Written Answers Nos. 125-128
125. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide the details of the various current hospital charges per person in the public system; the overall amount generated by such charges in one year; and if he will make a statement on the matter. [43418/14]
Amharc ar fhreagraThe Health Service Executive has been asked to examine the matter of income generated by hospital charges and to reply to the Deputy as soon as possible. If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them. The hospital charges that currently apply are as follows.
The Health (Out-Patient Charges) Regulations 2013 provides for a €100 charge for out-patient services provided at an emergency department, an accident and emergency department, a casualty department, a minor injury unit, an urgent care centre, a local injury unit or any other facility providing similar services, subject to certain exemptions. In addition, under the Health Services (Out-Patient) Regulations 1993, the HSE may levy a charge on private patients for the use of an MRI machine in a public hospital.
Under the Health (In-Patient Charges) Regulations 1987 (as amended) public in-patients in public hospitals are liable to a €75 per day charge subject to a maximum of €750 in any 12 consecutive months, subject to certain exemptions. Under the Health (Amendment) Act 2013 private in-patients in public hospitals are subject to charges that range from €329 to €1,000 per day. The charge levied depends on whether accommodation is provided in a single or multiple occupancy room and if overnight accommodation is provided.
As required by the Health (Amendment) Act 1986, where a hospital is informed that the patient, their personal representative or a dependent is pursuing a Road Traffic Accident (RTA) claim, billing data is generated on the local billing system. Invoices can be raised for an RTA related in-patient or out-patient charge depending on the services provided at the hospital.
The Health (Charges for In-Patient Services) Regulations 2005-2011 provide that, subject to certain exemptions, charges apply to the maintenance element of "long-stay" in-patient services (excluding acute in-patient services or services supported under the Nursing Homes Support Scheme) provided in hospitals or other specified settings by or on behalf of the HSE for over 30 days within a rolling 12 month period. Charges apply to those with full or limited eligibility and may not exceed 80% of the weekly non-contributory State pension. The Regulations provide for sliding scales of charges based on income, with the current maximum being €175 per week where 24-hour nursing care is provided or €130 per week where 24-hour nursing care is not provided. The charges may be waived or reduced where necessary to avoid financial hardship, having regard to each individual's financial circumstances (including whether he or she has dependants).
126. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if bulk buying on an international level with either the NHS or EU has been examined for medications or equipment; and if he will make a statement on the matter. [43419/14]
Amharc ar fhreagraMost drugs, medicines and consumable appliances which are paid for by the HSE are supplied to patients through over 1,800 community pharmacies who, in turn, purchase them from wholesalers or, to a lesser extent, directly from drug manufacturers.
The current pharmacy based model results in over 70 million items being dispensed annually through local pharmacies across the State, including low population centres in rural areas. It enables pharmacies to receive deliveries each day from multiple wholesalers ensuring that all patients have continued access to essential medicines without delay. Under this model, as the drugs are purchased by individual pharmacies with no direct input by the HSE, there is no scope for the type of central procurement arrangement envisaged by the Deputy.
Establishing an alternative centralised distribution centre capable of distributing 70 million items across the State would be extremely difficult to achieve and would absorb any potential savings available to the HSE from directly purchasing medicines.
There is however, a Joint Procurement Agreement for medical countermeasures in place at an EU level which enables countries, including Ireland, to procure pandemic vaccines and other medical countermeasures on a group rather than individual basis.
127. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if there is any roadmap for the elimination of hospital charges planned alongside the introduction of universal health insurance; and if he will make a statement on the matter. [43420/14]
Amharc ar fhreagraThe question of the whether there will be hospital charges under a future system of universal healthcare remains to be determined.
Co-payments for certain services are often a feature of health insurance systems in other countries. The White Paper on Universal Health Insurance, published earlier this year, had stated that the State would determine the standard UHI package, including the minimum and maximum out of pocket payments which may be applied as part of the package. Some level of co-payments could assist in reducing the cost of insurance plans under a future system of UHI. However, there would have to be careful consideration of any proposed co-payments to ensure that they would not become a barrier to accessing the health services which citizens need and are entitled to.
