asked the Minister for Health if he is aware that a consultant surgeon (name supplied) has stated that the cost per day of maintaining a patient in a Dublin general teaching hospital is now £13 and will probably increase to more than £16 next year; if these figures are correct; and, if so, if he is aware of the grave hardship the extra cost will impose on many ratepayers; and if he has any new proposals to meet the burden that will fall on ratepayers this year.
Ceisteanna—Questions. Oral Answers. - Hospital Costs.
6.
I am aware that the present average daily cost of maintaining and treating an in-patient in a Dublin specialist voluntary hospital is estimated to be in the range of £10 to £13. The daily rate of payment by a health board for these services is £4.25 per patient and the revenue deficits of the hospitals, arising mainly from the discrepancies between the cost of providing the services and the amounts paid by health boards, are met by grants from the Hospitals Trust Fund to which a substantial Exchequer subvention is made. The expenditure of the health boards is, of course, also recouped to the extent of 55.7 per cent, on average, from the Vote for my Department.
It will be seen, therefore, that from the point of view of the local rating authorities this is one field in which services are obtained on extremely favourable terms.
The estimates of expenditure of the hospitals for the coming year are only now becoming available to my Department, and the costs and charges which will be applicable to that year will be determined when the examination of these estimates has been completed.
In view of the compassion the Fianna Fáil Party had for the ratepayers when in Opposition, is the Minister now aware of the grave hardship imposed on ratepayers by the ever-increasing burden of rates? Is he further aware that it is reckoned that the health rate in some counties will rise by £1 in the £ this year? In view of the fact that a definite promise was made by a former Minister for Health to stabilise the health rate in 1965, are the Minister and the Government now prepared to make any provision to combat the ever-increasing cost to the ratepayers?
I have already replied to that question on several occasions in the Dáil. The Deputy is merely repeating a question which I have already answered.
Why not stabilise the health rate at the 1965 level as promised? I remember when we were told that the health service would only put 2s in the £ on the rate. That is not so long ago.
That is not my interpretation of it.
Would it be more correct to say that this figure also represents the out-patients department facilities and all the other services provided and is not really just a charge per patient per day?
I should have to go into that. I am not quite sure exactly what the elements of it are.
According to the report it said the cost per day of maintaining a patient in a hospital.
It is not an accurate figure.
(Interruptions.)
In view of the statement by the medical consultant of the cost of an in-patient's maintenance per day of £13, or £91 per week, and in view of the reply which the Minister gave a fortnight ago from his brief that the average cost of maintaining a patient was between £60 and £80, how does he reconcile the difference between these figures?
I gave a reply about the average weekly cost in the Dublin voluntary teaching hospitals and in the maternity hospitals: I gave the reply in relation to the health board hospitals and the Deputy can look back and see what the replies were.
7.
asked the Minister for Health if he is aware of the rise in hospital costs in recent years and especially in recent months; and if he will give a break down of the cost under the headings of (a) wages and salaries, (b) food and provisions, (c) drugs and hospital appliances, (d) buildings and (e) others.
I am aware that there has been a considerable increase in hospital costs in recent years and that this is largely in line with the trend in other sectors of the economy. The increases in hospital costs can be mainly attributed to the increased cost of medicines and drugs, improved pay and conditions for staff and to general improvements and extensions of hospital services.
As the remainder of the reply is in the form of a tabular statement, I propose with your permission, a Cheann Comhairle, to circulate it with the Official Report.
ESTIMATED Costs of Health Board and Voluntary Hospitals
|
1969-70 |
1970-71 |
1971-72 |
|
|
(a) Salaries and Wages |
26,584,700 |
33,259,500 |
39,843,500 |
|
(b) Food and Provisions |
4,029,800 |
4,506,600 |
5,054,800 |
|
(c) Drugs and Appliances |
3,448,600 |
4,177,700 |
4,884,000 |
|
(d) Buildings |
1,778,600 |
1,986,900 |
2,323,300 |
|
(e) Others |
6,746,700 |
7,727,300 |
8,963,100 |
Is the Minister aware that since the health boards were set up we have done nothing except to appoint more and more highly paid officials and that we have not given even an aspro extra to the patients?
I do not agree with the Deputy at all.
Is he not aware that different health boards have appointed six or seven officials at salaries of between £4,000 and £5,000 per annum and that 20 to 25 people have been appointed to assist them?
This does not arise out of the question.
The Deputy will be disappointed to hear that the cost of the administration of the health services is only 3 per cent of the total cost and I would defend that as an extremely low percentage. The cost of the new management structure of the health services has meant an increase of only a quarter of one per cent of the total cost of the health services. If the Deputy wants to ask me what the likely cost is of some of the support staff under the health boards and if I subtract the previous cost of the same kind of staff working for the health authorities, the Deputy will again be disappointed to hear that the actual percentage of the total cost of the health services is extremely low.
I want to ask the Minister if the patients have even got an aspro extra. It is the patients we are interested in.
The services are constantly improving.
Will the Minister say——
Question No. 8.
What does the Minister mean by "management costs"?
This would better be discussed on the Health Estimate. "Management costs" is the cost of providing the head management staff for the health boards. When that cost is examined in relation to what it formerly was under the health authorities, the increase is only a quarter of 1 per cent.
That is a very vague figure. The Minister might spell it out for us.
The Deputy can put down a question. The waste of time in this House replying to questions that have already been answered is ridiculous. I have already published a statement. I am talking about the programme managers and the CEOs. Underneath them there are some other supporting staff. Some of the supporting staff have not yet been appointed because the position is being examined in relation to the McKinsey Report. When it has all been examined, it will not be found that the health boards' extra staff costs will be anything that need seriously worry the ratepayers or the taxpayer.
Why did the Minister say he has given the figures when he has not got them?