Vol. 562 No. 6
2 Ms McManus asked the Minister for Health and Children the steps he intends to take to address the severe funding crisis facing major teaching hospitals in the greater Dublin area; the budget allocations for each for 2002 and 2003; the deficit for each at the end of 2002; the estimated deficit for each at the end of 2003 unless cutbacks are made; and if he will make a statement on the matter. [6828/03]
The Government's commitment to the health services is clear from the significant increase the services have received for 2003. Despite the tight budgetary situation overall, health obtained the largest increase by far of any Department this year, at €970 million, which was a 12% increase, and this continues the high level of investment since 1997 – the percentage increase since that year is 162%.
The health boards and the ERHA have drawn up their service plans having regard to the approved limits. There will be a need to manage carefully the service plan delivery, in particular within the acute hospital programme, which can be the subject of great pressure, both from activity and cost. The major teaching hospitals in the greater Dublin area will of course face these pressures as will all major acute hospitals throughout the country. The ERHA is concluding its series of meetings with the major hospitals to agree funding levels and service plans in respect of 2003.
The figures available for 2002 projected outturns and the 2003 proposed funding for the major acute Dublin hospitals are set out in the following tables:
Major Dublin Acute Hospitals – 2002 Determinations and Outturn.
|
2002 Determination |
Outturn 2002 |
Variance 2002 |
|
|
€ |
€ |
€ |
|
|
St. James's |
254,919,621 |
254,900,000 |
-19,621 |
|
Beaumont |
175,126,888 |
178,900,000 |
3,773,112 |
|
Mater |
155,030,362 |
160,300,000 |
5,269,638 |
|
St. Vincent's |
136,090,748 |
141,200,000 |
5,109,252 |
|
Tallaght – Including FDVH |
150,601,535 |
150,600,000 |
-1,535 |
|
Total |
871,769,154 |
885,900,000 |
14,130,846 |
Major Dublin Acute Hospitals – 2003 Determination.
|
2003 Determination |
2002 DeterminationLess Once Offs |
Percentage Increase |
|
|
€ |
€ |
||
|
St. James's |
259,000,000 |
238,100,000 |
8.78% |
|
Beaumont |
174,400,000 |
160,900,000 |
8.39% |
|
Mater |
155,200,000 |
141,300,000 |
9.84% |
|
St. Vincent's |
133,200,000 |
120,800,000 |
10.26% |
|
Tallaght – Including FDVH |
149,400,000 |
144,200,000 |
3.61% |
|
Total |
871,200,000 |
805,300,000 |
8.18% |
When comparing the 2002 outturn with the 2003 determinations, care must be taken to avoid simple comparisons. The 2002 outturn, for comparison purposes, must be adjusted for the impact of once-off elements. These include such items as pay arrears and medical indemnity insurance. It will be appreciated that during the year, as is normal for agencies, the ERHA's determination will be increased by, for example, tranche 2 of the waiting list funding, bed capacity funds, winter initiative funds, pay settlements and other initiatives. Therefore, it would be misleading to make a straight comparison between final determinations for last year and the original figure for 2003.
It is clear that they will have to manage their services in a proactive and effective manner throughout 2003. I emphasise that the discussions between the ERHA and the hospitals are ongoing and the precise make-up of the service agreements for 2003 are not finalised. My Department is in contact with the ERHA and will receive a report from the authority when its discussions are finalised in regard to 2003. The Secretary General and the senior management team in my Department will also meet the ERHA and chief executive officers of the major Dublin area teaching hospitals together as part of an ongoing consultative process.
That is a disgraceful answer to give a Deputy who has asked for specific information. Information to be circulated on a table is of no use to me when I do not know what is that information. I specifically asked for information—
I will read it out if the Deputy wishes.
If the Minister reads it out I will have no chance to ask him questions. The Minister could have given me the information I sought. Will the Ceann Comhairle ensure that when questions are asked they are answered in a way that meets the needs and the restrictions of the House?
The Chair has no control over the Minister's replies.
I am in a predicament. I have asked parliamentary questions in the past and was told that while the information was not readily available it would be sent to me. I still have not received an answer to a question I asked previously. It is grossly inadequate for the Minister to give this kind of reply.
Will the Minister face up to the reality and clearly state the position of major acute hospitals in Dublin? Beaumont Hospital is facing a funding cutback of 10%, the Mater Hospital is facing a 12% cutback and I presume the position is similar in St. James's Hospital. Will the Minister guarantee that patient care will not be affected by what the ERHA has described as "a difficult year"? Will he ensure the 11,000 treatments that have been denied to patients in the Mater Hospital will not be denied over the year? Will he ensure the major Dublin hospitals can meet the needs of their patients without any question of cutbacks impacting on patients?
I take issue with what the Deputy has raised about the manner in which the question was answered – I answered it in the normal way. When statistics are requested we circulate them with the question and that is what I have done in this case. I can go through the deficits if the Deputy wishes. I will give the Deputy the figures she made such a big song and dance about receiving.
I resent that. The Minister should withdraw that remark. I asked him a question and he did not answer it. The Minister is trying to avoid answering my question.
I will answer it. I do not agree with the Deputy. She is trying to hog the time and will not allow me the chance to respond.
The Deputy should allow the Minister to answer the question.
I asked the Minister what he is going to do to ensure hospital services are not affected.
I am going to answer the question the Deputy made such a big deal about.
Six minutes have been set aside for this question and I ask the Deputy to allow the Minister to answer it.
The Minister is wriggling.
I am not.
The Minister is being evasive and refuses to accept we have a crisis in our hospitals. He has a responsibility—
If one excludes once-off payments received last year, the percentage increase for St. James's Hospital is 8%. Other increases are 8% for Beaumont Hospital, 9% for the Mater Hospital, 10% for St. Vincent's and 3% for Tallaght. The additional allocation that is made at the beginning of the year is added to throughout the year for waiting list initiatives, bed capacity, pay arrears and medical indemnity etc. It is simplistic to compare outturn figures with the initial figure. The additional amount we gave last year would have been greater than that which was originally allocated at the start of 2002.
The final determination for St. James's in 2002 was €259 million, €175 million for Beaumont, €155 million for the Mater, €136 million for St. Vincent's and €150 million for Tallaght. The variance between the determination and the outturn in St. James's was €19,000, the variance for Beaumont was a deficit of €3.7 million, the variance for the Mater was a deficit of €5 million while there was also a €5 million deficit for St. Vincent's. Tallaght more or less broke even with a variance of €1,000. The statistics were available for the Deputy and it was disingenuous of her to make such an issue of this.
The Chair allowed an extension of time for a previous question. I have not received an adequate response to the question I asked—
We had not concluded the six minutes in the case of the previous question.
Why did the Chair tell the Deputy that he had?
That he had what?
Gone over the six minutes.
I did not tell the Deputy that.
You did, a Cheann Comhairle.
I did not. I told the Deputy that there were only seconds remaining.
The Minister is masking the information I sought.
The Deputy hogged the time and did not allow me to answer the question.
The Minister did not give the information about the deficit at the end of this year.
As the time for questions is limited by Standing Orders, I suggest Deputies confine themselves to asking questions rather than making statements and that the Minister answers the questions.
That is all I am looking for but the Minister still has not answered my question.
I have.
The Minister did not give the figure for the estimated deficit at the end of 2003.
How could one answer such a question.
Deputy McManus and the Minister should both resume their seats. Most of the time allocated to that question was taken up by not submitting a question and not answering it.
