I propose to take Questions Nos. 222 and 223 together.
The following table sets out the number of attendances at casualty (accident and emergency) Departments in public hospitals in the period 1992 to 1997.
A charge for out-patient services was introduced in 1987 under powers conferred on the Minister by section 5 of the Health Act, 1947, and section 56 of the Health Act, 1970, as substituted by section 1 of the Health (Amendment) Act, 1987. From 1987 to 1993 the charge for attendance at casualty (accident and emergency) departments was set at £10 per episode of care. In March 1993 the charge was levied at £6 per visit subject to a maximum charge of £42 in any period of 12 consecutive months. The charge was changed again in March 1994 to £12 for the first consultation in any episode of care for persons attending the accident and emergency department directly, without having a referral note from their general practitioner. This charge has now been increased to £20 effective from 1 January 1998 on the same basis.
The charge applies only to those attending the accident and emergency department without referral from their general practitioner and only to the first consultation in any episode of care. There are a number of exemptions from the charge including medical card holders and their dependants, women receiving services in respect of motherhood, children up to the age of six weeks, children suffering from prescribed diseases and children referred for treatment from child health clinics and school health examinations.
It is estimated that income from the accident and emergency charge in 1997 was of the order of £1.7 million. On the basis that attendance at accident and emergency departments remains the same as 1997 the estimated increase in income for 1998 is expected to be in the region of £1.15 million.
In relation to the matters of the accident and emergency treatment fees paid, numbers who did not pay and the amount collected in each year, I am not in a position to supply the Deputy with details as the audited financial statements, as submitted to my Department, do not provide this type of analysis.
