Enda Kenny (Mayo, Fine Gael) | Oireachtas source

The question I was asked by Deputy Martin was if the Government has a policy of the Government Information Service sending out reports or press releases on St. Stephen's Day, and if I would make a statement on the matter. I have answered that by saying there are no policy issues in that regard.

This was the report entitled Review of Measures to Reduce Costs in the Private Health Insurance Market 2013. There was an imperative on the Department of Health to publish it before the end of last year, and it let it out on St. Stephen's Day or the day after that. The document is the first of two reports produced by the author, Pat McLoughlin, and the second will be published in 2014. The health insurance companies, to be honest, were very keen for its publication and, far from burying it where it would not be seen, it was expected that the report would be of interest to a lot of people out there and to the media itself.

As the Deputies know, last year Christmas fell in the middle of the week. Consideration was given to the fact a document published on St. Stephen's Day would be of interest and would be the subject of considerable commentary in the post-Christmas period. It was not a case of shoving it off on a shelf where it would not be seen. The report was produced for public discourse and, accordingly, the health insurance companies and the author were alerted to the intention to publish the document on St. Stephen's Day. It was the subject of a number of news reports.

As the Deputies are aware, the phase 1 report which was published contained 32 recommendations under nine different headings. These were about reducing costs of private health insurance and dealt with the following: controlling costs in private health insurance; care settings and use of resources; the age structure of the market; clinical audit and utilisation management; industry approach to private psychiatry; fraud, waste and abuse; chronic disease management; claims processing; and admission and discharge procedures and processes. Most of the recommendations in phase 1 could be implemented on an administrative basis, while a small number, if adopted, would require legislation. There were also a number of key recommendations to drive down costs.

The report, far from being hidden, is absolutely relevant in order to ensure that patients are treated at the lowest possible level consistent with quality, and insurers should use existing information on the appropriate treatment locations for individual procedures.

It recommended that insurers use information of this kind to query cases claimed as an inpatient which might have been carried out on a day basis. In other words, was the right treatment provided? It recommended that insurers provide data to aid a more detailed analysis of the drivers behind the rising costs in the private health insurance. A template to be agreed with the industry is to be completed within the next six weeks to aid further analysis for the phase 2 report. It recommended that in future, the Health Insurance Authority collect these data from insurers regularly to make matters even clearer. It also recommended that the current clinical audit and utilisation arrangements by insurers be assessed in phase 2 to determine whether they are in line with the robustness of international practice; that the extent of clinical audit being carried out by each insurer be independently evaluated in phase 2 of this work; that in line with the plans for implementing money follows the patient, case-based charging be implemented using diagnosis related groups, DRGs, which would mean a fixed, pre-established payment for each case or patient episode, which did not happen previously; that health insurers publicly acknowledge that fraud and malpractice exist and publish data on the extent of moneys recovered from hospitals and consultants; and that the Minister for Health consider introducing measures to encourage younger members into the market and discourage, by means of a financial penalty, people who take out health insurance for the first time after age of 30. This is known as lifetime community rating.

To recap, there is no policy of issuing reports on St. Stephen's Day, Easter Sunday or Easter Monday. This report was due out before the end of the year. It is an important report that contained clear recommendations for driving down costs in everyone's interest. If Christmas Day was at the beginning or end of the week, it might be different. It was in the middle of the week and that decision was taken. I assure the Deputy that there was no intention of hiding the report or deciding we would publish it and no one would read it. The report contains important recommendations that are in the interests of the patient and driving down the costs of private health insurance.

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