VHI subscribers will have to make up a shortfall for medical treatment in 12 specialities as up to 300 medical consultants reintroduced "balance billing" on their services from yesterday. This follows the VHI's issuing of a fee schedule last week which includes a reduction in fees paid for some procedures.
If the schedule for 1997 and 1998 represents a final offer to the State's 1,300 consultants, balance billing is inevitable in the 12 areas, according to the general secretary of the Irish Hospital Consultants' Association, Mr Finbarr Fitzpatrick. VHI subscribers will not feel the impact until mid-May.
Where it was applied by a consultant yesterday, payment from the VHI would not materialise until May. The first bills would then go out to patients. "There will be a considerable lead-in time until bills arrive in their letterboxes," he said.
The IHCA estimates that between 200 and 300 consultants felt the offer was unacceptable. These cover dermatology, ear, nose and throat surgery, radiology, neurosurgery, vascular surgery, rheumatology, radiotherapy, cardiology, oncology and gastro enterology. Balance billing was inevitable in these areas, he believed. However, a representative of cancer specialists, Mr Des Carney, has said that there would be no topping-up of bills for cancer patients in the short term.
An exact figure on those topping up their bills is not possible to confirm yet as the VHI reaches an agreement on an individual basis and not through the IHCA. Some consultants have yet toe receive the offer. But meetings between the VHI and groups of are scheduled over the next month which may yield an agreement.
Meanwhile, oncologists are to meet today to discuss the VHI offer.
The IHCA national council would be meeting on Saturday to endorse the balance billing stance in specific areas, Mr Fitzpatrick said.
The VHI did not make any move suggesting that it was prepared to change its offer. "The schedule has gone out to consultants. Participation in a full cover scheme is a matter for individual consultants. Ninety-four per cent of consultants are in such a scheme at present. We have not been advised otherwise by anybody," a VHI spokeswoman said.
BUPA is expected to ensure that there is no shortfall in cover for its subscribers by offering consultants new terms, but has not commented on the dispute.
