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Dáil Éireann debate -
Tuesday, 28 Mar 2000

Vol. 516 No. 6

Written Answers. - Hospital Charges.

John McGuinness

Question:

309 Mr. McGuinness asked the Minister for Health and Children the assistance available to a person (details supplied) in County Laois in relation to his son (details supplied) who requires an immediate life saving heart operation and must bear the cost of almost £15,000 in view of the fact that there is not medical insurance cover; if he will encourage through the health board a pro-active approach to the needs of the family; and if he will make a statement on the matter. [9110/00]

I understand from Our Lady's Hospital for Sick Children, Crumlin, that the child in question has had his surgery carried out in the United Kingdom privately and has been discharged home.

Under arrangements for public hospital services introduced in June 1991, everyone, regardless of income, is entitled to public hospital and public consultant services subject only to modest statutory charges, from which medical card holders are exempt. At present these charges are set at £26 per night, subject to a maximum of £260 in any twelve month period, in respect of in-patient public hospital services. Hospital services are provided on the basis of medical need and clinical urgency.

Alternatively, one can opt to be the private patient of both the consultant and the hospital. Any patient, whether a medical card holder or not, who opts for treatment in a private hospital or as a private patient in a public hospital is liable for the costs relating to such treatment, and neither my Department nor the health boards are in a position to provide financial assistance towards these costs.

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 or by obtaining a private bed.
As the Deputy will be aware, my Department is funding the purchase of paediatric cardiac surgery procedures from appropriate UK paediatric hospitals under the cardiac waiting list initiative and in this regard I wish to advise the Deputy that £0.7 million was allocated to Our Lady's Hospital for Sick Children in 2000 under this initiative.
The decision to refer a patient to the UK for congenital cardiac surgery is based entirely on the degree of medical urgency. These patients who are on the urgent list on Our Lady's Hospital for Sick Children and who cannot be operated on there because of limited facilities are referred to the UK according to the degree of medical urgency as determined by the consultant cardiologist/surgeon involved. Should a child be considered appropriate for transfer to the UK for surgery by the consultant concerned, the associated costs will be met under the initiative.
It is important to note that the prioritisation of the waiting list is a matter for the clinicians concerned and that immediate medical treatment is provided to all urgent cases.
I am aware of the need to increase the hospital's cardiac surgical capacity and in this regard a design team for a new theatre development at the hospital has been appointed. When completed, the new theatre development will provide five new operating theatres complete with ancillary accommodation, a day surgery area and a central sterile supplies department. The existing theatre facilities will also be upgraded to provide a further two theatre suites. When these theatres are fully commissioned it is expected that Our Lady's Hospital for Sick Children will be in a position to perform an additional 100 paediatric cardiac procedures per annum, which is an increase of 40% on its existing capacity. The estimated completion date for the development is 2002.
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