Alex White (Dublin South, Labour) | Oireachtas source

The first grouping takes in amendments Nos. 1, 3 and 10. Section 2 of the Bill provides for the commencement of the Bill's provisions and amendment No. 1 made by the Dáil related to the commencement provisions in respect of the private inpatient charge, together with technical amendments regarding other commencement provisions. To briefly summarise the technical changes to section 2, amendment No. 1 included a provision to commence, upon enactment of the Bill, Part 1 and sections 5 and 14, in addition to section 6 and most of section 7. Other sections or subsections of the Bill shall be commenced as appropriate by way of commencement order.

As regards the private inpatient charge, sections 13, 15, 16 and 17 all require co-ordination in the commencement. As a result of discussions the Department has had with the private insurance industry in order to agree a phasing in of charges for all private patients, including those occupying public beds, the Minister has decided to implement these charges from 1 January 2014 to ensure the agreed additional revenue is realised. As a result, the hospital income will be received in the latter eight months of 2014 rather than in 12 months, based on an implementation date of 1 September 2013.

The rates included in the legislation are set at the level to raise an additional €30 million in hospital revenue in 2014. This phasing is intended to enable the insurance market to adjust to the new charges without destabilising impacts. It will also allow for assurances to be provided to insurers that the additional revenues raised in 2014 will amount to €30 million in the calendar year. The Minister will keep rates under review to deliver the targeted revenue in 2014, as well as for the phasing in over future years.

As a result of this Bill, the hospital charge for a private day-case patient will be reduced from €828 to €407 in a Category 1 hospital, specified in the Fifth Schedule to the Health Act 1970. The daily charge for a private patient accommodated overnight in a multi-occupancy room in a Category 1 hospital will be €813. Currently the equivalent charges applied to a patient in a semi-private bed come to €1,008. To support this phasing approach, the private health insurers have confirmed their commitment in principle to continuing this year's process of payments to public hospitals in respect of private patients who have already been treated, as well as their commitment to participating in the initiative to be chaired by Mr. Pat McLoughlin that will address costs in the private health insurance industry to support the ongoing sustainability of the market.

Amendment No. 3 passed by the Dáil is purely technical in respect of section 9(c)(i), which is unchanged, apart from syntax and numbering, from section 9(c) as initiated. Regarding Dáil approval of the insertion of section 9(c)(ii), it has always been the case that where a person "does not avail of" some part of inpatient services under their full or limited eligibility, then under section 52 of the Health Act 1970 they are "deemed not to have full or limited eligibility, as the case may be, for those in-patient services", and may therefore be charged accordingly. The insertion of "waives his or her right to avail of, some part of those services”, mirrors the language in section 13 of the Bill and reflects the freedom of choice that patients currently have to access private care if they so wish.