Jan O'Sullivan (Limerick East, Labour)
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Question 430: To ask the Minister for Health and Children her plans to empower public hospitals to reclaim funding from health insurers in situations in which private patients have been admitted to publicly designated beds; and if she will make a statement on the matter. [33236/09]

Jan O'Sullivan (Limerick East, Labour)
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Question 580: To ask the Minister for Health and Children if she has had discussions with the Health Service Executive regarding the problems surrounding the collection of money from private health insurers in relation to private patients in public hospitals; if changes are proposed with regard to persons who are treated by consultants who opted for a public only contract and private patients who are accommodated in beds designated for public patients; if she has received further information from the HSE on retrieving money owed; and if she will make a statement on the matter. [34520/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 430 and 580 together.

The Government's focus is to achieve fair access by patients to publicly-funded hospital capacity based on medical need. The new consultants' contract includes new measures designed to progress this, for example, through the operation of one-for-all outpatient and ambulatory diagnostic clinics, a key entry point to hospital care. There are also clear new rules on consultants' public-private mix of patients and new measures to manage these rules by newly appointed clinical directors. These contractual features complement existing 'bed designation' rules, set out as follows.

Although patients may be treated in public hospitals on a private basis, the core purpose of the public hospital system is to provide services for all patients under the statutory eligibility provisions. All persons ordinarily resident in Ireland have full eligibility for hospital services, meaning there is universal access to public hospital care. The fact that a person may have private health insurance does not take away from his/her eligibility for services as a public patient.

Bed designation was introduced as part of the mechanism to control the level of private activity in publicly funded hospitals and to help ensure equitable access for public patients. Under the Health (In-Patient) Regulations 1991, beds in public hospitals are categorised as public, private or non-designated. Under these Regulations no private patient being admitted electively may be accommodated in a designated public bed. Similarly no private patient admitted as an emergency may be accommodated in a designated public bed unless (and only for such time as) a designated private bed is not available. The Regulations contain reciprocal provisions regarding the accommodation of public patients in beds designated as private.

Thus, there are limits provided for, and implemented, on the usage of publicly-funded hospital capacity for private activity. The absence of such limits — even if the economic cost of private activity were fully recouped — would create an unacceptable incentive for both consultants and hospitals to maximise private activity, which, while certainly generating income for public-contract holding consultants and for public hospitals, could only be at the expense of fair access for public patients. Indeed, it would call into question why Exchequer funds were allocated for such hospital capacity at all.

It is important that the application of these Regulations and the operation of the mixed public/private hospital system supports the achievement of Government policy on fair access for public patients. I have no plans, therefore, to enable the HSE to levy an accommodation charge in respect of the situations referred to by the Deputy as I believe it would be contrary to the fundamental purpose of public hospital services.

With the support of my Department, the HSE is working to improve business processes for collecting outstanding debts due from private health insurers in respect of patients using private facilities in public hospitals. This includes engagement with private health insurers. The HSE has also drawn up proposals for centralising the management of patient debts and other income. Earlier this year the VHI agreed to make a payment of €50m towards outstanding debts. This was in response to an initiative that I undertook to enable the HSE to implement its National Service Plan for 2009.