asked the Minister for Health if he accepts all or part of the figure of £199,500 furnished by Dublin Health Authority in respect of the Authority's expenditure on public assistance in the current year which has the effect of reducing hospital and medical costs; and, if so, if he will accept such expenditure as ranking for State recoupment with expenditure on the health services recognised for grant purposes.
Ceisteanna — Questions. Oral Answers. - Public Assistance Expenditure.
76.
The question of accepting public assistance expenditure as recognised health expenditure qualifying for Health Services Grant has been examined. While it might be contended that in certain cases the grant of public assistance could help to lessen the need for admission to an institution, I am satisfied that relative to total health costs the amount that could be shown to represent an alternative to expenditure on institutional care would not be significant, and the computation of the amounts would be difficult. Furthermore, any question of such an arrangement would have to be considered generally and not in relation to an individual health authority. I do not, therefore, propose to extend in the manner indicated in the question the scope of the grant payable from the Health Vote to the Dublin Health Authority in respect of the current financial year.
On the basis of the figures supplied to my Department by Dublin Health Authority that body will, however, receive £499,000 as a supplementary grant over and above the statutory amount payable for 1968-69 in recoupment of the cost of the health services. This assistance to the rates is far in excess of any relief that could be claimed on the grounds indicated in the question.
Is the Minister prepared to accept any part of this figure of just £200,000 as having an effect upon reducing hospital and institutional costs? Is the Minister aware that we have now reached the turningpoint in the Dublin Health Authority where we can show that the rate of application for admission to institutions has fallen and that this is attributable to out-patient facilities and domiciliary care which are being paid for exclusively out of the rates and which are included in this figure which the Minister has in his Department now for eight months?
This is a problem which would have to be dealt with on a national basis rather than from the point of view of a particular local authority. There is a problem throughout the country regarding classification for home assistance as distinct from health services.
Has the Minister submitted the matter for the consideration of his colleague in the Cabinet?
Yes, he had a deputation last January in the matter. He has fully looked into it and decided that the better way to do it is on an ad hoc basis where there is a supplementary grant.
He gave an ad hoc grant before the submission of these figures.
This would require a complete revamping of the whole problem throughout the country. It is not just a problem in relation to Dublin.
Questions 77 to 81, inclusive, postponed.