There is currently no proposal from the Department of Finance to exclude private patients from public hospitals. The Finance Act, 2001, includes measures which allow for the establishment of private hospital facilities under certain conditions which include provisions to ensure that 20% of the capacity of such facilities would be made available annually for the treatment of persons who have been awaiting in-patient or out-patient services as public patients subject to service requirements specified by the health board in whose area the facility is located.
The private hospital concerned must provide a discount of at least 10% to the State in respect of fees to be charged in regard to the treatment of any such public patients as compared to the fees charged in respect of similar treatment afforded to a person who has private health insurance. The intention of these measures is also that the benefits in terms of additional beds should be captured for the public system by the redesignation as public of an equivalent number of beds in the public system that had been designated as private. The aim of this is to reduce pressure on public hospital beds.
Under arrangements for public hospital services introduced in June 1991, on foot of the Health (Amendment) Act, 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. Alternatively one can opt to be the private patient of both the consultant and the hospital. Private patients are liable for the appropriate accommodation charges and consultants fees in addition to the statutory charges.
The 1991 Act also provides that beds in public hospitals are formally designated as public, private or non-designated. The Health Service (In-Patient) Regulations, 1991, which were introduced pursuant to the Health (Amendment) Act, 1991, state that a hospital providing services under section 52 and 55 of the Health Act, 1970, shall designate every bed, other than non-designated beds as a designated public bed or a designated private bed. The category non-designated beds refers to beds such as intensive care beds which it was not considered appropriate to designate as public or private. In its report published late last year, Private Practice in Irish Public Hospitals, the ESRI found that about 20% of in-patient beds in acute public hospitals are currently designated as being for private patient use.