asked the Minister for Health the amount of the reduction in the 1972-73 Eastern Health Board estimate requested by his Department; the reasons for this decision; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Eastern Health Board Estimate.
4.
The estimate of the Eastern Health Board for the year 1972-73 as submitted to my Department showed an increase of £4,422,000 over the corresponding estimates for the year 1971-72, and an increase of £3,243,000 over the most recently ascertained expenditure figure for that year. The estimate was examined in my Department and was discussed in detail with officers of the board on a number of occasions. A number of items which showed increases over the preceding year which could not be substantiated were adjusted while additions were made for increases in costs not provided for in the original estimate. The additions include a sum for increases in the capitation rates payable for patients treated in voluntary hospitals which the board were not in a position to provide for when the estimate was prepared, but, disregarding that item, the net result was a reduction of about £900,000 which represents less than 4 per cent on the board's original estimate of over £25 million.
The reductions to which I have referred were made only where the projected expenditure could not be reconciled with the requirements of the services, including planned developments, and there is no question of limitation of the services to be provided by the board.
Does the Minister not accept that it is quite an extraordinary state of affairs that a projected expenditure for 12 months hence only by the Eastern Health Board to the tune of £900,000 could not be substantiated, if I may quote the Minister's words, and that a further sum of £1.1 million could not be reconciled? Surely if there is any system of budgetary control or projected expenditure for 12 months hence, the Minister should consider it to be quite an extraordinary state of affairs that the Eastern Health Board——
We cannot have a debate on this question. We seem to have a debate on each question.
We have negotiations with a number of health boards on their estimates in relation to the services. We think, for example, that they over-estimated the extra amount required to provide the choice-of-doctor scheme. We based our costs on very careful estimates, based on research done by the Royal General College of Practitioners in areas where there is a choice of doctor, the number of services per patient, et cetera. We think there was a mistake in that. That accounted for £510,000. We think that the rate of increase in the number of persons receiving disablement allowances was placed at an excessive figure by the Eastern Health Board and so we reduced it. The only actual item where one might say that the progress in new services was limited was in the case of the St. James Hospital and the James Connolly Memorial Hospital where we allowed for 270 extra staff instead of 398 as suggested, showing quite clearly that progress could be made in the development of those two institutions but on a slightly more limited basis. All the rest were normal differences of opinion that occur from time to time between health authorities, now the health boards, and the Department as to what the general cost of the medical services would be.
Would the Minister not agree that the very fact that he has had to intervene in this highly unusual manner is an indication, if not actual proof, that a grievous mistake was made in removing the health functions from the county councils and establishing——
That is a separate question.
I would not agree at all. I do not think they will have had proper experience of their administration until 1974-75. Until they have the opportunity of working on a 100 per cent efficiency basis with all their staff appointed, and with the principles suggested in volume 3 of the McKinsey Report applied particularly in regard to costings and efficiency of operation, I would expect that there would be differences of opinion between my Department and the health boards.