Eamon Gilmore (Dún Laoghaire, Labour)
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Question 9: To ask the Tánaiste and Minister for Health and Children the reason the increase in the drugs refund threshold, the cost of an overnight stay in a hospital and the cost of a visit to an accident and emergency were implemented from 1 January 2005 when it is still not clear when the new doctor-only cards will be issued; the estimated additional revenue that will accrue from these increased charges; and if she will make a statement on the matter. [4255/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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On the issue of the January 2005 increases in hospital charges in question, it should be noted that such increases follow on from the announcement in November 2004 of the 2005 health Estimates. The overall health Estimate for 2005, therefore, takes into account the full-year income implications arising from the implementation of the new charges with effect from 1 January 2005. The income goes towards supporting services in public hospitals and is, therefore, part of their budgets.

In regard to the overnight levy, the amount charged was increased by €10 to €55 per night, subject to a maximum of €550 in any 12 consecutive months. The charge for a visit to an accident and emergency department was also increased by €10 to €55. This increase in the accident and emergency charge will facilitate more appropriate attendances at accident and emergency units by reducing an incentive for people to attend accident and emergency units when they might appropriately receive services from general practitioners.

The charges do not apply to a number of categories of person, including those with full eligibility, women receiving services in respect of motherhood, children up to the age of six weeks and children suffering from prescribed long-term diseases. Additionally, the accident and emergency charge does not apply in circumstances where the person has been referred by a medical practitioner or where the attendance results in a hospital admission. It should also be noted that the Health Service Executive has the discretion to waive the charges if it considers that the charges would cause undue hardship.

On the doctor visit card, my Department is considering the nature of the legislative changes required to enable effect to be given to the decision to introduce the new cards. Legislation will be introduced as quickly as possible. I intend to take this legislation to the Government meeting, as I said on the Order of Business this morning, on Tuesday week.

In addition to the foregoing increases, the daily cost of private and semi-private accommodation in public hospitals was also increased by 25%. In the interests of equity, it is Government policy to eliminate gradually the effective subsidy for private stays in public hospital beds and relieve taxpayers of the burden of carrying these costs. Even with this increase, the cost of providing services to private patients in major hospitals remains significantly greater than the income from the private insurance companies in many cases. The increase being implemented is aimed at closing that gap. The combination of the hospital charge increases effective from 1 January 2005 will yield approximately €50 million a year.

As regards the drugs payment scheme, it is the case that prior to its introduction in 1999, the drug cost subsidisation scheme was available to people certified as having a medical condition with a regular and ongoing requirement for prescribed drugs and medicines. Those eligible for this scheme did not have to pay more than £32 in any month on prescribed medication. Under the drug refund scheme, families and individuals who did not qualify for the drug cost subsidisation or medical card schemes paid the full cost of their prescription medicines and, at the end of each quarter, could claim reimbursement from their health board for expenditure over £90 in that calendar quarter.

Additional information not given on the floor of the House.

From 1999, the drugs payment scheme replaced the drug cost subsidisation scheme and the drug refund scheme. Under this scheme, no individual or family paid more than £42 or €53.33 per month for approved prescribed drugs and medicines for use in that month.

The current threshold for the drugs payment scheme is €85 per calendar month. Based on figures supplied by the primary care reimbursement service, formerly the GMS payments board, a €7 increase in the threshold to €85 per month would lead to savings of €8.4 million. Given the need to prioritise health spending to maximise the benefit over a wide range of pressing health expenditure options together with the advantages of the drugs payment scheme over the schemes it replaced, an increase of €7 per calendar month in the threshold is not considered to be excessive.