Professor Anthony Clare, the director of St Patrick's Hospital in Dublin, Republic of Ireland—and better known throughout Britain for his work in the media—has accused one of Ireland's two main health insurers of delaying the admission to hospital of psychiatric patients. He has predicted that the situation will get worse as the number of patients with private insurance increases.
The problem, he told one of the Irish national newspapers, was that BUPA (a private health insurance scheme) insisted on detailed diagnostic information before admission of a patient, including the diagnosis, prognosis, and expected date of discharge. The organisation did not require this information for any other type of hospital admission. The company's Irish competitor, VHI, required simply a quotation from the referral note for admission.
Professor Clare is not alone in his concerns. Other doctors, including GPs, have complained about the preadmission requirements, saying that they stigmatise those with psychiatric illnesses.
A spokeswoman for BUPA Ireland said that psychiatric admissions were often emergencies, with many referrals made by GPs who, although able to decide whether a patient required psychiatric hospital admission, could not always provide an accurate diagnosis and prognosis for the patient. Admissions could often involve long hospital stays, the spokeswoman added, so the form was simply “prudent economic planning.”
The concern of which Professor Clare spoke comes about because the BUPA requirement creates delays in a patient receiving treatment. A patient on a GP referral, for example, has first to be sent to a local psychiatrist for assessment.
In the meantime, the patient could be waiting at home, or in a secure unit at a local hospital, for anything from several hours to several days. As BUPA's customer base increased in Ireland, the problem would worsen, Professor Clare said.
The BUPA spokeswoman said that if the policy had “a serious impact on patients and delays,” the company “would have to look at it carefully.”