The Department of Health says it has no plans to scrap the charge levied on those forced to stay in hospital overnight following motor accidents, despite calls to do so by the Motor Insurance Advisory Board (MIAB).
Since 1986 all in-patients, except those involved in motor accidents, are entitled to free treatment in a public hospital.
However, instead of extending this entitlement to crash victims, the Department wants to implement a more efficient way of collecting fees from those awarded compensation after accidents.
Motor accident victims treated as in-patients have to pay the Road Traffic Accident charge of up to €800 per day. This sum could rise in the near future to €1,000 per day for some of the larger public teaching hospitals.
The MIAB, which is responsible for recommendations to cut the costs of insurance, called for the charge to be abolished, saying it discriminated against motor accident victims as it imposed a charge on them which didn't apply to someone with the same injury acquired otherwise.
In its report it said the charge adds to insurance costs as it is ultimately paid by motor policy holders, not just the negligent, many of whom are the same taxpayers who fund the health system and victims of motor accidents are less than 1 per cent of hospital users.
The Road Traffic Accident charge is based on the Average Daily Cost of the treating hospital. "This charge was reiterated by a Supreme Court ruling a number of years ago," says Charles Hardy, head of planning and evaluation at the Department of Health.
MIAB believes that this fee is is a multiple of what health insurance companies are charged for using the same services over the same length of time.
However, many in the health system see it as no more than the person responsible for driving negligently paying the hospital's costs. According to Dorothea Dowling, chairperson of the MIAB: "The system is a nonsense in that you have scarce resources in hospitals issuing bills, many of which remain unpaid."
Michael Hourihan of the Irish Medical Organisation (IMO) says the system needs to be simplified and administered in another way. "Very often doctors waive their entitlements to professional fees for treating motor accident victims because of the administration difficulties and the obstacles of having to resort to litigation."
But like the MIAB, the Irish Insurance Federation (IIF) also believes the charge is a form of double taxation and motor accident victims and policy holders end up paying a second time. "It needs a bit of joined-up Government. If the Government wants to be consistent and implement the MIAB's recommendations, the logical thing is to abolish the charge," says Michael Horan of the IIF.