Key Post Do private patients skip the queue in public hospitals?

Over the last two days, I have heard both Eoin O'Broin of Sinn Féin and Róisín Shortall of the Social Democrats say the following:
1) Public hospitals are under pressure to maximise fee income from patients with private health insurance
2) So they give them priority which disadvantages the public patients.

I don't believe that this is true anymore.

It's certainly not true in A&E
If you go in through A&E, you will be treated irrespective of whether you have private health insurance or not. You will be admitted to a bed based on your medical need.

If a public patient needs to be admitted, they will be put into whatever bed is available - public or private.

I don't think it's true of waiting lists either
It used to be true of waiting lists. Consultants had separate waiting lists for private and public patients. They, and the hospitals, prioritised the private list as they earned fees from it.

But there is only one waiting list now.

Even if you see a consultant privately, 3 months ahead of someone who sees him publicly, he must not put you ahead of the public patient. In other words, seeing a consultant privately has no advantage in a public hospital.

This is discussed more fully here:
"Can I see a consultant privately, and then go public for the procedure?"

Of course, going to a private hospital is quicker than going to a public hospital.

But that is a separate argument.

The common waiting list was introduced in 2009

3. Common Waiting List for Outpatient Diagnostics and Treatment

All patients – public or private – requiring diagnostic or treatment procedures following an
outpatient consultation must be placed on a Common Waiting List if there is a waiting
period for access to the procedure.

A Common Waiting List is one which includes all patients – irrespective of public or
private status – awaiting a particular procedure.

Patients must be called from Common Waiting Lists regardless of public or private status:

i) in order of clinical priority, followed by
ii) length of waiting time.

I agree and disagree. When going to A/E and being seen by someone in the A/E all is equal in my experience. However that's where it more or less ends. If your life is in danger, health will take priority and beds will be given on demand, but if the diagnosis is not as serious as that, but still needs hospitalization, the private health patient will get a bed quicker. This is my experience and indeed is also the experience of people I know.

OK, Laya says the following on its website:

1) Would you like private treatment at public hospitals only, or at private hospitals too?
You can get private treatment at both public and private hospitals.

If you choose private care in a public hospital, you’ll be eligible for a bed in a private or semi-private room. You’ll also have access to the private consultants attached to the hospital. And, of course, your waiting times will be reduced.

Hi noproblem

Just to be absolutely clear...

Are you saying that those admitted through A&E who need hospitalisation, will be hospitalised whether private or public, but that the private patient will get the bed quicker?

This might be correct, but I wonder why it would be? I think that the private patients get charged the €850 (?) whether they are in a bed or a trolley.

Brendan

Yes, I am saying that. However, I do not know the answer to you saying that being on a trolley in A/E and having a bed in a ward/room are the same price. I was always under the impression you get charged once you're in your room.

Brendan Burgess said:

I think that the private patients get charged the €850 (?) whether they are in a bed or a trolley.

Click to expand...

That is certainly my understanding based on the articles I have read in the papers over last 12 months. The Insurance Co is billed the €850 or so irrespective of whether u get a room or not.

Brendan Burgess said:

The common waiting list was introduced in 2009

3. Common Waiting List for Outpatient Diagnostics and Treatment

All patients – public or private – requiring diagnostic or treatment procedures following an
outpatient consultation must be placed on a Common Waiting List if there is a waiting
period for access to the procedure.

A Common Waiting List is one which includes all patients – irrespective of public or
private status – awaiting a particular procedure.

Patients must be called from Common Waiting Lists regardless of public or private status:

i) in order of clinical priority, followed by
ii) length of waiting time.

Click to expand...

I have worked in several public hospitals since this rule came out and have never seen this implemented for elective (non-emergency) procedures.

http://www.thejournal.ie/health-insurance-waiver-3341372-Apr2017/

"Private health care is charged at a rate of €813 per day. Public care is charged at €80 per day, capped at €800 for a full year. Both are charged through your insurer, despite the fact public care is funded via general taxation.

That’s not a typo. Private care is 10 times more expensive than the public variety. And unless you know that you can be guaranteed a private or semi-private room, the treatment you will receive is exactly the same. Even if you are unlucky enough to be lying on a trolley for a matter of days, if you’ve signed the form you’ll be billed at the higher rate."

If you come in through A&E you have every right to be seen as a public patient even if you have private health insurance. It can be very difficult not to sign that form but unless the hospital can give you a private or semi private room you gain nothing and your premium will go up eventually.

I only have experience with my kids but 2 years ago in Crumlin I was asked if we wanted to be treated as public or private. I choose private and I did get some costs back for parent accommodation but my child got no special treatment. Her treatment since has been great, we have great access to consultants all the time, but we choose public all the time.

Do I think my child skips the queue, yes, big time. But she has a serious condition and queue skips on the basis of need. Last week she needed to see a consultant but when I phoned the earliest appointment I could get was November, so we discussed it with our main consultant, a few phone calls later we were seen last Friday.

3 weeks ago I felt unwell, and went to the mater private, I had some tests and saw the consultant the same day. I went back a week later for a small procedure. It was all quick and smooth and I chose to use my private health insurance for it all, knowing from the start I would need to pay excesses etc. I wasn't on any waiting list and did not take the spot of a public patient waiting for the same tests/ procedure.

So my advice is, arriving via A&E go public and stay public for the duration of your hospital stay. If you have private health insurance and it is not an emergency then choose which option suits you best at the time.

Hospital attempted to charge €800 a night for private care as patient lay on a trolley in ward

"A patient can be charged €800 a night if they have private health insurance, even if they are on an A&E trolley which has been moved to a ward."

"The private health insurance fee cannot be imposed if the patient is on the trolley in A&E - but it can trigger once they move to a ward. However, the patient can remain on the same trolley in some cases."

http://www.independent.ie/irish-new...atient-lay-on-a-trolley-in-ward-35883414.html

The staff member in question should be charged with fraud.

Do you have to tell them that you have private insurance, does it matter if you say you don't have insurance even though you do

delfio said:

Do you have to tell them that you have private insurance, does it matter if you say you don't have insurance even though you do

Click to expand...

I'm not aware of any law compelling you to provide this information.

Hello,

I believe the reason we usually would tell the hospital, is because we are of the belief that it will get us a private bed, or other preferential services in line with our insurance cover.

If we don't tell them, then we never get the "upgrades", so it's a case of having to tell them imho.

Whats wrong here is the blatant fraud that is being reported - not that people have private health insurance and declare it.

I am very annoyed with the health insurance companies for not doing more to help put a stop to what has been going on. However, it's clear that it is far easier for them to say very little, then just keep passing on the rate increases each year. In my view, the health insurance providers should be running a large scale and very public campaign to get their members to put pressure on government to bring an end to this.

That is not to say that I am not also very annoyed with our government, who clearly have given their "blessing" to this sharp practice, knowing that they have patients when they are most vulnerable and easily taken advantage of. By virtue of this shady practice, all of our insurance premiums are being increased (more) year on year... and yet the government would like us to believe that they are trying to get the insurers to bring our premiums down.

It's time to start fighting back !

Brendan Burgess said:

Hi noproblem

Just to be absolutely clear...

Are you saying that those admitted through A&E who need hospitalisation, will be hospitalised whether private or public, but that the private patient will get the bed quicker?

This might be correct, but I wonder why it would be? I think that the private patients get charged the €850 (?) whether they are in a bed or a trolley.

Brendan

Click to expand...

Hi. It's not the patients who are charged 850. It's the insurance company. And don't be fooled, when you have private insurance, you get treatment faster, much faster. I had 3 stents fitted a day after I was in hospital. If I had had no insurance, I would have been given a spray for under my tongue and told to go home.....

I know the conversation has moved on. I used to work as a clerk in the HSE hospital system. Often, I was the first person the patient met when attending a clinic (meeting a consultant). Private and Public Patients attended the same clinics. On nearly every occasion some Private Patients would approach my desk and inform me that they were Private Patients and understood that they would be treated before the Public Patients. I would advise that patients are called in order of the time of appointment. I wish to point out here that none other than the seriously ill were treated before others. So, it might not be a bad place to be down the queue.