Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank Deputies Tóibín and Berry for giving me the opportunity to set out the Government's view on the issue of car park charges at our hospitals. The Bill seeks to provide for an entitlement to parking free of charge for outpatients attending public hospitals. The question of car park charges for those attending hospitals and the financial burden this can place on patients is well recognised and has been spoken about in this House recently. I acknowledge the spirit and intent of the Bill in seeking to ease the financial burden on those attending hospital and the difficulties that may be faced in paying car parking charges by those with no alternative to using their car. For these reasons, the Government does not intend to oppose the Bill at Second Stage.

The issue of hospital car parking charges is under active consideration. Programme for Government: Our Shared Future, makes a commitment to introducing a maximum daily car parking charge for patients and visitors at all hospitals, where possible, and to introduce flexible passes in all public hospitals for patients and their families. That is a reflection of the Government's appreciation of the financial challenge that can be faced by people in meeting these expenses, in particular, as the Deputy said, where they are frequent users of hospital services. Consideration is being given to how best to ensure this commitment is addressed, taking account of existing arrangements.

There is a good deal of variation in such arrangements and it will be useful to set out the overall position across the country. The most recent information provided by the HSE indicated that the majority of acute hospitals charge for parking, although there are reported to be nine acute hospitals which provide free parking. The HSE does not have in place a single contract to provide parking services at all hospitals; instead, each hospital has its own arrangements, which vary depending on the circumstances. Data gathered by the HSE on this issue in 2018 showed that 16 hospitals used a third party provider to manage their car parks, although the car parks may still be owned by the hospital in question. Some hospitals have a third party to service parking meters, entry and exit barriers and security.

It is important to say that the HSE has been clear that hospitals that charge car parking fees are cognisant of the financial implications of parking costs. With that in mind, many hospitals have already introduced concessionary arrangements of one kind or another, in particular to assist long-term patients and visitors for whom the payment of the full rate would cause hardship. The HSE has confirmed that all hospitals that charge for parking already have a maximum daily rate. That rate is €10 or less in 27 out of 34 hospitals which charge for parking. I believe Roscommon University Hospital and Portiuncula Hospital Ballinasloe are the only hospitals to offer free parking, though I am open to correction on that.

Almost all hospitals are reported to have some form of exemptions or concessions in place. A small number have the option of flexible day passes or multitrip entry passes for regular hospital attenders. The vast majority offer concessions based on the type of inpatient.

In examining this issue in recent years, the HSE acknowledged that the concessions in place were not necessarily widely advertised, as the Deputy stated, and were often only communicated to the patient or family member via the ward manager or ward staff, or through the hospital's social work department. There is undoubtedly a need to make sure there is clear, straightforward information that is well advertised and easily found.

It is important to know how much is raised in car park charges and how that money is used. The HSE has reported that over €17 million was generated from parking charges at HSE hospitals in the past two years, comprising €12 million in 2019 and €5 million in 2020. Of course, 2020 was an atypical year in our hospitals so it is likely the 2019 figure is a more accurate reflection of charging income year by year. The HSE has indicated that parking revenue is used for a range of purposes. This might be maintenance and re-investment in parking facilities, including repayment of loans obtained for upgrading such facilities, or investment in security. It may also cover the cost of parking provision more generally, with any additional income being used to contribute to the general hospital budget for provision of care or research.

That means that if less money is to be raised from car park charges, the shortfall in hospitals' income will need to be met from another source. That might be from the Exchequer or by charging some groups more and others less. One consideration is how to ensure that car parking concessionary rates are targeted at those who need them and not at occasional users. In that respect, while I welcome the spirit of the Deputies' Bill, I wonder whether a blanket elimination of charges for outpatients is the optimal approach. It does not make any distinction between someone who arrives for a first outpatient appointment and is then discharged back to their GP, and someone who is attending for a series of outpatient appointments. Neither does it address the needs of other hospital users, such as those visiting, collecting inpatients or arriving for day case procedures. There are also people who may arrive at emergency departments, whether with a family member or on their own. While these are outpatients, they would not have a letter or message in relation to an appointment as a means of verification, even if they had letters of referral from a GP. I appreciate that the Deputies will have considered all of this as fully as possible, but it is clear that in examining how best to address the commitment in our programme for Government, we will need to take account of all car park users.

There is some evidence that removing car park charges can make it more difficult for patients to find parking. Where car parking charges were eliminated in other jurisdictions, that led to an increase in demand for car parking spaces, resulting in full car parks and further frustration for users. In areas in Wales and Northern Ireland, hospitals had to introduce measures to prevent people abusing free car parking amid concerns that patients were struggling to park, including in some cases the re-introduction of charges or penalties.

It is clear that any car park charging regime will need to be cognisant of how to ensure that car parking spaces are available to those who need them. That will be core to the Government's consideration of how best to implement our commitment in the programme for Government. I appreciate that the Deputies have sought to acknowledge this possibility in their Bill by proposing an arrangement to revoke free car parking when hospitals are full. This would mean that some users who arrive expecting free parking suddenly have to pay. This will be more of a problem for some than others but, in general, having the potential for someone to be faced with a surprise charge may not be the optimal way to manage this issue.

I assure the House that the needs of patients, accompanying persons and visitors must be core to consideration of the Government's commitment to easing the financial burden of car park charging and ensuring the full implementation of the programme for Government commitment as consistently as possible across our hospitals. In particular, those who are frequent users of hospital car parks, whether due to recurring treatment or longer stays, are more financially impacted by charges than those who may be ambulatory outpatient attendees. It is important to reflect this.

It has been the general principle and policy that future car parks should be self-funding so as not to divert money from patient care. That is not to suggest that previous policy cannot be replaced, but it will be important to have an appropriate balance in ensuring that public funding is used in the most appropriate way. In easing the financial burden on users of hospital car parks, it will be important to, as much as possible, direct public funding towards those who need it and not those who are infrequent users of the hospital car park or are otherwise in a position to bear the cost of car parking with some ease.

All of these issues will be considered as we implement the Government's commitment to ease the financial pressure on patients, in particular, in relation to car parking.

I share the Deputy's views. Often, when going to visit people the cost of car parking could be €10. It is a high charge, and it would be good to see some mechanism put in place to address these charges. It is certainly an issue that many of my constituents have complained about, Sligo hospital being one of the locations mentioned. We all share the view that this must be done. While I have indicated some limitations with the Deputy's Bill, the Government is happy to acknowledge the spirit and intent this legislation sets out in seeking to ease the financial burden on those attending hospitals. We will not oppose the Bill on Second Stage.

See this speech in context