Written answers

Tuesday, 3 November 2015

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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814. To ask the Minister for Health the revenue raised in each year from 2007 to date from hospital charges on patients by emergency department charges; from inpatient charges, etc., each in tabular form. [38129/15]

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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Your question has been referred to the Health Service Executive for direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office who will follow up on the matter.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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815. To ask the Minister for Health the estimated cost of replacing hospital charges for patients with Exchequer funding; and if this total is unknown, if he will outline as much information on the matter as is available. [38130/15]

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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The issue of hospital financing has been the subject of recent Departmental reports. In the case of public acute hospital care, a prospective, casemix-adjusted activity based system was recommended. It has been recommended that the existing ‘per diem’ charging regime for private activity in public hospitals be replaced by a case-based charge using DRGs. Taking account of international evidence and of the detailed analysis already undertaken in the context of the above reports it was advised that the Programme for Government commitment on ‘Money Follows the Patient’ should be realised through the introduction of a prospective Diagnosis-Related Group (DRG) case-based payment system. Since January, 2014 the Diagnosis Related Group (DRG) grouping system has been used to facilitate the introduction of a new prospective, case-based funding model for public hospital care called Activity Based Funding (ABF - also known as Money Follows the Patient).

Activity Based Funding is being rolled-out on a phased basis and full implementation will take a number of years. The ABF approach is initially being applied to in-patient and daycase activity in public hospitals. It is the Government’s intention to develop policy proposals for the introduction of a case-based charging system for private patients in public hospitals. However, it must be acknowledged that given the complexity and breadth of the issues to be examined and addressed, significant preparatory policy work must be undertaken. This work must take full account of eligibility and legal issues, private income issues and the need for a sustainable mechanism for meeting the cost of private patients in public hospitals. It would require substantial technical work and analysis on the financial impact on public hospitals. The focus for the short to medium term is on implementing ABF in the public system, as outlined in the recently launched HSE ABF Implementation Plan 2015 – 2017. Until this further work has been completed it will not be possible to present the Deputy with the figure requested.

The Health Service Executive’s Financial Statements 2014 (page 105) provided the following breakdown for patient income which will inform the Deputy on the sums generated by patient charges.

20142013
€m€m
Private charges *298.010239.187
In-patient charges *18.01136.613
Emergency Department charges9.2259.225
Road Traffic Accident charges4.8414.841
Long Stay charges79.82080.140
EU Income - E111 Claims0.0150.015
409.922371.124
* With effect from 1 January 2014, a revised charging structure was introduced for in-patient services provided under Section 55 of the Health Act 1970 (as amended by Health (Amendment) Act 2013.) These include charging all private patients, including those accommodated in a public-designated or non-designated bed, which could not be billed for previously, and a reduction in statutory charges applicable to private patients.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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816. To ask the Minister for Health the savings that were targeted on each occasion that hospital charges for patients have been increased. [38131/15]

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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The Health (Amendment) Act, 2013 (No. 31 of 2013) provided for the introduction of a revised private in-patient charge for all patients receiving private in-patient services. As a result of discussions between my Department and the private insurance industry during the Act's passage through the Oireachtas, in order to agree a phasing-in of the charges for all private in-patients, it was decided to implement the charges from 1 January 2014 at a rate calculated to raise an additional €30 million in hospital revenue in 2014.

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