Patrick D. Harte
Ceist:13 Mr. Harte asked the Minister for Health his views on whether there is a need to appoint an independent assessor to balance VHI fees in respect of consultants.
Ceisteanna—Questions. Oral Answers. - Balance Billing by Consultants.
P. J. Sheehan
Ceist:27 Mr. Sheehan asked the Minister for Health his views on whether there is a need to appoint an independent assessor to balance VHI fees in respect of consultants.
Liz McManus
Ceist:48 Ms McManus asked the Minister for Health in view of the recent comments from the chairperson of the VHI, the action, if any, he intends to take in order to stop the practice of balance billing to VHI subscribers.
Theresa Ahearn
Ceist:53 Mrs. T. Ahearn asked the Minister for Health if he will acknowledge the need to appoint an independent assessor to balance VHI fees in respect of consultants.
I propose to take Questions Nos. 13, 27, 48 and 53.
I acknowledge there is a problem to be addressed in relation to balance billing by consultants. However, it is a complex issue which must be resolved in a way which is acceptable to patients, consultants and insurers.
While this is primarily a matter to be resolved between the insurer and the consultants, I am considering the issue in the context of health insurance legislation which will be laid before the House later this year. I have also asked the review group, established by me, which is carrying out an examination on the strategic and operational capacity of the VHI in the context of the Single Market, to consider the problem as part of its remit.
I have noted with interest the recommendation by the Oireachtas Joint Committee on State Sponsored Bodies to appoint an independent assessor with functions in relation to consultant fees. I agree this proposal is worthy of consideration as one of a number of approaches to resolving or easing the real problem. It will certainly be carefully considered in my Department.
Does the Minister recognise that he carries responsibility for this problem and that it is not adequate to refer it to a committee? The Labour Party policy in the manifesto seems to ensure that every decision to be made must first be referred to a committee. This is a problem and it is not adequate or acceptable to tell the general public who are paying the VHI premium to wait until legislation in the context of the Single Market is introduced. That is not the issue. What is at issue is a breakdown of the system, whereby consultants are taking advantage of a particular arrangement, charging what they like and people are forced to pay. The Minister has a responsibility in this regard. What is he doing about it?
I told the Deputy what I am doing about it.
The Minister is doing nothing.
The Deputy made a comment that it is my party's policy to refer matters to committees. That is a little unfair and my actions in the past 12 months could not be characterised as buck passing.
That was quite restrained.
I dealt with the issues facing me.
The Minister is doing it now.
Clearly the Deputy does not want to hear the answer.
I am tired of self-congratulations.
I will not take unfair criticism. I do not refer matters, I deal with them and that has been my record for the past 12 months. This is a complex issue — I cannot force consultants to work for a set fee.
Even in the public hospitals?
Balance billing applies only in the private sector. The VHI will need to operate on the basis of the Single Market. I am required to present legislation to this House to set the parameters for the operation of the Single Market and I will do that before the summer. I have set up an advisory group to look at all the implications of the Single Market to ensure that the best possible arrangement to protect vital issues such as community rating, entry into cover and all the other benefits are preserved.
I will also ask them to consider this matter. Only 65 per cent of consultants participate in the scheme and accept the fees negotiated with the VHI. I would like all consultants to participate in the scheme but I cannot put a gun to their heads. The suggestions that we appoint an assessor to determine fees or that we exclude consultants who will not accept the set fee do not represent a solution. I will evaluate the proposals in a calm way to see which is the best solution.
Given that widespread concern has been expressed, does the Minister accept that rather than refer the matter to a review group or committee he should carry out a detailed analysis as a matter of extreme urgency? Does he further accept that in this instance the insurance system is being pushed to meet requirements and that because of this there is a grave danger the matter will get out of hand from the point of view of the patient deemed to be in need of surgery?
I am not sure if I followed all of the Deputy's comments.
The Minister should have.
I propose to initiate a detailed analysis which will be carried out by a committee of three who will make recommendations to me.
When?
Comh luath agus is féidir — as soon as possible. The legislation has to be enacted before the open market comes into being in the summer. Therefore we are working to a tight timeframe. The Deputies opposite and I have the same objective. I want to ensure full cover at the cheapest rate for private patients.