The cost of providing care for a psychiatric patient depends on the level of service being provided and on whether the patient is in a hospital or community based setting. The total cost of each local mental health service is set out in the annual reports of the Inspector of Mental Hospitals.
The legislation governing the regulation of the private health insurance industry in this country requires insurers to provide a minimum level of cover under health insurance contracts. Insurers are obliged to provide a minimum benefit which covers the cost of 100 days in-patient care for a psychiatric patient. This minimum benefit is considerably higher than is required in many other countries where a voluntary private health insurance operates.
The Deputy referred to the cover provided by the Voluntary Health Insurance Board. The VHI provides cover for the cost of 180 days in-patient psychiatric treatment. This cover is significantly in excess of the minimum required by law. If a person chooses to avail of a private psychiatric hospital rather than the public health system the State does not provide any funding towards the patients care.
Nursing home subvention is not payable if the hospital in question is a private psychiatric hospital, registered in accordance with the Mental Treatment Acts. Subvention cannot be availed of as the hospital cannot be registered in accordance with the Health (Nursing Homes) Act, 1990. If the patient were to transfer to another facility, he may qualify for nursing home subvention. This transfer would be subject to the medical care needs of the patient being appropriate to this facility.
The Second Schedule of the Nursing Homes (Subvention) Regulations, 1993, sets out the general rules for the assessment of means in respect of an application for a nursing home subvention. Means are assessed for this scheme to ensure that the available funding is directed at those older people who have the greatest need of financial assistance. Section 22 of the regulations set out an exclusion whereby a health board may refuse to pay a subvention to a person if his or her principal residence is valued at £75,000 or more.
