Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I thank the witnesses for their submissions and attendance. On Dr. de Buitléir's reference to "ideological" being a pejorative term, it is not in my house. It never was and I pride myself on consistency in that.

On the notion of private facilities within the confines of public facilities, I have a serious concern that although we are saying we want to remove private health care from the public system, which is good and laudable and there is cross-party support for Sláintecare on the one hand, we can see two big facilities being built into which private care will be stacked on the other. My fear is that if those consulting rooms and facilities were not available to private patients, they would be available for public patients and therefore would have an impact on the waiting lists.

Perhaps this question is for Mr. Keegan because he outlined that while he did not have access to comparable routinely collected administrative data in private hospitals, he could collect some of it. My difficulty is that does not give us the total cost. We have asked the HSE repeatedly the cost to the public system of effectively subsidising private healthcare. It is very difficult to put a money amount on it. We previously have had people in here from the HSE who described to us what they called stretch income targets that are set for them, whereby they must collect a certain amount of money back from private health insurance. This creates a perverse incentive. I have never been able to see a definitive cost put on private healthcare. We know the impacts on the waiting lists because clearly it will be public patients who will benefit from the availability of additional capacity. On the actual cost, I refer to when a private patient is treated and where he or she skips the queue. If two people with the same level of acuity happen to be in the accident and emergency unit - one with private health insurance and the other without - in my estimation, in all likelihood the person with private health insurance would be admitted in that instance. If that person has already been in the accident and emergency unit, one cannot quantify the actual cost to the public system and the subsidy that is provided to the private system or am I wrong in that assumption? Can it be quantified if so, how much is it?