Colm Burke (Fine Gael) | Oireachtas source

I am talking about the private health care sector. On the one hand, if the number of beds is increased, the level of competition increases, which could assist in reducing price. On the other hand, if the number of beds is increased, we are then creating a cashflow problem for the insurers in the sense that the more services provided, the more demand is placed on those services. It is about getting a balance. I raise that because I am aware of a company which was trying to provide extra facilities at a cheaper rate but it could not get cover from a particular insurance company.

We want to create competition to lower prices but there must be a balance in how the issue develops.

I am not sure if the next matter is under the remit of the witnesses. It concerns where practice has changed. People may have been required in the past to be admitted to hospital for a procedure but we have moved on, yet there may not be an adjustment to how payment is made. For example, payment would only be made in some cases to a medical practitioner if a person is admitted to hospital. In most cases certain procedures are done through day care. It seems there has been a slow changing of the rules in adapting to the medical changes that occurred.

Another issue is the requirement by the HSE to get consultants to sign claim forms where the consultant has not seen the patient. For example, a person may be admitted through the accident and emergency department to a ward and seen by a registrar before treatment is provided. The person may be admitted because he or she had health insurance and be treated as a private patient. May the HSE claim where the consultant has not seen the person, although the person would have been adequately looked after by a senior registrar? The cost factor must be considered.