The war of words between the Bon Secours in Cork, the largest private hospital in the State, and the VHI seems to be over, and for the moment thousands of healthcare subscribers in the Munster region can breathe a sigh of relief.
However, the truce is at best temporary, and in the worst case scenario by July 31st next the hospital may leave the VHI scheme and ask patients to pay before they are discharged.
At its most simple, the row is about a 9 per cent increase in fees which the VHI is prepared to pay the Bon Secours and a 23 per cent increase which the Cork hospital is demanding.
Under the current fee arrangements, the hospital says, it is losing £39 a night per patient.
The increase sought by the hospital had two elements, 11 per cent to cover medical inflation and 12 per cent to reflect the increased cost of providing emergency facilities which had not been factored into VHI reimbursement scales until now, according to hospital management.
In the middle, although both sides stress their concern for patients/customers, are up to 18,000 VHI subscribers who use the hospital each year and who have been left wondering for the past number of weeks whether their health insurance would be honoured in the event of hospitalisation.
The Bon Secours has a long and proud tradition of healthcare and is favoured by thousands who took out health insurance to be able to go there should the need arise.
The modern hospital is also a business. It recorded a small loss last year and faces a more substantial one in the coming year. The loss, it is understood, could be in six figures.
The hospital claims the VHI is not treating it fairly and is failing to compensate it for the full range of services provided. It points to the fact that the semi-private room rate allowed by the VHI at its sister hospital in Galway is £250 while the rate for Cork is £209, despite the fact that the Cork hospital offers more advanced facilities and a far more comprehensive range of services.
These facilities include digital mammography, which has just been commissioned, Magnetic Resonance Imaging, due to be commissioned in July, nuclear medicine and digital multi-slice CT which allows doctors to scan the brain or other areas of the body and strip away the various layers on computer until only the blood vessels which may contain the danger are revealed. The machine represents a quantum leap in terms of diagnostic medicine.
If a patient stays in the Bon Secours for five days the average cost, excluding consultants' fees, is £2,000. It is hard not to make a comparison between those charges and what it would cost to stay in a top-class hotel for the same period.
People regularly do, says Mr Harry Canning, general manager at the hospital, but the comparison is a simplistic one and does not take into account the range of expertise and services available.
For the past two weeks the hospital and the VHI have engaged in a very public row. The VHI threatened to withdraw its 20 per cent bonus allowed to hospitals which participate fully in its scheme.
The Bon Secours countered that this amounted to a 20 per cent penalty on VHI patients who wished to be treated there.
The hospital said the VHI was dragging its feet on an interim solution, brokered by local representatives, which would give patients cover at the disputed increased rate of 9 per cent while the VHI would commit itself to devising a new package reflecting more truly the level of services provided by the hospital.
By last weekend, however reluctantly, both sides were in a position to announce that the interim agreement would operate until July 31st, by which time the VHI would be expected to produce its new package.
At present the 345-bed Bon Secours is a Plan B hospital. What is needed, says Mr Canning, is a package somewhere between Plan B and Plan C. If one is not produced by July 31st, then the hospital will pursue one of two courses.
It will begin to charge patients up front at what it considers to be the appropriate rate and advise them after that to take it up with the VHI or it will cease doing business with the organisation, in which case the full bill will have to be settled before a patient leaves the hospital.
The Bon Secours also caters for patients who are covered by the VHI's rival, BUPA, which has a full cover agreement with the hospital.
At present, BUPA patients account for only 3.5 per cent of the hospital's annual intake, but clearly the newcomer to Irish healthcare is well aware of potential opportunities.