Hospital inpatient and outpatient fees could be scrapped, says Donnelly

A&E department fees unlikely to be dropped as part of Government review

The abolition of hospital inpatient and outpatient charges is being considered by the Government according to Minister for Health Stephen Donnelly who says he believes that access to health services should be free of charge at the point of access.

The changes, which could come to effect next year would be of particular benefit to those receiving ongoing treatment requiring repeated attendance at a hospital.

A spokesman for Mr Donnelly told The Irish Times the “Minister would like to abolish inpatient and day case charges in 2023, subject to funding. We’ve started with paediatrics this year”.

A day inpatient charge of €80 is generally imposed on such patients who do not have a medical card or other exemption while a fee of €100 can charged to a patient who attends an outpatient clinic without a letter of referral from a GP.

Covid-19 is one of a number of conditions which attracts an exclusion from the charges.

There is no suggestion that the current fee of €100 imposed on those attending emergency departments would be scrapped as part of this review.

“Last month, I got the green light from the Cabinet to abolish in-patient hospital charges for children under 16,” writes the Minister in The Irish Independent. “We plan to abolish these charges this summer, an important step toward universal healthcare.

“At present, families and guardians can be charged €80 a night in a public hospital, up to a maximum of €800 a year.

“It’s a lot of money. I would like to go further. We are actively exploring removing hospital charges for all public patients who are availing of in-patient care in our public hospitals.

“For far too long, access to care and health outcomes has been adversely impacted by ability to pay. I believe health services should be affordable, or free at the point of delivery.”

In terms of other measures intended to save users of the State’s health services money, Mr Donnelly points to the recent cut in the cap of the drug Payment Scheme from €144 to €80, something he suggests is worth €768 per annum to families coping with long-term of chronic illness.

He also highlights the intention to expand free GP care to six and seven-year-olds later this year and the provision, starting in August, of free contraception to women aged between 17 and 25 “as a first step toward providing free contraception to all”.

In terms of waiting lists, Mr Donnelly acknowledges that they have been unacceptably long and restates his determination to tackle them.

He argues that investment in services has been substantial with €21.7 billion in net funding due to be provided this year, €6 billion more than in 2018..

He also states that there are: “14,000 more staff in the HSE than at the start of 2020 – 4,000 more nurses and midwives, 2,200 health and social care professionals, 1,300 doctors and dentists and 2,500 working in in-patient and client care.”

Mr Donnelly recognises, he says, that waiting times for treatment are still causing “enormous distress, pain and discomfort”. But, he insists, progress is being made.

“We had 75,000 patients on active hospital (in-patient and day case) waiting lists at the end of last year,” he says.

“Almost all those patients will be treated by year’s end, bringing the number of patients on active waiting lists to its lowest point in five years.

“We will ensure that those waiting longer than six months on in-patient or day-case waiting lists for 15 specific high-volume procedures will be offered treatment.”

In the meantime, he says: “We must build more beds, reform how we deliver services, digitise our health service and hire more staff to ensure backlogs and delays do not keep recurring in our public health service.

“Our ambition is to have one of the top healthcare services anywhere in the world. Our nation must be one where everyone can access great healthcare when they need it.”