HEALTH: The cost of private beds in public hospitals is set to increase, as is the amount patients will have to pay for drugs every month before they will be entitled to a refund.
Private beds will cost 10 per cent more, but the increase in the threshold for drugs refunds has not yet been decided.
It was already increased to €65 earlier this year.
The Minister for Health, Mr Martin, confirmed he was now looking at a means tested approach to the scheme.
As expected, there will be no provision to extend the medical card scheme in 2003.
This is despite a 31 per cent increase in the GMS budget.
The entire scheme is now under review.
However, overall spending on health will increase by 6 per cent next year, bringing the budget for the Department of Health and Children to €8.9 billion.
Some 70 per cent of the budget will be eaten up by pay.
The remainder will provide for:
An additional 109 hospital beds and cover the cost of the additional 600 beds provided this year;
The commencement of the heart/lung transplant programme in the Mater Hospital, Dublin;
Taking more than 7,000 people off waiting lists by having them treated in private hospitals at home and abroad under the Treatment Purchase Fund, which will have a budget of €31 million;
€60 million to compensate people infected with HIV and hepatitis C;
The development of GP co-ops across the State. This area gets an extra €10 million;
Building projects worth €514 million.
The hospitals to benefit include many where building already is in progress.
They are: Our Lady's Hospital for Sick Children, Crumlin; St Vincent's Hospital, Dublin; St James's Hospital; Cork University Hospital; University College Hospital, Galway; Naas General Hospital; James Connolly Memorial Hospital; St Joseph's Hospital, Clonmel; Tullamore General Hospital; Portlaoise General Hospital; Roscommon County Hospital; Beaumont Hospital; Nenagh Hospital; Our Lady's Hospital, Cashel; St Ita's in Newcastle West; and St John's Hospital, Enniscorthy.
Mr Martin said an additional sum of €29 million was also being allocated for cancer services.
This would allow for the development of centres of excellence to treat breast cancer but he said issues such as the provision of radiotherapy in Waterford were not included.
Breastcheck, he said, would be extended over a two-year period and he said funding was available to start extending it this year.
Acute hospitals will also get an extra €26 million in 2003 and while there is funding to recruit additional cardiologists, the Minister said next year would not see "a similar expansion in staffing" as in other years.
Meanwhile, an extra €15 million is being provided for services for older people and an additional €2.7 million has been set aside to tackle adult homelessness.
Furthermore, an additional €7.5 million is being provided for childcare services, including €1.5 million to combat youth homelessness.
Mr Martin said the cost of providing services to private patients in public hospitals was far greater than the income from the private insurance companies, even after his 10 per cent increase was accounted for.
"In the interests of equity, it is Government policy to gradually eliminate the subsidy," he said.
He said he would have liked to have had a greater allocation at his disposal but he believed a "fiscal correction" was necessary.
It was a case of "short-term pain in the interests of medium-term gain".
The health spending proposed was sharply criticised by Opposition parties.
Fine Gael's health spokeswoman, Ms Olivia Mitchell, said the budget for hospitals would need to have increased by €380 million to maintain existing services. The actual increase was just €26 million.
"The order of these cuts would suggest that it is hospital closures rather than bed closures that are envisaged," she said.
Labour's health spokeswoman, Ms Liz McManus, said the spending plan would result in longer hospital waiting lists and put an end to the national health strategy.
She also criticised the decision to raise the threshold for the drugs refund scheme for the second time within months, describing it as "a tax on illness".
It would hit the people already affected by the "reneging" on the decision to extend medical cards, she said.