A proposal that private patients should meet the full costs of private care, published in a draft report of a Government advisory body, was dropped from the edited public versions.
The draft report of the National Economic and Social Forum on Equity of Access for Hospital Care was discussed yesterday at a plenary session attended by representatives of interested groups.
On the issues of "two-tier" access to hospitals for public and private patients, public summaries of the report were handed out with a list of amendments which did not mention the proposal.
The full draft report marked "confidential" contained the potentially controversial line: "We would like to see a clear commitment to ensuring that private patients meet the full costs of private care."
Forum chairperson Dr Maureen Gaffney said after the meeting there was agreement by the project team to drop the proposal and it was amended. She said there were different interests expressed by the social partners.
She said there was a lot of public anxiety about health care. There was rigorous negotiation among the project team and full and frank discussions about every aspect of the report but they had reached consensus.
The draft report commented on the Government's Health Strategy and said additional resources would not be sufficient in themselves but must also be complemented and reinforced with parallel moves on structural deficiencies.
"Unless these are tackled more decisively and the system more radically overhauled, the feasibility of delivering on the Health Strategy's goals and objectives will be seriously undermined," it stated.
The intermingling of private and public care in hospitals was unique to the State. The forum was concerned that no specific commitment was made to ensure that "all admissions to public hospitals - whether public or private - should be prioritised in accordance with medical need, and not that of ability to pay.
"Access to public hospitals should be on the basis of a common waiting list, otherwise the underlying inequality in the system will continue," it said.
Part of the problem for public patients was the length of time they had to wait for their first consultant appointment after referral by a GP, but this was not recognised or addressed by the strategy, said the report. This inequity between public and private patients must be addressed.
The report said the forum regarded it as critically important that any greater reliance on the private sector to provide for the needs of public patients should not undermine public provision.