The public hospital charges for private and semi-private accommodation in public hospitals in categories 1 and 2 are being increased by 25%. The charges are a contribution towards overall hospital running costs and represent significantly less than the full economic cost in major hospitals. The equivalent charges for the health board district hospitals have not been increased as they already approximate to the economic cost of such care. The increases take effect from 1 January 2005 and are outlined in the following table:
Hospital Category
|
Private Accommodation
|
Semi-Private Accommodation
|
Day-care
|
|
€
|
€
|
€
|
Health Board Regional Hospitals Voluntary and Joint Board Teaching Hospitals
|
501
|
393
|
361
|
Health Board County Hospitals Voluntary Non-Teaching Hospitals
|
418
|
336
|
299
|
Health Board District Hospitals
|
179
|
153
|
133
|
These charges are additional to the public hospital statutory in-patient charge which is being increased from €45 to €55 in respect of each day during which a person is maintained. The maximum payment in any 12 consecutive months is being increased to €550. The new charge for outpatient services in respect of attendance at accident and emergency or casualty departments where the person concerned has not been referred by a medical practitioner is €55. This is the only statutory out-patient charge.
There are a number of exemptions to the statutory charges, including for medical card holders with full eligibility, women receiving services in respect of motherhood, children up to the age of six weeks and children referred for treatment from child health clinics and school health examinations. Also exempt from the charges in respect of treatment for a particular condition are children suffering from prescribed diseases such as mental handicap, mental illness, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, haemophilia and cerebral palsy. Persons holding a doctor-visit medical card will not be exempt from statutory charges unless they are covered by one of the other exemptions specified above. Where exemptions do not apply, the charge may still be waived if, in the opinion of the chief executive officer of the appropriate health board, payment would cause undue hardship.
Entitlement to health services in Ireland is primarily based on means and residency. Under the Health Act 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board other than for persons aged 70 years and over who are automatically eligible for a medical card. Medical cards are issued to persons who, in the opinion of the chief executive officer, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship. The health board CEOs have, in the past, exercised discretionary powers in granting medical cards to those in special need where the income guidelines have been exceeded. The incoming Health Service Executive will be asked to draw up a transparent policy governing discretionary medical cards.