Private income and public hospitals


Sir, – The Irish Hospital Consultants Association has warned about the possible effects of the removal of the current private-income stream from public hospitals under the Sláintecare plan (Opinion, February 12th).

There is a further potentially larger, but totally unquantifiable, demand-side threat to the success of the plan.

The burden of the provision of the majority of elective care for people with private health cover is currently removed from the public system by the voluntary purchase by these people of private insurance, and by their accessing of this care in private hospitals. Increasingly, emergency care is also being provided by the private hospitals. There is thus a very large hidden subsidy to the public system, by way of demand reduction for exchequer-funded public hospital care.

It is entirely reasonable to project that, in proportion to the success of Slaintecare in improving access to care in the public system, the purchase of private cover will reduce. This will result in increased demand in the public system, requiring further increase in public funding to provide increased capacity, and to provide for increased attendances and admissions. It will then be “back to the drawing board”.

Much greater scrutiny and questioning of the Sláintecare plan is needed than it has heretofore had. – Yours, etc,



Dublin 15.