Hospitals will continue to chase people for debt as abolition of in-patient fees ‘not an amnesty’

Patients who owe hospitals €8.1m in outstanding charges will not be given any amnesty when in-patient fees are abolished next month, it has been confirmed.

It means hospitals will continue to chase these people for the debt, mostly through the use of debt collectors.

Health Minister Stephen Donnelly has received government approval to publish the Health (Amendment) Bill 2023, which provides for the abolition of public in-patient charges in all public hospitals.

When enacted next month, it will remove the acute public in-patient charge of €80 per day, up to a maximum of €800 in a year, including day-case charges, for people accessing care as a public patient in all public hospitals.

However, the HSE told the Irish Independent: “Any debt incurred prior to the abolition of the statutory in-patient charge in April 2023 will be subject to the normal financial regulations.”

The net in-patient debtor balance for HSE statutory acute services as of December 31 stood at around €8.1m.

The HSE spokesman said patients who attend at public hospitals are, depending on their eligibility, and subject to certain exemptions, liable to statutory charges levied under the provisions of the 1970 Health Act.

The charges are €100 for an emergency department attendance and, before its abolition next month, €80 for an in-patient or day-services charge, with the latter charge capped at €800 in a rolling 12-month period.

“The HSE has a statutory obligation to levy and collect these charges, and hospitals have the discretion to operate instalment payment plans where appropriate,” the spokesman said.

“Any debt incurred prior to the abolition of the statutory in-patient charge in April 2023 will be subject to the normal financial regulations.

“Debt collection continues to be managed at a local hospital level.”

Hospitals are required to refer an unpaid debt to a collection agency after a period of time from date of billing.

“If any patient has difficulty paying a hospital bill, the regulations allow for the hospital and the patient to agree an instalment arrangement,” the spokesman said.

“We would advise that they contact their hospital directly to discuss this on a one-to-one basis.”

The spokesman added that hospital groups are mindful in implementing these processes that patients may be experiencing stress or financial challenges.

They would encourage patients who are having difficulties fulfilling their debt to contact the hospital to which the debt is owed in order to make alternative payment arrangements.

“If hospitals are made aware or become aware of such challenges, agreements may be reached between the patient and hospital on a case-by-case basis and debt collectors are not included in the process.”

The minister said: “This legislation, when enacted, will remove for everybody the existing financial burden of public in-patient charges when accessing care in a public hospital. I intend to bring this legislation through the Houses of the Oireachtas as a priority in the coming weeks.

“This measure builds on the abolition of public in-patient charges for children, which I introduced last year, and is another significant step in ensuring that people have access to affordable healthcare services.”

HSE-run hospitals spent nearly €1m hiring debt collectors to chase patients for outstanding debts during 2020 and 2021, new figures show.

The figures show University Hospital Galway spent €25,233 on debt collectors in 2020 and €4,451 to October in 2021.

University Hospital Limerick, which has high levels of emergency department overcrowding, paid out €24,197 in 2020 and €10,162 in the first nine months of 2021 to debt collection agencies.

Connolly Hospital in Dublin paid €32,094 in debt collector fees in 2020 and another €38,987 in 2021.