asked the Minister for Health the steps he proposes to take to alleviate the considerable hardship imposed by the 20 per cent increase in hospital charges.
Ceisteanna—Questions . Oral Answers . - Hospital Charges .
11.
: Hospital maintenance charges are payable only by persons who are not eligible for health services and by eligible persons who decide to arrange for treatment in private or semi-private accommodation. The increases in the rates of charge are necessitated by increased costs incurred in the running of the hospitals.
I do not consider that the increases in hospital charges from 1 May 1978 are likely to cause hardship. The majority of persons who are liable for charges are insured with the Voluntary Health Insurance Board or may have alternative cover. Arising from the increase in the rates of charge the board will be recommending increased levels of insurance and are arranging to allow members to increase their cover as from 1 May and in advance of ordinary renewal dates.
I understand that if a person has adequate cover at this point the additional cost involved will be relatively modest. For example, in the case of a single person without statutory entitlement to health services the extra costs, based on the increased minimum cover recommended by the Voluntary Health Insurance Board, will amount to £5.80 a year for private accommodation and £3.48 a year for semi-private accommodation. The corresponding increase in insurance costs for a married couple with two children will be £17 and £10.20, respectively. The extra costs will be about 10 per cent less where members are in group schemes.
Income tax relief, which applies to voluntary health insurance premiums, will, depending on the taxable status of the person involved, operate to reduce substantially the extra insurance costs. If it should occur, in exceptional circumstance, that a person without statutory entitlement finds difficulty in meeting the cost of hospital services, he can apply for assistance to the health board. The health board has authority to provide a service for an ineligible person who is considered by the chief executive officer of the board to be unable, without undue hardship, to provide the service from his own resources.
: While this appears to be a small imposition on the individual it is part of many similar impositions which have been imposed by the Government. Effectively it can lead to considerable hardship on the individual. Did the Minister not come into office as a reforming Minister who was going to make the health services more easy of access rather than more difficult to obtain? That is a complete reversal of his policy.
: I would not accept that. The increase in the charges is relatively modest. I am sure the Deputy understands that, even at the increased level, the charges are still far below the economic cost of accommodation in hospital.
: Would the Minister not agree that, in reading out the eligibility escape clause where a person can claim more in one way or another, he is now adding to one of the big complaints of the NESC report on the multiplicity of criteria for eligibility? This is the one thing they recommended should be dealt with at once. Instead of eliminating the various categories for limited eligibility the Minister is adding to them at the expense of the services. He is making it more difficult and more complicated instead of easing the process.
: The Deputy is not correct. First, I do not want to go back over the implications of the NESC report. I have explained what my view of that report is, that at this stage it is very much an academic exercise, an examination of the position. Apart from that, I am not adding any new criteria. The charge for hospital accommodation has always been there, and the provision with regard to access to the CEO in cases of hardship has always been there. I am not adding any new criterion to the situation.
: Is it not a fact that, whatever else we disagree on in the NESC report—and I am not dealing with that—there is a general trend throughout Europe towards the elimination of impediments to a free health service rather than increasing the impediments by increasing the cost of the charges which the Minister is now doing?
: I am afraid the Deputy is not up to date with the European situation in this regard. In fact, the general trend throughout Europe, and particularly in the EEC countries recently, has been in the opposite direction, to cut down on the availability of free health services. More and more countries in Europe, the richest of them are finding it increasingly impossible to bear the full burden of a free health service.
: They are getting better value for their money.