as drafted, they will have far reaching, serious, negative effects for patients and psychiatric care generally.