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.
Currently, there is a statutory charge of £25 for attendance at accident and emergency departments where a person has not been referred by a medical practitioner. Medical card holders are exempt from this charge. On admission to hospital, following directly from attendance at an accident and emergency department, a patient must then decide whether he or she wishes to be treated as a public or private patient. In relation to each clinical consultation, private patients, following admission to hospital, are liable for the appropriate accommodation charges and consultants fees in addition to the statutory charges once they explicitly exercise their option to be treated as a private patient.