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

The issue I am going to raise will not come as a surprise to the Minister because I am sure it was provided in his briefing note. I gave ample notice this time last year that I would revisit this issue this year if nothing had been done about it.

What have South Tipperary General Hospital in Clonmel, Roscommon County Hospital, Our Lady's Hospital, Navan, Louth County Hospital, Dundalk, St. John's Hospital, Limerick, Our Lady's Hospital, Manorhamilton, Naas General Hospital, St. Luke's Hospital, Rathgar, St. Michael's Hospital, Dún Laoghaire, St. Joseph's Hospital, Raheny, St. Columcille's Hospital, Loughlinstown, Peamount Hospital, Newcastle, County Dublin, Connolly Hospital, Dublin and Mallow General Hospital got in common? First, they are all public hospitals. Second, if one is unfortunate to buy one's health insurance from Irish Life Health and goes for list 2, 3 or 4 in coverage, one cannot be treated in any of those hospitals.

All of the hospitals in question happen to be level 2 hospitals. As the Minister knows and would have pointed out ad nauseam himself in the past, it has been the priority of Governments over the past decade to put more work through level 2 hospitals. However, these specific level 2 hospitals, public hospitals, are not being provided with hospital cover from one of the major health insurers.

This time last year I raised this specific issue with the then Minister for Health, Deputy Harris. I had been pursuing him on the issue of the injury units in hospitals like Nenagh, Roscommon, Monaghan and so forth. I was arguing that we needed to utilise those particular hospitals and get more patients to use them. In fairness to the then Minister, he took on board what I said and reduced the fees for people attending an injury unit from €100 back to €75. He would not go any further than that because he feared the service would compete with general practice. People might go to the injury units rather than their GPs if the cost was reduced further than that, he felt.

This morning, I happened to be on Galway Bay FM discussing another health issue. The HSE is actively promoting the minor injury unit at Roscommon County Hospital, encouraging people to go to it to avoid going to emergency departments. Over the past number of years, people from as far away as Eyrecourt would be better travelling to Roscommon hospital where they would be treated quicker for injuries than going to Portiuncula hospital in Ballinasloe where they would wait hours for an X-ray.

It is wrong that any health insurer should be blatantly acting against stated government policy, which is to put more work through our smaller hospitals and take pressure off our bigger acute hospitals where beds are being occupied for very sick patients in our emergency departments. Deputy Shortall earlier said this was effectively a tax on access to health cover, amounting to €167 a month. Not only is it a tax, it is a disincentive in some cases to go to the most appropriate hospital. Instead, the insurers want people to go to the bigger hospitals, putting pressure on them and their accident and emergency departments, when they can be treated in local hospitals. It is not right that any insurer should be availing of risk equalisation while at the same time going blatantly against the Government's policy of putting less complex work through our smaller local hospitals.

On foot of taking up this issue last year with the then Minister, Deputy Harris, he stated he would ask his Department, working with the Health Insurance Authority. to review the current regulations that allow Irish Life Health to do what it is doing with a view to removing those particular exclusion clauses whereby providers are effectively banning people from attending smaller hospitals. Insurance companies should not be allowed to carry out that particular practice. We are 12 months down the road now. The Department has been given fair warning on this. I have not put down an amendment on this occasion because last year the then Minister said the amendment I put down then would have unintended consequences. I do not see in this legislation provision being made to ban this particular practice. When the Minister responds, I hope I get a detailed response as to what specific actions have been taken. The difficulty is that we are 12 months further down the road but nothing has changed. The list I read out to the Minister is from the Irish Life Health website tonight. It precludes people from using smaller local hospitals and discriminates against those who do so. Irish Life Health wants people to spend hours sitting or lying on trolleys in accident and emergency departments rather than accessing the local injury units or elective surgery in our smaller hospitals where we do not have waiting lists.

These were the hospitals which were able to continue to deal with outpatient appointments during the first Covid lockdown. That did not happen in our bigger hospitals. If one happens to use Irish Life Health, it wants one to be left waiting or be unable to access outpatient appointments during Covid lockdowns or to get timely access to treatment. Instead, it wants people to wait and put further pressure on our busiest hospitals.

I want to see movement on this issue. I was promised this time last year that would happen by the then Minister. I was informed we would have action and an update by this time today. This evening, however, I see we still have the same practice from Irish Life Health, advertising openly the blatant discrimination against level 2 hospitals. This practice must stop. As someone who knows how urgent and necessary it is to encourage people to use our smaller hospitals, will the Minister directly intervene and ask his officials to table an urgent amendment on this and ensure all health insurers cover all hospitals?

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