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Accident and Emergency Services.

Dáil Éireann Debate, Wednesday - 17 November 2004

Wednesday, 17 November 2004

Questions (109)

Willie Penrose

Question:

148 Mr. Penrose asked the Tánaiste and Minister for Health and Children the various charges that persons who are not medical card holders have to pay in the event of their having to attend an accident and emergency unit of a hospital; the amount they would have to pay if they were admitted into the hospital ward; and if she will make a statement on the matter. [28864/04]

View answer

Written answers

Entitlement to health services in Ireland is primarily based on residency and means rather than income. Any person who is accepted by the health boards as being ordinarily resident in Ireland is entitled to either full eligibility — category 1, that is, medical card holders — or limited eligibility — category 2 — for health services. Persons in category 1 are medical card holders and are entitled to a full range of services including all outpatient public hospital services without charge. Persons in category 2 are those who do not hold medical cards, and they are entitled, subject to certain charges, to outpatient public hospital services including consultants services.

With regard to an attendance at accident and emergency departments, the Health (Out-Patient Charges) (Amendment) Regulations 2002, provide for a statutory charge of €45 per visit. This charge is levied only on persons who attend at accident and emergency departments without a referral note from their doctor and applies only for the first visit of any episode of care. Other than this charge which refers only to visits to an accident and emergency department, there are no other charges for public patients attending outpatient public hospital clinics.

There are a number of people who are exempt from this charge, including medical card holders, women receiving services in respect of motherhood, children up to the age of six weeks, children referred for treatment from child health clinics and school health examinations and persons whose attendance results in admission as an inpatient. Also exempt from these charges, in respect of treatment for the particular condition, are children suffering from prescribed diseases, i.e. mental handicap, mental illness, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, haemophilia and cerebral palsy.

On admission, a person is designated an in-patient and charges are applicable subject to eligibility status. The Health (In-Patient Charges) Regulations 1987, specify categories of persons exempted from public hospital statutory in-patient charges, which currently stand at €45 per night up to a maximum of €450 in any 12 consecutive months for those with category 2 eligibility status — that is, non-medical card holders. Persons with category 1 eligibility status, i.e. those covered by the medical card scheme, are amongst the categories exempted.

As with the accident and emergency charge, the 1987 regulations provide that, pursuant to section 45 (7) of the Health Act 1970, a person may also be exempted from public hospital charges on hardship grounds if deemed so by the chief executive officer of a health board. 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. Charges set by my Department in respect of private and semi-private rooms in public hospitals are additional to the statutory inpatient charge and are a contribution towards overall hospital running costs. These charges, effective from 1 January 2004, are outlined in the table below.

Hospital Category

Private Accommodation

Semi-Private Accommodation

Day-care

Health Board Regional Hospitals Voluntary and Joint Board Teaching Hospitals

401

314

289

Health Board County Hospitals Voluntary Non-Teaching Hospitals

334

269

239

Health Board District Hospitals

179

153

133

Where exemptions do not apply, the public charge may be waived if, in the opinion of the chief executive officer of the appropriate health board, payment would cause undue hardship. Under the Health Act, 1970, the determination of eligibility for health services is primarily the responsibility of the chief executive officer of the appropriate health board.

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