James Reilly (Dublin North, Fine Gael) | Oireachtas source

It is very difficult not to remind the Deputy that during his party's tenure the price of premia went up and up and up. Since last year we have made serious attempts but they are not enough - more needs to be done and I have made that very clear in my initial response. We are reducing consultant fees, there has been a 15% reduction in the past two years, and the price of procedures has been reduced by between 13% and 53%. This has already been done. A payment scheme for radiologists and pathologists was introduced, based on the national quality benchmarks which will lead to reduced lengths of stay and has the potential to save €42 million per year for the VHI. The reduction in length of stay and price for some high volume procedures saved €7 million in 2012.

I could go on but I have advised the VHI that notwithstanding that it is responsible for only 57% of the market it is responsible for 80% of the pay-out. It must reduce the cost of each procedure. Why are we still paying the same rate for procedures that used to take two hours but now take only 20 minutes because of modern technology? We must pay by procedure rather than average length of stay which only encourages inefficiency. We have to introduce a more robust audit because the audit has clearly not been robust enough. Finally we need to bring in clinical audit so that clinicians are challenged as to why they are performing and repeating tests that others with a more objective view might say are unnecessary.

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