Hospital Services - Introduction

Information

Broadly speaking, there are three different types of hospital in Ireland but there is very little difference in practice between the first two types:

• Health Service Executive hospitals, owned and funded by the Health Service Executive
• Voluntary public hospitals, most of whose income comes directly from the government. Voluntary public hospitals are sometimes owned by private bodies, i.e., religious orders. Other voluntary public hospitals are incorporated by charter or statute and are run by boards often appointed by the Minister for Health and Children
• Private hospitals, which receive no state funding

Public health services are provided in what can broadly be termed the public hospitals - Health Service Executive hospitals and public voluntary hospitals. Most of these hospitals also provide private health care but they must clearly distinguish between public and private beds.

The distinction between the broadly termed public hospitals and private hospitals is the same, regardless of the range of services provided by the hospitals.

Acute hospital services in Ireland exist to diagnose, treat and care for seriously ill or injured patients. Acute hospital services are provided in Health Service Executive hospitals, public voluntary hospitals and private hospitals. Some hospitals are specialist - for example, maternity hospitals, psychiatric hospitals, cancer hospitals, while others are general.

The large general and regional hospitals in Ireland provide a broad range of services. Smaller local hospitals may not be able to cater for all illnesses and treatments and you may have to be transferred to a larger hospital or to a specialist hospital. Everyone living in the country and certain visitors to Ireland are entitled to free maintenance and treatment in public beds in Health Service Executive and voluntary hospitals. Some people may have to pay some hospital charges.

Out-patient services in public hospitals are also free of charge but some people may have to pay an initial charge if they have not been referred by a GP.

If you are in a private hospital or in a private bed in a public hospital, you must pay for both maintenance and treatment. Your private health insurance may cover some or all of the costs.

Rules

Normally, you must be referred by a GP in order to avail of hospital services. There are waiting lists for non-emergency services in many areas.

Accident and Emergency/Casualty

Most general hospitals and some specialist hospitals have accident and emergency or casualty departments which patients may attend without being referred by a GP. If you attend without a GP referral, you will be charged €100 (January 2009). If you have to return for further visits to an out-patient clinic in relation to the same illness or accident you should not have to pay the charge again. The following groups do not have to pay the charge if they do not have a referral from their GP.

• Medical card holders
• People who are admitted to hospital as a result of attending the casualty department (you may then be subject to in-patient charges).
• People receiving treatment for prescribed infectious diseases
• Children up to six weeks of age, children suffering from prescribed diseases and disabilities and children referred for treatment from child health clinics and school health examinations
• People who are entitled to hospital services because of EU Regulations.
• Women receiving maternity services.

Long-stay patients

Sometimes people become long-stay patients in acute hospitals. There is no clear definition of the distinction between acute and long stay. Some district hospitals and geriatric hospitals have designated long-stay beds.

Entitlement to care

Everyone is entitled to public in-patient and out-patient services but some people may have to pay some hospital charges.

Entitlement to care means that you are entitled to a bed in a public ward and free consultant services while you are there and to out-patient services in a public hospital.

If you avail of private treatment either in a private bed in a public hospital or in a private hospital, you have to pay for your maintenance and treatment.

The cost of a private bed in a public hospital is set from time to time.

If you are not ordinarily resident in Ireland and are not entitled to free or subsidised health services as a visitor to Ireland, you have to pay the full economic cost of the service. This means you pay for the full economic cost of all the services provided, including maintenance, cleaning, etc., in addition to medical and surgical costs. If you use a public bed, you also have to pay the full economic cost.

Your entitlement to free care is the same in specialist as in general hospitals.

How to apply

You should obtain a letter of referral from your GP if you want to receive hospital treatment. You can attend accident and emergency departments in most general hospitals and some specialist hospitals without a letter of referral, but it is important to remember that you may have to pay for your visit.

You can view contact information for public hospitals in your area here.