asked the Minister for Health and Children if he intends to increase the price of private beds in public hospitals during the next 12 months; and, if so, the likely increased cost of health insurance as a result of any such proposed price increase. [22436/98]

There will be a 9 per cent increase from 1 January next in the charges for private and semi-private accommodation in public hospitals. The determination of any premium increase is a matter for each individual insurer, having regard to all considerations relating to the financing of its particular operations. For example, the VHI increased its premia by 9 per cent from September 1998 and it is estimated that about 2 per cent of the premia increase was attributable to the increase from 1 January in the private bed accommodation charges in public hospitals.

It should be noted that my Department, in informal discussion earlier this year with VHI and BUPA, advised that it would be prudent for them to incorporate in their financial plans the likelihood of an increase of this order from 1 January 1999.

The actual cost for the public hospitals of providing a service for a private patient is still well in excess of the increased charge. This is due to medical inflation, including pay increases, and the impact of technology on the costs that a hospital must bear. Successive Governments have accepted the need for charges to reflect more fully the economic cost of delivering health services for private patients. Any other approach represents an unjustified subsidy of the private health sector generally and the taxpayer should not be asked to meet such a bill. It might also be noted that there was no price increase at all in hospital charges in 1994, 1995 and 1996, despite a significant increase of about 16 per cent in public hospitals costs for that period.

Is the Minister saying the substantial increases announced by the VHI and, no doubt, similar increases by BUPA, derive not merely from the increased charge imposed on private beds in public hospitals in last year's budget, which became operative on 1 January 1998, but that he is imposing a further 9 per cent as and from 1 January 1999 and that that was factored into the September VHI increases?

No, that is not correct. I told them to factor it in for any future increases they may be contemplating for next year. We estimate that every 1 per cent increase in the charge on private patients using public hospital beds in public hospitals represents a quarter of 1 per cent increase in premia. We estimate it represents about a 2 per cent increase in premia for VHI users.

Is the Minister saying another 2 per cent will be added to the premium as and from January 1999, owing to his proposal to increase the cost by a further 9 per cent?

No. The VHI, if applying for an increase, usually approaches my Department in July or August. The proposed increases, if not rejected by me, will come into operation from 1 September 1999.

Will the Minister accept he is playing the role of price fixer for private beds in public hospitals? Will he accept that the roles of the owner of the VHI and of the regulator of health insurance are mutually exclusive and contradictory? Will he also accept that if he continues to increase the cost of private beds in public hospitals there is a risk that it will put the cost of health insurance beyond the reach of young couples who are already struggling to make mortgage repayments? In that context it may impose greater pressures on the public hospital system which has a burgeoning waiting list. Has the Minister any immediate plans to transfer his function as a regulator of the health insurance industry to any other Department, as required by EU regulations?

The latter matter raised by the Deputy was discussed in the context of the Voluntary Health Insurance (Amendment) Bill. He will be aware a White Paper on that matter is due shortly. We can discuss the matter in greater detail on that occasion. To answer the Deputy's first question, I have a simple question to ask the Deputy. Is he in favour of a subsidy by the taxpayer at the expense of public patients, where private patients are using public hospital beds? As a matter of social justice I do not believe that is tenable. I believe a greater part of the economic cost should be paid by private patients using public hospital facilities. If the Deputy does not agree, perhaps he will say so. I have no apology to make in seeking to insist that the taxpayer and the public patient — we have just had a discussion about public patient waiting lists — get a fair crack of the whip.

That is what we keep on asking.

The Deputy can pick and choose when it suits his argument. I am not prepared to allow the taxpayer subsidise to the extent he is subsidising the use of public hospital beds by private patients. People should pay a greater amount of the economic cost. The Deputy either agrees with that or he does not. He cannot pick and choose and change his argument depending on the question.

Will the Minister acknowledge that, in the absence of a mixed system of medical care, the current public hospital system would totally collapse and that under his Administration we have had the most dramatic increase in public hospital waiting lists over an 18-month period experienced at any time in the history of the State, which is an indictment of his term of office?

The Deputy keeps changing his argument. Does the Deputy agree with this or not? He will not answer.