Health: No provision has been made in the health estimates to increase medical card eligibility next year despite a commitment in the Programme for Government to do so.
The Minister for Health, Mr Martin, told a press conference yesterday evening that he clearly did not have the money which would be required to change the guidelines for issuing medical cards next year.
Health has, however, received the single biggest increase of all Government Departments. It gets more than €700 million extra next year, bringing its total budget for 2004 to €10.05 billion. Some 70 per cent of the overall budget will go on pay and 20 per cent of the additional money will go on benchmarking.
As a result, the Department said that it would have to increase a number of health charges. These include:
A €5 increase in hospital accident and emergency charges, bringing the fee to €45. The Department says that it will stop people attending A&E when they could see their GP instead.
A 15 per cent increase in the cost of private beds in public hospitals - which will have a knock-on effect on the cost of private health insurance premiums. However, Mr Martin said that he expected the insurance companies, which had good profit margins, to absorb at least some of this.
The threshold for seeking refunds under the Drug Payment Scheme will increase by €8 to €78.
There will be a €5 increase in in-patient bed charges, bringing the charge to €45 per night for a maximum of 10 nights a year. These are fees which are paid by public patients who do not have a medical card or private health insurance.
These charges will generate €35 million and Mr Martin insisted that they were only "marginal" increases. He said that he would also have to look at other subheadings in the Department to see where further revenue could be yielded.
The Minister said that he would be prioritising acute hospitals, including the provision of extra hospital beds, as well as cardiac, cancer and renal services. "I think there will continue to be an improvement in the health service," he said.
However, how this will happen is unclear, as the secretary-general of the Department, Mr Michael Kelly, indicated some months ago that the Department would need a minimum of €900 million to "stand still" next year. Yesterday Mr Kelly said that he would always have argued for more money than the Department of Finance could provide.
Mr Martin said that funding for the health service reform programme would also be prioritised. This would include "initial set-up costs" for the interim Health Service Executive and funding for "initial steps in the implementation of the Hanly report in the pilot areas".
The money available for capital expenditure in 2004 is €509 million, some 8 per cent less than in 2003. This would allow a range of projects to go ahead or be completed. These include providing a long-awaited MRI scanner at Our Lady's Hospital for Sick Children in Crumlin, Dublin.
Funding for information systems in the health service is to be doubled to €60 million. In addition, €32 million, €1 million more than last year, goes to the National Treatment Purchase Fund to enable it to continue buying private treatment for public patients who have been on waiting lists for long periods.