Dáil Éireann Debate, Thursday - 8 July 2004
256 Mr. Naughten asked the Minister for Health and Children the reason a person attending an acute hospital who has been referred by a general practitioner does not have to pay for an x-ray but if referred by a consultant is billed for the procedure; the plans he has to review this matter; and if he will make a statement on the matter. [21174/04]
Amharc ar fhreagraUnder the Health Act 1970, the determination of eligibility for health services is based on residency and means and is the responsibility of the chief executive officer of the appropriate health board.
Persons in category 1 are medical card holders and they are entitled to a full range of services including general practitioner services, prescribed drugs and medicines, all in-patient public hospital services in public wards including consultants services, all out-patient public hospital services including consultants services, dental, ophthalmic and aural services and appliances and a maternity and infant care service.
Persons in category 2 — non-medical card holders — are entitled, subject to certain charges, to all in-patient public hospital services in public wards including consultants services and out-patient public hospital services including consultants services. The current public hospital statutory in-patient charge is €45 per night, up to a maximum of €450 in any 12 consecutive months. Attendance at accident and emergency departments is subject to a charge of €45 where the patient does not have a referral note from his or her doctor. This charge applies only to the first visit in any episode of care.
A person in category I or category II who is referred by a general practitioner or a consultant to a public hospital for an X-ray as a public patient is not liable to be charged for this service by the hospital. However if a patient is being referred for out-patient services, for example, tests, X-rays, arising from a private out-patient consultation, he or she is automatically private to the consultants providing the service in the hospital and is liable to be charged.
The Health (Amendment) Act 1991 and the Health Services (Out-Patient) Regulations 1993 clarify the eligibility status of consultant's private patients. The regulations state clearly that a person availing of out-patient consultant services as a private patient of a consultant is the private patient of all consultants providing out-patient services in relation to that particular consultation.
The position regarding consultants fees for private patients is that the level of the fees is a private matter between the consultants concerned and those persons in receipt of their services. Under the health insurance regulations, the payment of hospital charges and consultants fees by health insurers, for example, BUPA, VHI, for out-patient services provided by hospitals to members is a matter for these insurers. It should be noted that my Department is committed to the preparation of new legislation to update and codify the whole legal framework for eligibility and entitlements in regard to health services.
