Simon Harris (Wicklow, Fine Gael) | Oireachtas source

Deputy Naughten also raised the matter he has just spoken about at length on Committee Stage, when my colleague, the Minister of State, Deputy Daly, took the debate on my behalf. My officials were in a degree of provisional contact with Deputy Naughten in this regard. My officials have also consulted with colleagues in the Health Insurance Authority and with the Department's internal legal advisers.

I very much understand and accept the Deputy's motivation. It does not seem to make sense to the Deputy, to me or to this House that where the fee for providing the procedure would be the same in one hospital versus another, why a specific public hospital would be excluded, particularly a level 2 hospital. Indeed, on Committee Stage Deputy Naughten stated:

insurance companies should not refuse cover in small hospitals such as those in Ennis, Roscommon, Mallow or Bantry. People should automatically get cover in these hospitals.

For the record of the House, I need to clarify today that many insurance companies provide cover in these type of hospitals. The Deputy acknowledged that as well. Insurers operating in the Irish market are required to provide services according to the Health Insurance Act 1994 (Minimum Benefit) Regulations 1996. All of the plans available on the Irish market have been approved by the Health Insurance Authority, which is, as the House will be aware, the statutory regulator of the private health insurance market.

Pursuant to Article 9 in Part VI of the 1996 regulations, insurers may exclude specified services and specified providers in their policy. Therefore, it is the law of the land, through those regulations, that an insurance company can exclude a certain service or a certain provider. The Deputy is asking me tonight if I would review those regulations in respect of the specified provider and should that be looked at in the context of level 2 hospitals.

The information relating to the services covered by any policy is contained in the policy document provided to the consumer when purchasing such a policy. Insurers can, of course, have many reasons that they do not cover certain services or providers. One of them can be that not all hospitals can or should provide the full range of health services available in the State. I take it that is not the point Deputy Naughten is making.

Notwithstanding the exclusion clause allowed under the minimum benefit regulations, there are policies available on the market that explicitly provide coverage in many model 2 hospitals across the country. To be clear, it is the view of my Department and me that there is no need to legislate for insurers to cover model 2 hospitals because some insurers already provide this coverage. Consumers obviously have a choice when they go to purchase an insurance policy to purchase one that meets their healthcare needs. The current insurance regime allows insurers to provide policies at a range of prices and different rates as well.

However, in response to Deputy Naughten's request, I will ask my Department, in working with the Health Insurance Authority, to review those regulations, specifically, the exclusion clause relating to service providers, and I will report back to this House on that matter.

I appreciate the fact that Deputy Naughten stated that he did not wish to divide the House on this.

Were I to accept this amendment, my fear, based on legal advice, is that we could accidentally and entirely unintentionally interfere with the risk equalisation scheme. I acknowledge that is not Deputy Naughten's intention. The amendment would interfere with the scheme and policies that do not include this type of cover as envisaged by the amendment would have to be excluded from calculations and projections that the Health Insurance Authority, HIA, carries out, therefore invalidating the other recommendations the Bill makes. I ask the Deputy to consider not pressing his amendment on Report Stage. I will work with my Department and the Health Insurance Authority to undertake that review of the regulations, specifically insofar as it pertains to the idea of excluding specific public service providers and I will report back to the House.

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