Soldier hit with €1,600 hospital bill after training injury

[B Inman]

Soldier hit with €1,600 hospital bill after training injury
ANITA GUIDERA
Saturday October 31 2009
A RESERVE soldier who was hospitalised during an army training exercise wants the Department of Defence to pick up his €1,600 medical bill.
Tim McGillen was taken to Tallaght Hospital complaining of chest pains while taking part in a military exercise and spent 11 days in hospital.
But the department said it does not pay private hospital charges for enlisted personnel who, as citizens, are eligible for treatment as public patients in public hospitals.
Mr McGillen, a member of the 'A Company' 58th battalion, based at Finner, Co Donegal, claims if they continue to refuse to pick up the tab, reserve soldiers would "leave in droves".
The Derry man had been taking part in a military training exercise in June 2008 when he developed chest pains and was sent to hospital on the advice of the medical corps.
He was taken in military vehicle to Tallaght Hospital and processed through the accident and emergency department. When asked if he had private medical insurance, he informed them he was entitled to medical cover as a member of the Defence Forces.
"While at the hospital, at no stage did I say I was a private patient. I didn't ask for private treatment and I didn't sign any document to that effect. But now the hospital want €1,557 and the army is not willing to pay it," he claimed.
"I don't have the money to pay it. But I'm really angry about receiving it in the first place. It is causing me a lot of stress."
He is particularly angry that he was on military duty at the time the incident occurred.
"I was on a non-commissioned officer's (NCO) course which the Army chose me to go on. I passed the fitness test to go on the course, which is quite physically demanding. I was evacuated from the field and sent to hospital. I was admitted on June 28 and I was discharged on July 9," he said.
The Derry man said the implications of his case are widespread.
Treatment
"All other European armies look after their reservists. This wouldn't happen anywhere else. "I have talked to a lot of my military colleagues and they are awaiting the outcome of this case. If they get injured will they have to pay for their treatment too?
"The reality is most reservists have full time 'civvy' jobs so I think a lot of them will vote with their feet if the Army don't pay up. If it can happen to me, it can happen to them," he said. He added that he is also unhappy with what he said was the lack of response he got from RDFRA, the association which represents the interests of reservists.
Solicitors acting for Mr McGillen, were informed by the Department of Defence that there was "no regulatory authority for the Medical Corps to pay private hospital accounts for enlisted personnel".
A spokesperson for the Department of Defence told the Irish Independent that it was department policy not to comment on individual cases.
- ANITA GUIDERA
Irish Independent

http://www.independent.ie/national-news/soldier-hit-with-83641600-hospital-bill-after-training-injury-1929950.html

[Groundhog]

....When asked if he had private medical insurance, he informed them he was entitled to medical cover as a member of the Defence Forces....

And the correct answer is No.

Tough luck Tim, you foot the bill.

[Come-quickly]

Shouldn't he be in the TA anyway? As a UK Resident he should also have NHS cover.

[ZULU]

The Derry man had been taking part in a military training exercise in June 2008 when he developed chest pains and was sent to hospital on the advice of the medical corps.
He was taken in military vehicle to Tallaght Hospital and processed through the accident and emergency department.

When asked if he had private medical insurance, he informed them he was entitled to medical cover as a member of the Defence Forces.
"While at the hospital, at no stage did I say I was a private patient. I didn't ask for private treatment and I didn't sign any document to that effect.

1) Why wasn't there a member of the Medical Corp there with their patient to make sure that they were processed and liase with medical staff as to casulties condition like what an EMT/Paramedic/ambulance crew would do? What would happen if the casualty was unconcious?

2) He was taken to Hospital by military vehicle (duty of care) on the advice of Medical Corp (duty of care).

3) He didn't say he was on private insurance. He told them that he was a member of the DF. The hospital and DF should have a procedure for this.

4) Why wasn't he taken to a military medical facility?

5) What would happen to PDF personnel in this position?

[SwiftandSure]

It's going to cost the DF a lot more than €1557 in solicitors fees to get out of this one. They should have exercised their duty of care to THEIR soldiers, coughed up, and put it down as a mistake with a view to review the procedure for this kind of instance.
The RDF doesn't need bad press in a time like this. It's really cutting it's nose off to spite it's face! I mean seriously, aside from solicitors, who is this benefitting?

[WES]

When asked if he had private medical insurance, he informed them he was entitled to medical cover as a member of the Defence Forces.

I can see where the wires were crossed here.

Shouldn't he be in the TA anyway? As a UK Resident he should also have NHS cover.

Why should he be in the TA? Just because he lives in NI? Since when does the NHS cover hospitals in the Republic?

1) Why wasn't there a member of the Medical Corp there with their patient to make sure that they were processed and liase with medical staff as to casulties condition like what an EMT/Paramedic/ambulance crew would do? What would happen if the casualty was unconcious?

At the subsequent Court of Inquiry.....

2) He was taken to Hospital by military vehicle (duty of care) on the advice of Medical Corp (duty of care).

Seems to be the case. Duty of care covered.

3) He didn't say he was on private insurance. He told them that he was a member of the DF. The hospital and DF should have a procedure for this.

According to the article he said that he was entitled to medical cover as a member of the Defence Forces. He got it arseways as he's not and the hospital staff should know he's not. The DF will pay for public healthcare for its members and not private healthcare.

4) Why wasn't he taken to a military medical facility?

What???

5) What would happen to PDF personnel in this position?

When asked if they had private healthcare they would reply either yes or no. If they answer no they are admitted to the public ward. The bill is issued on discharge and routed through the proper channels and paid for by the Minister. Simple.

[WES]

It's going to cost the DF a lot more than €1557 in solicitors fees to get out of this one.

No it's not. The argument of,"Sure I thought I was covered", will not work here I'm afraid.

[ZULU]

According to the article he said that he was entitled to medical cover as a member of the Defence Forces. He got it arseways as he's not and the hospital staff should know he's not. The DF will pay for public healthcare for its members and not private healthcare.

He is entitled to medical care as a member of the DF. This happens to be public health care. This is what he seems to have referred to.
The details will be critical in this one but from the first look
1)He notified medical staff he was member of Defence Forces and informed he was entitled to the health care provided to them.

2) If any member of the DF wishes to not avail of public health care, it is their choice but by default I would have thought that it would be public.

3) I think it was the medical staff that got it arseways, as again he informed them that he was enitled to "medical cover" as part of the DF. This, as the DF has acknowledged is Public cover. So whywas he admitted into private care? Where was the member of the DF Medical Corp to make sure that these proceedures were followed?

The Duty of care does not stop by dropping them off at the hospital door. If that was the case, someone who was unconcious could be dropped off outside A&E and left there for someone to come across.

When asked if they had private healthcare they would reply either yes or no. If they answer no they are admitted to the public ward. The bill is issued on discharge and routed through the proper channels and paid for by the Minister. Simple.

[/QUOTE]

And what if they couldn't reply? What if they were suffering from concussion and were incapable of making decisions or recalling from memory? Who makes the call to whether they get cover by public or private health care? I would have thought in this situation public would be the default proceedure until otherwise stated by either a family member or member of the Medical Corp.


The facts and developments of this case will be interesting.

[knocker]

Why wasnt there a member of the PDF cadre there asap ? call it duty of care / covering their own ass - someone has dropped the ball on this big time

[trellheim]

No no why do you need PDF ? It's not their problem. This is a major issue for me. If I get a training incident on an Ex in the Glen, say a compound fracture, and I despatch the lad in the FFR to Tallaght what's the story ? when you're under DF Law you're allowed medical care same as a PDF man

.. and where the hell is RDFRA on this, this is smack in the middle of represention ?



OH PS : Now do you see why we wanted some proper guarantees before signing that Overseas contract ?

[SwiftandSure]

Maybe when asked if he wanted to go Private or Public? He replied he was a Private in the DF and the confusion started from there....

[FougaM]

This is not an RDF issue;

Looking at this from the hospitals point of view, the same mistake could have happened to a member of the PDF.

Why do Officers get private health care? and enlisted get public?

Maybe its because officers pay for private health insurance? or get it through the job? I dont know, but whatever the reason, the same opportunities for healthcare should be available to enlisted personnel.

Little be little we are seeing how the Defence Forces treats its people.

[ZULU]

Executive Summary - DF Medical Services review

The Irish Defence Forces (DF) consist of the Permanent Defence Force (PDF) and the Reserve Defence Force (RDF).

The Medical Corps has three main service objectives:

To maintain and promote health and well-being for members of the PDF
To maximise the medical readiness of the PDF for operational activities both at home and overseas
To provide field medical support in operational and training settings both at home and overseas.

Says it all really

[The real Jack]

1) Why wasn't there a member of the Medical Corp there with their patient to make sure that they were processed and liase with medical staff as to casulties condition like what an EMT/Paramedic/ambulance crew would do?

the army does not do that, many a rdf person has woken up in naas covered in camo cream with no money and no means of communications. Some units have SOPs that when someone is hospitalised another bod is sent with them to do that shit.

3) He didn't say he was on private insurance. He told them that he was a member of the DF. The hospital and DF should have a procedure for this.

Its not the hospital's problem, its purely the armys incompetence with RDF matters, i assume there's procedures in place for PDF.

4) Why wasn't he taken to a military medical facility?

Because they didn't want him to die.

[ZULU]

Page 4 - DF Medical Sevices review

http://www.defence.ie/WebSite.nsf/Publication+ID/D760C15B878715DE802575C50052B730?editDocument

Planning and management of services

The Medical Corps does not undertake regular strategic or operational planning for health service delivery.

Developing projections of demand would allow the Medical Corps to plan how capacity should be organised to deliver the strategic requirements of the Defence Forces and the needs of individual personnel. It would highlight potential capacity shortfalls in advance, providing a meaningfulcontext for discussions regarding the approach to civilian outsourcing and the degree to which services should be delivered locally or accessed centrally.

Without a DF wide, prospective view of demand, delivery is reactive and locally driven and this gives rise to a number of issues:

· The Medical Corps’ governance arrangements for outsourcing are unclear, for example in terms of accountability for budget planning, reporting and monitoring on spend.

· The quality of the clinical service provided by civilians is not assessed in a systematic way.

· The Medical Corps does not have a framework in place to support internal or external audit of care provision. Clinical governance and audit is increasingly becoming a feature of defence forces internationally.

· There is an absence of detailed, regular management information on patient access, Medical Corps delivery, efficiency and performance.

The DF has been made aware of the problems facing the provison of medical care in the organisation since 16 June 2009.

As can be seen, specific to this incident, the Medical Corp is failing in its duty of care and the provision of services. Armed with this info the DF should be worried if it goes to court.