Brian Cowen (Laois-Offaly, Fianna Fail)

The specialist inpatient units have a number of private health insurance beds. Where patients have private health insurance, the health insurance company is billed directly for accommodation costs in the specialist inpatient unit. Both public and private patients are seen by the consultant in palliative medicine. All consultations with the consultant in palliative care are delivered free of charge to public patients. Consultations with private patients incur a charge billed directly to the private insurance company.

A baseline study undertaken by the Irish Hospice Foundation found regional variations across the country in the provision of hospice specialist palliative care services. In particular, there are apparent gaps between supply and demand in a number of locations. There are 131 external beds in hospices and specialist care units against a recommended level of 390. This represents a deficit of 259. The programme for Government contains a commitment to removing the regional disparities in the provision of funding for palliative care, ensuring that the needs of all those who require palliative care are met.

Legislation requires the pre-approval of any proposed development in this area by the HSE with the consent of the Minister for Health and Children. The 20 beds issue arises from discussions with the Department of Health and Children to ensure the long-term feasibility of units. Population size and catchment area recommendations in various reports are for eight beds per 100,000 of population. This is a minimum level to ensure that units develop in accordance with policy for this area. With regard to the specific issue raised by Deputies Finneran, Calleary, Naughten and others, if a project receives approval from the HSE, from a tax point of view the same company running both facilities with an aggregate figure of 20 beds could qualify for relief. It is a matter of obtaining prior HSE approval in the first instance.

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