Mr. Simon Nugent:

I will start with that question and I will try to respond to Deputies Kelly and Brassil as well.

I can understand the committee's efforts to try to work out costs, value for money, efficiency and so on. While that makes perfect sense, there are lots of mechanisms to work out whether the State is getting value for money for any particular expenditure. If we are to have a universal single tier health service, the committee should anticipate all hospitals - private, public and voluntary - as hospitals that are delivery mechanisms that will deliver services in such a system. Then it is up to the procurer, presumably the Department of Health, or whoever is responsible for procuring services to make sure that he or she is getting value for money from whichever hospital is delivering the service. I do not see anything inconsistent between having a universal health service and having private hospitals providing treatment in such a scenario.

In terms of value for money, I would add that the last time there was a detailed exercise done on this was when the NTPF was running previously. The Comptroller and Auditor General, understandably, took close interest in how it worked. The committee might be interested to note that at that time, back in 2008 and 2009, the Comptroller and Auditor General’s reports concluded that relative to the case-mix benchmark, procedures purchased from private hospitals by the NTPF generally cost less than those carried out in the publicly funded system.

The procedures we offer are offered on a value for money basis. We would not expect any Government procurement body to be purchasing services unless we were delivering value for money.