Persons who are ordinarily resident in Ireland but who do not qualify for a medical card automatically have category two eligibility. Persons in this category are subject to in-patient charges in a public ward in a public hospital of £26 per night to a maximum of £260 in any 12 month period.
At present 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. Persons with dependants are not liable for these charges.
The over-riding consideration in applying long-stay charges is that persons with means who are in receipt of long-stay 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. It is accepted that the position regarding eligibility is complex and that, in the interest of equity and transparency, it should be made more clear. The whole eligibility framework for health services generally is one of the key issues to be addressed in the new health strategy currently being prepared.
