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The journal of developments in social services, policy - page 7 / 11

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(often religious orders) while others are incorporated by charter or established by statute and are run by boards. In some cases, the Minister for Health and Children appoints some members of the boards.

Private hospitals which receive no direct State funding (they may get funding to treat patients under the National Treatment Purchase Fund (NTPF) arrangements).

Public health services are provided in what can broadly be termed the public hospitals – the HSE hospitals and public voluntary hospitals. Most of these hospitals also provide private healthcare but they must clearly distinguish between public and private beds. There is no legal distinction between acute hospitals and long-stay hospitals.

Establishment of hospitals

There is no statutory licensing or regulatory system for the establishment of hospitals, whether they are public or private. This is one of the issues being examined by the Commission on Patient Safety and Quality Assurance (see below).

Co-location policy

It is Government policy to facilitate the building of a number of private hospitals on the grounds of public hospitals; this is generally known as co-location. The Minister for Health and Children issued a policy direction to the HSE on co-location in 2005 and this direction was amended in 2007 as regards the exact locations. Section 10 of the Health Act 2004 is the statutory basis on which the Minister may issue such directions. It is proposed to have co-located hospitals at St James’s Hospital, Beaumont Hospital, Cork University Hospital, Limerick Regional Hospital, Waterford Regional Hospital, Blanchardstown (Connolly Hospital), Sligo Regional

Hospital and Tallaght (Adelaide and Meath incorporating the National Children’s Hospital).

The aim of the co-location policy is to provide about 1,000 extra public beds. The existing private beds in the acute public hospitals would largely be transferred to the new hospitals.

In-patient services

The HSE is obliged to provide in-patient services for people with full eligibility and those with limited eligibility (Section 52 Health Act 1970 as amended by the Health (Amendment) Act 1991) – in effect that means it is obliged to provide inpatient services for everyone ordinarily resident in the State.

In-patient services are “institutional services provided for people while maintained in a hospital, convalescent home, or home for persons suffering from physical or mental disability or in accommodation ancillary thereto”.

Public and private acute hospital services

In the case of acute hospitals, the HSE provides in-patient services under Section 52 in public beds in public hospitals. If you go into a private bed in a public hospital or into a private hospital, you are not availing of services under Section 52.

Beds in public hospitals are designated as being public or private or non-designated (Health Services (In-Patient) Regulations 1991; SI 135/1991). The designation of beds is mainly a matter of numbers – it is quite possible that, for example, a six-bed ward may be designated public in one hospital and private in another. The designation of  beds within each hospital is subject to the direction and approval of the Minister

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