I move:
That a supplementary sum not exceeding £36,725,000 be granted to defray the charge which will come in course of payment during the year ending on the 31st day of December, 1975, for the salaries and expenses of the Office of the Minister for Health (including Oifig an Ard-Chláraitheora), and certain services administered by that Office, including grants to health boards, miscellaneous grants, and certain grants-in-aid.
The House has already approved of the original Estimate of £177,022,000 and of a Supplementary Estimate of £414,000 in respect of compensation for thalidomide children.
The supplementary sum of £36,725,000, for which I am now seeking the approval of the House, brings the total Health Vote requirements for 1975 to £214,161,000. The additional Vote requirement relates to subhead A, salaries, wages and allowances for the Department; subhead G.1, grants to health boards; subhead G.2, payments to health bodies other than health boards; and subhead K, capital grant-in-aid of the Hospitals Trust Fund.
An additional amount of £20,244,000 is required under subhead G.1. Subhead G.1 provides for the payment of grants to health boards under section 32 of the Health Act, 1970 to meet all of their approved non-capital expenditures apart from the contributions from the rates. The rates' share of the expenditure in 1975 has been fixed at a level equivalent to the produce of a rate in the £ equal to 25 per cent of the rate struck by each rating authority for 1972-73.
Subhead G.2 provides for payments on behalf of health boards to voluntary hospitals, homes for mentally handicapped persons, joint board hospitals and to the General Medical Services (Payments) Board. The additional grant required under subhead G.2. in 1975 is £15,482,000. The arrangements for the direct funding of these bodies by the Department were introduced with effect from 1st April, 1974.
As the factors which have given rise to additional expenditure are common to bodies financed under subheads G.1 and G.2, I propose to explain the components of the combined additional requirements under these subheads.
The additional provision sought under subheads G.1 and G.2 combined amounts to £35,726,000. The components of this amount are as follows: An additional provision of £12 million is required to meet the cost of pay adjustments resulting from awards under conciliation and arbitration proceedings. These awards include the adjustments in the fees for doctors and pharmacists for services provided under the choice-of-doctor scheme, awards for hospital consultants, nurses and certain other grades. A supplementary sum of £10.2 million is required to meet price increases of the various commodities which are required for the health services in excess of the provision for price increases included in the original estimate.
An extra provision of £8.9 million is required to meet the cost of pay increases resulting from the application of the terms of national pay agreements to personnel employed throughout the health services.
An additional sum of £2 million is required to meet extra expenditure in relation to the choice-of-doctor scheme due to increases in numbers covered by medical cards and a consequential increase in doctors' visits and in the volume of prescriptions.
Under the 1975 budget provision was made for adjustments as from 1st April, 1975, and 1st October, 1975, in the rates of allowances for disabled persons and those payable under the Infectious Diseases (Maintenance) Regulations. The cost of these adjustments in 1975 will be about £1.8 million.
Increases as from 1st July, 1975, in the pensions of retired health services personnel and increases as from 1st April, 1975, in the employers' share of social welfare contributions account for £0.8 million of the supplementary estimate.
The additional amount required under subhead A is £99,000. This provision is necessary to meet pay increases to the staff of the Department in accordance with national agreements.
Finally, an extra provision of £0.9 million is required under subhead K, capital grant-in-aid of the Hospitals Trust Fund. There is a corresponding reduction in the amount to be drawn by health boards from another Exchequer source, the Local Loans Fund. The nature of capital projects determines the source from which the Exchequer provides the funds. In 1975 changes were made in the detailed programme of works which increased the volume and cost of projects to be financed from the Hospitals Trust Fund but provided at the same time for a corresponding reduction in the volume and cost of projects to be financed from the Local Loans Fund. Accordingly, the total Exchequer liability in 1975 in respect of the Department's capital programme remains unaltered.
A large part of the additional funds sought is required to meet the monthly grants to health boards, voluntary hospitals and homes and joint board hospitals due by the end of the month. Because of the urgent need for extra funds I would ask the House to pass the supplementary estimate now.
If the House agrees, I will provide an opportunity for a fuller debate later in conjunction with a debate on the general hospital development plan. For this purpose, I will arrange for the introduction of a token supplementary estimate of £10.
