Dáil Éireann Debate, Tuesday - 3 November 2015
815. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the estimated cost of replacing hospital charges for patients with Exchequer funding; and if this total is unknown, if he will outline as much information on the matter as is available. [38130/15]
View answerThe issue of hospital financing has been the subject of recent Departmental reports. In the case of public acute hospital care, a prospective, casemix-adjusted activity based system was recommended. It has been recommended that the existing ‘per diem’ charging regime for private activity in public hospitals be replaced by a case-based charge using DRGs. Taking account of international evidence and of the detailed analysis already undertaken in the context of the above reports it was advised that the Programme for Government commitment on ‘Money Follows the Patient’ should be realised through the introduction of a prospective Diagnosis-Related Group (DRG) case-based payment system. Since January, 2014 the Diagnosis Related Group (DRG) grouping system has been used to facilitate the introduction of a new prospective, case-based funding model for public hospital care called Activity Based Funding (ABF - also known as Money Follows the Patient).
Activity Based Funding is being rolled-out on a phased basis and full implementation will take a number of years. The ABF approach is initially being applied to in-patient and daycase activity in public hospitals. It is the Government’s intention to develop policy proposals for the introduction of a case-based charging system for private patients in public hospitals. However, it must be acknowledged that given the complexity and breadth of the issues to be examined and addressed, significant preparatory policy work must be undertaken. This work must take full account of eligibility and legal issues, private income issues and the need for a sustainable mechanism for meeting the cost of private patients in public hospitals. It would require substantial technical work and analysis on the financial impact on public hospitals. The focus for the short to medium term is on implementing ABF in the public system, as outlined in the recently launched HSE ABF Implementation Plan 2015 – 2017. Until this further work has been completed it will not be possible to present the Deputy with the figure requested.
The Health Service Executive’s Financial Statements 2014 (page 105) provided the following breakdown for patient income which will inform the Deputy on the sums generated by patient charges.
|
2014 |
2013 |
|
|
€m |
€m |
|
|
Private charges * |
298.010 |
239.187 |
|
In-patient charges * |
18.011 |
36.613 |
|
Emergency Department charges |
9.225 |
9.225 |
|
Road Traffic Accident charges |
4.841 |
4.841 |
|
Long Stay charges |
79.820 |
80.140 |
|
EU Income - E111 Claims |
0.015 |
0.015 |
|
409.922 |
371.124 |
* With effect from 1 January 2014, a revised charging structure was introduced for in-patient services provided under Section 55 of the Health Act 1970 (as amended by Health (Amendment) Act 2013.) These include charging all private patients, including those accommodated in a public-designated or non-designated bed, which could not be billed for previously, and a reduction in statutory charges applicable to private patients.
