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Health Insurance

Dáil Éireann Debate, Tuesday - 3 November 2020

Tuesday, 3 November 2020

Ceisteanna (1245)

Mattie McGrath

Ceist:

1245. Deputy Mattie McGrath asked the Minister for Health if it is now policy for public hospitals to refuse admission and care to a patient that holds private health insurance until such time as the private health insurance details are presented to the hospital; if a medical card holder that also holds private health insurance is not entitled to be treated in the public system without presenting private health insurance details; if this is not the policy, the reason a patient been refused care in a public hospital until these details are presented; if this is not the policy, the disciplinary action that will be taken against a staff member that refuses admission to a patient until health insurance details were presented (details supplied); and if he will make a statement on the matter. [32767/20]

Amharc ar fhreagra

Freagraí scríofa

The Health Act 1970 (as amended) provides that all persons ordinarily resident in the country are eligible, subject to certain charges, to public in-patient hospital services including consultant services.

Section 53C of the Health Act 1970 provides that the current public hospital statutory in-patient charge is €80 per day. This charge is currently subject to a maximum of €800 in any twelve consecutive months.

While the Government’s policy is that the core function of the public hospital system is to provide equitable access to hospital services for public patients, patients may opt for private in-patient care in public hospitals subject to the requirement that the proportion of private activity is public hospitals should in the main be limited to 20% of total activity and private patient charges are set to recoup the cost of the hospital services provided to private patients.

Section 55 of the Health Act 1970 (as amended) provides that the HSE may make available private in-patient services to persons who are not entitled to, or have waived their eligibility to public in-patient services. In these circumstances the statutory hospital charges under Section 55 that apply for such an episode of care is set out in the table below and depends on the category of hospital, duration of stay and whether the accommodation was provided in a single or multi-occupancy room. It is also noted that patients opting to be treated privately must also pay the consultant fees associated with their treatment.

Hospital Category

Daily charge for in-patient services where overnight accommodation provided in a single occupancy room

Daily charge for in-patient services where overnight accommodation provided in a multiple occupancy room

Daily charge for day case in-patient services where overnight accommodation not provided

Hospital specified in Fifth Schedule

€1,000

€813

€407

Hospital specified in Sixth Schedule

€800

€659

€329

The admission of patients to public hospitals is an operational matter and therefore I have asked the HSE to respond directly to the Deputy on this particular matter.

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