Tommy Broughan (Dublin North East, Labour)
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Question 636: To ask the Minister for Health his powers in relation to the VHI and each of the other health insurance providers; if he has issued to the VHI or any other health insurance providers and on what issue; and if he will make a statement on the matter. [27543/11]

James Reilly (Dublin North, Fine Gael)
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The VHI is accountable to me under the terms of the Voluntary Health Insurance Acts. As Minister for Health I have statutory responsibility for governance matters relating to the VHI, such as Board appointments and the receipt of its annual report and accounts. While owned by the State, the VHI is a not-for-profit company operating in a competitive market. It would be inappropriate for me to interfere in the day to day operations of, or the commercial decisions of any health insurance provider, including the VHI, which is required to compete fairly within the market.

I understand the Deputy has in mind the provision of services for individuals with eating disorders. However, each private health insurance provider in the Irish market has the right to determine how much capacity in any particular area is purchased by them to deliver the services required by their customers. Health insurance contracts must provide a certain minimum level of cover prescribed in the relevant regulations. Beyond that, it is not the role of the Minister for Health to direct private health insurers as to which services or facilities they cover. This is a commercial decision for the insurers themselves.

Section 2 of the 1996 VHI act (amended in 2008 to remove the requirement for the consent of the Minister) allows the VHI to 'make and carry out health insurance related schemes as it may think fit' and other provisions relating to entering agreements with service providers. The Health Insurance Authority (HIA) is the statutory regulator of the private health insurance market and insurers must comply with the HIA in terms of registration, compliance with minimum benefits, risk equalisation returns and open enrolment.

In relation to the provision of services for individuals with eating disorders, the national policy document for mental health 'A Vision for Change' sets out the framework for the development of mental health services generally. HSE services for people with eating disorders are embedded in the Community Mental Health Teams and with Primary Care.

The HSE has developed a Mental Health in Primary Care accredited training programme for primary care practitioners with Dublin City University. The skills included in this programme are designed to enhance the capacity of primary care to recognise, assess and treat a range of mental illnesses within the primary care setting. As individuals with eating disorders frequently present to the primary care practitioner with complications of their condition, early intervention at this level greatly improves outcomes.

Community based Adult Mental Health Services receive referrals from Primary Care and provide assessment and treatment to individuals with eating disorders. Child and Adolescent Mental Health Teams provide a similar role for their cohort of referrals. Where the individual's psychiatric or medical needs are more acute, in-patient admission is offered within the local psychiatric services or acute medical care where necessary.

Following the recommendation of the Consultant Psychiatrist, the HSE can and has worked with service providers in the independent sector to provide specialised care, on an in-patient and/or an out-patient basis. In a limited number of cases, referrals to specialised eating disorder services in Dublin or the UK can be clinically recommended and supported in appropriate circumstances subject of course to the necessary resources being available.