Dáil Éireann debate -
Thursday, 8 Oct 1998

Vol. 494 No. 6

Written Answers. - Consultant Fees.

Pat Rabbitte

Question:

36 Mr. Rabbitte asked the Minister for Health and Children if it is permissible for a consultant to charge private fees for insured patients where a private bed in public hospital is not available and the person is accommodated in a public bed and if he will make a statement on the matter. [18845/98]

Minister for Health and Children (Mr. Cowen)

Under the Health Services (In-Patient) Regulations, 1991, a private patient being admitted to a public hospital as an elective admission shall not be accommodated in a designated public bed. However, a private patient being admitted to hospital as an emergency admission shall be accommodated in a designated public bed if, and only for such time as, a designated private bed is not available.

Under the Health (In-Patient Charges) Regulations, 1987, as amended by the Health (In-Patient Charges) (Amendment) Regulations, 1997, a person is liable for a statutory charge unless otherwise exempt, in respect of in-patient public hospital services. The current charge of £25 in respect of each day during which a person is maintained up to a maximum of £250 is applicable to both public and private patients. In addition, private and semi-private maintenance charges are applicable to private patients accommodated in designated private beds.

The Health (Amendment) Act, 1991, removed the entitlement to combine public and private elements of in-patient care at the same time. The position now is that every patient is entitled to full public hospital services including public accommodation and public consultant care. Alternatively, one can opt to be the private patient of both the consultant and the hospital. Where a patient chooses to be a private patient, then he-she is liable for consultant fees even when, for reasons of lack of availability of a private bed, he-she has to, as an emergency admission, occupy a public bed.

The requirement that patients make an explicit choice between public and private care was recommended by the Commission on Health Funding on the grounds of equity since, under the previous system, it was possible that some public patients of the hospital could receive preferential treatment over other public patients by virtue of either being private to the consultant by obtaining a private bed.