The High Court has refused Laya Healthcare Limited’s application for two categories of documents from the Health Service Executive in a dispute over charges for insured patients treated privately in public hospitals.
The ruling, delivered by Mr Justice Twomey on 2 July 2019, addressed discovery ahead of the trial. The court did not decide whether the HSE may charge for a patient’s entire hospital stay when the patient elects private treatment, or only for treatment after the patient waives public care or signs a Private Insurance Patient (PIP) form.
The HSE’s pleaded case is that a patient’s election to be treated privately at any point makes the insurer liable for private inpatient charges from admission to discharge. Laya disputes that interpretation of section 52(3) of the Health Act 1970. It argues that services received before a patient signs a waiver were received as a public patient and should not attract private charges.
Laya sought internal communications between the HSE and the Department of Health concerning the interpretation of section 52, the meaning of the PIP form and how a waiver should be documented. It argued that the material could show whether the HSE and department had held consistent views and acted in line with them.
The court refused that category. Justice Twomey said the trial judge would have to interpret the legislation, and the department’s opinion as a third party had no relevance or necessity to that legal task.
Laya also sought agreements or other arrangements between the HSE and private health insurers about patients admitted as public patients who later become private patients during the same admission. It said these could show how the HSE or hospitals handled such patients and whether the process differed for Laya customers.
The court said the pleadings did not refer to other insurers, and a request made in interrogatories did not make the material relevant to discovery. Because the dispute was a question of statutory interpretation, the court found the agreements were not relevant or necessary and refused this category too.
The judgment dealt only with the two discovery categories described. The underlying dispute remained for determination at trial.