Denis Naughten (Roscommon-Galway, Independent) | Oireachtas source

I move amendment No. 1:

In page 3, after line 28, to insert the following: “(b) Schedule 3 to the Principal Act, shall not apply to policies that fail to provide cover for day case and inpatient care in model 2 hospitals.”.

The amendment arose out of discussions on Committee Stage. This is an issue regarding model 2 hospitals, including those in Roscommon, Nenagh, Ennis and Bantry. Following the reconfiguration of acute services in the country, these hospitals are supposed to be the workhorse of the health system. They are supposed to deal with routine surgeries, day surgeries, day cases and inpatients that had traditionally gone to model 3 and model 4 hospitals. They do not deal with urgent or emergency cases but the conditions treated can become chronic conditions if left over time. The work includes colonoscopy and urology appointments, computed tomography scans, X-rays, magnetic resonance imaging scans and so forth.

All these hospitals have urgent care centres and patients stay over in hospital as a result. These patients do not end up in our accident and emergency departments, many of which, sadly, are chaotic at the moment. Two hospitals in particular hit the headlines on a regular basis, namely, University Hospital Galway and University Hospital Limerick. Funnily enough, those two hospitals are serviced by the hospitals in Roscommon, Nenagh and Ennis.

The difficulty arises because we have one cowboy insurer in the country. It has decided under one of its policies that it will not cover patients with health insurance who are going into model 2 hospitals. This issue needs to be nipped in the bud now.

We took decisions in the House to ensure everyone has equality of treatment in terms of access to health insurance. I was one of the Members who brought through the legislation at the time. The intention was to provide everyone with equal access to private health insurance if they could afford to pay for it.Whether a policyholder was 18 or 80 years of age, he or she would pay the same as others for the same policy. Now, we have one insurer which has decided to undermine the health structure in this country, even though the health structure is about encouraging as much work as possible in the local hospitals.

I see the Minister for Business, Enterprise and Innovation, Deputy Humphreys, in the House. The hospital in Monaghan is another one affected. This insurer has decided that people cannot go to the hospitals in Monaghan, Roscommon, Ennis, Nenagh or Bantry. Yet in these hospitals, patients do not have to wait for months to get a colonoscopy or access to X-rays or CAT scans; they can have the service within a few hours. If this particular organisation gets away with this, I have no doubt others will follow.

I want the Minister to amend the minimum benefit regulations here and ensure that all the insurance companies provide cover in every one of the model 2 hospitals in this country. That is in the interests of putting work through those smaller hospitals. It is in the interests of taking pressure off the waiting lists in the larger model 3 hospitals, such as Portiuncula, Sligo and Castlebar, and the model 4 hospitals, such as Galway University Hospital, where people have been waiting for years to get access to care.

Thankfully, smaller hospitals, such as Roscommon, are dealing with the backlog of waiting lists. We are trying to move more work from the bigger hospitals to the smaller hospitals. This is an issue I raised with the Minister recently regarding the charges for accessing the urgent care centres, which I firmly believe should be less than for people attending an accident and emergency department. If our policy is to encourage people to attend the smaller hospitals with less complex needs, then we should clearly define that in both the policy and the charges, and similarly in respect of health insurance. We are saying that we will encourage people to go into Galway University Hospital, Portiuncula Hospital and Castlebar and Sligo hospitals, where patients are lying on trolleys at present. While we are saying that we will incentivise those hospitals to take a private patient instead of taking someone off a trolley, yet we are not prepared to ensure that such private patients can access what probably would be better care in the model 2 hospitals, such as Roscommon and Nenagh, where there is less pressure in emergency departments and admissions. We are saying "No" and that this insurer can have a blank cheque in this regard. This cannot be allowed to happen.

I came across a constituent who, unfortunately, had a policy with this company. The constituent went for an inpatient procedure in the local hospital, Roscommon hospital, only to find out that the insurer will not cover that person. I found out that my own policy was the same and that I was not covered. Unfortunately, I was with the same insurer, as are many other people, because it has a strong standing in other areas in Ireland and has now got involved in the health insurance area. It should not be allowed.

I ask the Minister to give me a commitment today that an amendment will be brought forward to the minimum benefit regulations, rather than dividing the House on this particular issue.

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