Liam Aylward
Question:514 Mr. Aylward asked the Minister for Health and Children the guidelines governing hospital charges in respect of medical card holders; and if they are liable for the daily charge in a public or district hospital. [18091/99]
Written Answers. - Hospital Charges.
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 provided for patients who are treated in a designated public or private bed. This charge is currently set at £25 per night, subject to a maximum of £250 in any 12 month period.
Persons who attend the accident and emergency department directly without having a referral note from their general practitioner are liable for a charge of £20 which applies only to the first visit of any episode of care. There are a number of exemptions to the accident and emergency charges and the in-patient charge, including medical card holders, women receiving services in respect of motherhood and children up to six weeks old.
In addition to these charges, which relate to short-term care, long-stay charges can be made under two sets of regulations. Charges can be made under the Institutional Assistance Regulations, 1965, where the patient receives "shelter and maintenance" rather than treatment. These charges apply from the date of admission and are payable by all patients who are in receipt of incomes, including medical card holders and persons with dependants.
Charges can also be made under the Health (Charges for In-Patient Services) Regulations, 1976, as amended by the Health (Charges for In-Patient Services) (Amendment) Regulations, 1987. These regulations enable charges to be made towards the cost of providing hospital in-patient services for persons with income who have been in receipt of such services for more than 30 days or for periods totalling more than 30 days within the previous 12 months. In practice, persons in long-stay care do not usually hold medical cards as the hospital takes responsibility for all of the person's health needs. Persons with dependants are also exempt.
The over-riding consideration in applying long-stay charges is that persons with means who are in receipt of long-term care should make a contribution towards the cost of their maintenance. In deciding the amount to be contributed health boards have regard to the person's individual circumstances. Allowance is made for any financial commitments the person may have and a reasonable amount is left to meet the person's personal needs. Charges may be waived if, in the opinion of the chief executive officer of the appropriate health board, payment would cause undue hardship.