Under Cabinet Procedures, Departments are not required to conduct a Regulatory Impact Analysis (RIA) in respect of a Bill which gives effect to decisions taken by the Government as part of the Budget. Some of the provisions in the Health (Amendment) Bill 2013 fall into this category while others do not. As the Health (Amendment) Bill is a combination of budgetary, charging and general policy matters, the position regarding RIAs is different, depending on the issue concerned.
Of the three main areas covered by the Bill the position in relation to RIAs is as follows: Amendment of the Nursing Homes Support Scheme Act 2009 - RIA undertaken. Arrangements are being made to have this RIA placed on my Department's website; Charges for public in-patient and long-term residential care services - Summary explanatory RIA undertaken for sole purpose of Government Memorandum; Charges for private in-patient services - No RIA undertaken.
With regard to private in-patient charges, the Government decided as part of Budget 2013 that all private patients using public hospital facilities and resources would be charged the economic cost of providing those services. The Government believes that the charge for private care in public hospitals should cover the hospitals' costs of providing the service, including the non-consultant hospital doctors, nursing staff, medical and surgical supplies, diagnostics, operating theatres, administration and support staff. Given that a private patient is using resources that cost, on average, in excess of €1,000 per day, it is clear that the current situation represents a significant loss of income to the public hospital system and an indirect subsidy of about €200 million to private insurance companies. This is equivalent to the cost of running a medium-sized public hospital. Budget 2013 provided for an additional €120 million to be raised in a full year in 2014 from applying charges to all private patients in public hospitals. The charges set out in the schedules to the Bill have been calculated with a view to raising this amount in a full year.