Ceisteanna—Questions. Oral Answers. - Health Services.

9.

asked the Minister for Health whether any revised estimate of the cost to the health service of the provision of a choice of doctor for the lower income groups has been made since a reply of 13th February, 1963; and, if so, what is the amount of this revised estimate.

Having regard to increases in remuneration generally and in some prices since the estimates of cost referred to in my reply of 13th February, 1963, were made, it is thought that the figures given in that reply might now be revised upwards to £1.1 million or £1.8 million a year, depending on the type of scheme. I would stress, however, that these figures merely give an indication of the order of extra expenditure involved in this type of scheme and should not be regarded as firm costings.

10.

asked the Minister for Health the amount of the increased expenditure to date incurred by each local health authority following the issue of his Department's circular of September, 1961, to the effect that persons not included in the general medical register may in certain limited circumstances be entitled to free or partially free drugs or medicines; and the amount of such expenditure incurred in the past three months.

The information given in the reply is in respect of the calendar years 1962 and 1963. I have been unable, in the limited time at my disposal, to obtain the information in respect of the current year to date, or in respect of the past three months, but if the Deputy repeats the question in the New Year, I expect to be in a position to supply these further particulars.

The Deputy will note that the information for the years 1962 and 1963 is incomplete in respect of some health authorities. The authorities concerned generally supplied the medicines and drugs in conjunction with the dispensary services and did not keep separate records of expenditure on such items. Health authorities should, however, be in a position to furnish full information in respect of the current year as they were requested in a supplementary circular letter issued from my Department on the 24th July, 1964, to keep full records of the cost of medicines and drugs supplied in hardship cases. That circular also requested health authorities to take all reasonable steps to ensure that persons who might wish to obtain medicines and drugs as hardship cases were aware of the facilities available.

As the reply is in the form of a tabular statement, I propose, a Cheann Comhairle, with your permission, to circulate it with the Official Report.

Following is the statement:

EXPENDITURE by health authorities in supplying medicines and drugs under Section 14 of the Health Act, 1953, in cases of hardship to persons not covered by general medical services cards.

Health Authority

Year ended 31/12/1962

Year ended 31/12/1963

£

£

Carlow County Council

75

113

Cavan County Council

223

279

Clare County Council

Details not available

Cork Health Authority

Details not available

Donegal County Council

Details not available

150

Dublin Health Authority

1,900

2,755

Galway County Council

Details not available

160

Kerry County Council

Details not available

40

Kildare County Council

139

167

Kilkenny County Council

33

121

Laois County Council

9

9

Leitrim County Council

Details not available

Limerick Health Authority

356

917

Longford County Council

52

42

Louth County Council

115

205

Mayo County Council

181

201

Meath County Council

175

279

£

£

Monaghan County Council

Details not available

Offaly County Council

Details not available

Roscommon County Council

8

10

Sligo County Council

Details not available

Tipperary (NR) County Council

150

375

Tipperary (SR) County Council

100

131

Waterford Health Authority

247

289

Westmeath County Council

4

117

Wexford County Council

13

11

Wicklow County Council

75

178

Is the Minister satisfied that the final matter referred to in the question as to local authorities being required to make known to persons that they may be entitled to free or partially free drugs or medicines has been fully complied with?

I have no evidence to the contrary.

I have received cases where manifestly the persons labouring under the hardship had no knowledge of this requirement and had made considerable outlay on the purchase of drugs and medicines, which caused them hardship, before consulting me on the matter.

I would be very grateful if the Deputy would give me any particulars of such cases.

I must say that having taken up the point with the local authority concerned, the benefit has been extended.

The point is that the local authority failed to advise these people of their rights.

Might I ask the Minister to recommend to local authorities that they do what was done by the Water-ford Health Authority—advertise in the public press?

I will consider that matter.

11.

asked the Minister for Health the cost of general medical services in the most recent year for which figures are available distinguishing between (a) payments made to dispensary doctors, (b) cost of pharmaceutical supplies, (c) cost of appliances, and (d) other costs.

The cost of the services referred to in respect of the year ended 31st March, 1964, was £1,682,000 made up of £870,000 for salaries of dispensary doctors, £608,000 for drugs, medicines and appliances and £204,000 for other expenses. Separate figures for appliances are not available but the amount is relatively small.

12.

asked the Minister for Health if he will state in respect of the most recent available year the estimated cost of drugs and medicines purchased for (a) local authority hospitals (b) health clinics and (c) dispensaries.

The cost of drugs and medicines in respect of the year ended 31st March, 1964, was £692,900 for local authority hospitals and health clinics, including £240,000 for mental hospitals. It is not possible from the information available in my Department to segregate the figures as between the hospitals and the clinics.

The cost of drugs, medicines and appliances in respect of the same year for dispensaries was £608,300. Separate figures for appliances are not available, but the amount is relatively insignificant.

13.

asked the Minister for Health the cost of the school medical service for the year 1962-63, and the estimated cost for 1963-64.

14.

asked the Minister for Health if he will state in respect of the estimated net health expenditure by health authorities in 1962-63 and 1963-64 the amount spent or to be spent on (a) dental services and (b) ophthalmic services.

20.

asked the Minister for Health the total current expenditure on general hospitals in 1962-63, and the expenditure for 1963-64.

21.

asked the Minister for Health the total current expenditure on mental hospitals in 1962-63, and the expenditure for 1963-64.

22.

asked the Minister for Health the total current expenditure on tuberculosis hospitals for 1962-63, and the expenditure for 1963-64.

23.

asked the Minister for Health the total current expenditure for hospitals and homes for chronic sick, mental defectives, etc., for 1962-63, and the expenditure for 1963-64.

24.

asked the Minister for Health the cost of the mother and child service for 1962-63 and 1963-64.

25.

asked the Minister for Health the cost of the infectious diseases service for 1962-63 and 1963-64.

26.

asked the Minister for Health the cost of allowances to disabled persons and rehabilitation services in 1962-63 and 1963-64.

With your permission, a Cheann Comhairle, I propose to take Questions Nos. 13, 14 and 20 to 26 together and to circulate with the Official Report a table giving the required information.

Following is the table:

REVENUE Expenditure of Health Authorities and payments from Hospitals Trust Fund towards revenue deficits of Voluntary Hospitals (a)

1962-63

1963-64

£

£

General Hospitals (b)

8,937,715 (c)

10,049,699(d)

Tuberculosis Hospitals

1,169,110 (e)

1,062,805 (f)

Mental Hospitals

4,723,900

5,047,700

Hospitals and Homes for Chronic Sick, Mentally Retarded etc.

2,085,400

2,229,200

Mother and Child Service (including Maternity Cash Grants)

969,500

949,900

School Medical Service

215,500

240,900

Infectious Diseases Services and Maintenance of Persons suffering from Infectious Diseases

781,300

715,200

Allowances to Disabled Persons and Rehabilitation Services

845,700

968,700

Dental Services

180,200

200,300

Ophthalmic and Aural Services

61,000

65,000

NOTES:

(a)The figures for revenue expenditure of health authorities are subject to audit.

(b)Certain special hospitals other than Tuberculosis, Mental Hospitals and Homes for Chronic Sick and Mentally Retarded are included (e.g. Maternity Hospitals and Units, Cancer Hospitals, Eye and Ear Hospitals and Units).

(c)includes £1,810,915 paid from the Hospitals Trust Fund for revenue deficits.

(d)includes £2,195,499 paid from the Hospitals Trust Fund for revenue deficits.

(e)includes £89,010 paid from the Hospitals Trust Fund for revenue deficits.

(f)includes £119,905 paid from the Hospitals Trust Fund for revenue deficits and £84,400 paid to the authorities of Newcastle Hospital towards compensation for staff whose employment was terminated by reason of closing of the Hospital.

15.

asked the Minister for Health the number of dentists normally engaged in active dental practice in the State, and the number employed full-time by health authorities.

I have not precise information as to the number of dentists engaged in active dental practice in the State. There are approximately 650 dentists at present registered with the Dental Board and, on that basis, it seems reasonable to assume that there are about 600 dentists in active dental practice in the State, either in a whole-time or a part-time capacity.

The number of approved full-time posts as dental surgeon in the local authority health service is 92; 88 of these are at present filled, either in a permanent or temporary capacity, and the other four vacant posts are now being filled through the machinery of the Local Appointments Commission.

16.

asked the Minister for Health the current salary scales of (a) medical doctors and (b) dental surgeons employed full-time by health authorities.

I assume that the Deputy wishes to have the information furnished in reply to a similar question from him on 5th February, 1963, in respect of dental officers and of certain medical officers brought up to date. As the reply contains a number of figures I propose, with your permission, a Cheann Comhairle, to circulate it with the Official Report.

Following is the reply:

Post

Salary Scale

(a) Medical Officers:

County Medical Officer*

£2,370+£81—£2,613+£82—£2,695

Assistant County Medical Officer

£1,510+£64—£1,830

District Mental Hospitals:

Senior Assistant Medical Officer

£1,915+£71—£2,270

Assistant Medical Officer

£1,640+£70—£2,060

Sanatoria:

Assistant Medical Officer

£1,510+£64—£1,830

Junior Assistant Medical Officer

£1,070+£36—£1,178+£97—£1,275+£36— £1,455

Junior Hospital Medical Staff Registrar

£1,315+£110, £115—£1,875 (with an additional £140 where the holder possesses a higher Degree)

House Surgeon/Physician

£925—£980—£1,090

Intern

£755—£840

(b) Dental Officers

Senior Dental Officer†

£1,895+£67—£2,230+£65—£2,295

Dental Officer

£1,455+£56—£2,015+£55—£2,070

*Special salary scales apply to the corresponding posts in Dublin, Cork, Limerick and Waterford.

†Special salary scales apply to the corresponding posts in Dublin and Cork.

17.

asked the Minister for Health the number of medical practitioners normally engaged in active medical practice in the State, and the number employed full-time by health authorities.

As I explained in reply to previous similar questions by the Deputy the number of medical practitioners normally engaged in active medical practice in the State cannot be stated accurately. The number of medical practitioners according to the 1961 Census of Population was 2,952 which compares with the figure of 2,921 obtained from the 1951 Census. As I stated on the earlier occasions referred to, the Census figure is believed to include a number of doctors not in active practice.

The number of doctors employed full-time by health authorities in the State is 594. The corresponding figure given in reply to a similar question by the Deputy in February, 1963 was 569.

18.

asked the Minister for Health the average number of persons on the general medical services register per district medical officer employed by each health authority.

As the reply to the question is in the form of a tabular statement, I propose, a Cheann Comhairle, with your permission, to circulate it with the Official Report.

The figures given are for 30th September, 1964, which is the latest date for which the information is available in my Department.

Following is the statement:

Health Authority

Average number of persons on the general medical services register per District Medical Officer

Carlow County Council

1,680

Cavan County Council

742

Clare County Council

914

Cork Health Authority

1,019

Donegal County Council

794

Dublin Health Authority

1,442

Galway County Council

1,467

Kerry County Council

1,553

Kildare County Council

1,294

Kilkenny County Council

1,294

Laois County Council

1,044

Leitrim County Council

624

Limerick Health Authority

1,576

Longford County Council

1,570

Louth County Council

1,231

Mayo County Council

1,761

Meath County Council

931

Monaghan County Council

1,622

Offaly County Council

1,333

Roscommon County Council

1,436

Sligo County Council

853

Tipperary (NR) County Council

803

Tipperary (SR) County Council

1,056

Waterford Health

Authority

1,250

Westmeath County Council

999

Wexford County Council

1,534

Wicklow County Council

1,151

19.

asked the Minister for Health if he will state the estimated cost of abolishing the charge of up to ten shillings per day in respect of hospital treatment for the middle income group, bearing in mind the savings in administrative costs that would accrue.

It is estimated that the amount received by health authorities in the financial year ended 31st March last by way of charges under section 15 of the Health Act, 1953, and section 231A of the Mental Treatment Act, 1945, was £520,000. This sum represents the direct loss of income which would result if the charges were abolished. It is not possible to estimate closely the saving which would accrue in the administrative costs of assessing and collecting these charges. Replies to an inquiry which my Department addressed to health authorities indicate that the saving might be in the region of £60,000 a year.