Mary Harney (Dublin Mid West, Independent)

Doctors who work out of hours are paid a fee per item or per patient. In the Republic that cost €108 million and in Northern Ireland, for the same number of people, the cost was £18 million. We must be very careful how we allocate resources. That is why we appointed a group of experts to advise in this area. This is important, particularly when resources are limited.

Public hospitals are paid by insurers on the basis of a bed charge per night. Doctors are paid separately. They are paid for every private patient who comes into the hospital, regardless of which bed the patient occupies. The hospital is paid only for the designated beds. Many issues arise in this regard.

We must drive down costs. I share Deputy O'Sullivan's view that many long-term patients in the public system have much higher levels of dependency and are more complex cases. We must be sure we are comparing like with like. A patient who requires more nursing care and support will cost more than one who does not require the same level of care. When we compare costs we must be fair in the comparisons we make.

See this speech in context