Vol. 437 No. 4
11 Mr. B. O'Keeffe asked the Minister for Health if he intends to intervene to ensure that the capping placed by VHI on health boards is removed in view of the fact that it is hampering efforts to generate realistic levels of revenue for health boards.
As Minister for Health I have a responsibility to ensure that the Voluntary Health Insurance Board remains financially viable. In that context my Department has negotiated with the VHI for the past two years a national budget for health boards and public voluntary hospitals. The budget relates to payments by the board to public agencies for maintenance and levy charges incurred by VHI members.
The negotiations between the board and my Department have resulted in substantial increased payments by VHI over the past two years; in that period there has been a total increase of 50 per cent in VHI payments to health boards and voluntary hospitals. This income is of considerable importance to the health boards and voluntary hospitals in maintaining services and my Department will begin discussions early in the new year with VHI in regard to payments to the public agencies for the VHI year 1994/95.
I want to thank the Minister for his comprehensive reply. Is the Minister aware that because of a management plan to have a mix of private and public patients at the Cork Regional Hospital there will be a shortfall in funding this year of £5,000 and at the end of next year it will be £500,000, a significant sum? As this policy has only recently been implemented and the quota is low, could the Minister see his way to ensuring that the VHI take this into account and also ensure that proper funding is made available by the Department to the regional hospital next year?
My primary responsibility is to public patients. I support the concept of private patients being treated in public hospitals in private wards as long as there is a complete separation in terms of the visibility of the private public. Besides generating income for the hospital it ensures that all specialists and consultants are available on the campus within the hospital rather than having to leave the campus to treat private patients. There is benefit in that. However, I cannot allow a situation where the private practice would expand in a way that might put pressure on the throughput of public patients. A balance must be struck.
I must also be aware of the viability of the VHI, which funds the private sector procedures for the most part. The balance I have struck in 1993 is reasonable and I hope to do similarly in 1994.
I suggest that we are between a rock and a hard place because of the deficits facing health boards. Given that in the Southern Health Board area there was very low interaction with the private patient sector — and that it is a good innovation — would the Minister agree to give special consideration to the regional hospital in Cork when a quota is set next year? What impact nationally will the VHI quota system have on public hospitals?
Let me repeat for the benefit of the Deputy and the House that we have encouraged and insisted on the payments from the VHI to the health boards and the voluntary hospitals. These have increased remarkably in the last two years by a factor of 50 per cent to the cap rate of £51 million this year. That is a significant new resource for hospitals and health boards. As to the deficits mentioned by the Deputy, I am close to concluding an agreement to address the problem of indebtedness of health boards. I know the Deputy will welcome that matter being brought to a conclusion.
In regard to allocations to hospitals generally, I am concerned that some hospitals, having regard to their throughput of public patients, have not done as others and I hope to improve that situation in the new Estimates, taking into account the data on case mix available to me.
The Minister said he was concerned for the viability of the VHI. Is he aware that in a report out today it is stated that the VHI is £5 million down on last year's taking? It was in serious financial difficulties about five years ago but had picked up in the meantime. Is there now a danger that it might be on a downward slope and, if so, what action does the Minister propose to take in that regard?
That is a separate question but I will address it because it is an important one. Is there another question tabled on this matter? I do not wish to pre-empt a question tabled by another Deputy.
I would appreciate if the Minister would respond to my question as the next question is only a related one.
Perhaps the Minister could respond to the Deputy's question when dealing with Question No. 12, as the Deputy's question is not directly related to Question No. 11.
