Dan Neville (Limerick, Fine Gael) | Oireachtas source

I welcome the opportunity to contribute to the debate. I will deal with the specific issue of the use of private health insurance by those who are hospitalised because of psychiatric ill health. There are a few issues of great concern and public patients often have a greater opportunity to recover in the long term when compared with those who enter private institutions, although all the facilities do very good work. Of great concern is the process of follow-up after discharge from a private hospital. There is no connectivity with the HSE, and the community-based after-care system with HSE involvement can be patchy in following up psychiatric patients discharged from private institutions. There should be some follow-up by the health insurance companies in that regard.

There are two main private psychiatric hospitals in the country. Many people who use those facilities would have insurance but may not have much other money. They would have to travel to and from Dublin and pay for a consultation with a psychiatrist and treatment. The expense can be quite significant for people who access health care in psychiatric hospitals. An initiative should be taken to bring the three groups - private hospitals, private insurers and the HSE - together to examine follow-up after discharge from private hospitals. There is a difficulty.

Private insurance lasts for six months in a private hospital and if people cannot pay privately after that time, people need to be transferred to the HSE hospitals or to their communities. Treatment often lasts longer than six months. Some years ago I mentioned an experience when somebody was discharged from St. Patrick's Hospital one evening in a highly suicidal state. Her mother took this 21 year old student back to Limerick on the train and she was taken into hospital late at night. There was not much investigation of her condition and a student nurse was assigned to care for her the next morning while the patient was still in a suicidal state. The nurse left at 1 p.m. and there was not enough cover, so the patient took her life at 1.30 p.m. in the hospital. There is a difficulty around discharge and after-care when patients have been cared for in private psychiatric hospitals. The follow-up for public patients is far superior to that seen by private patients. The issue should be addressed.

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