asked the Minister for Health if he will issue a directive to the Eastern Health Board and any other health board which might have such a retrograde proposal under consideration absolutely forbidding any reduction in the age-limit for the free milk service for children or any other limitation in the existing terms of eligibility.
Ceisteanna—Questions. Oral Answers. - Health Services.
2.
I have no intention of proposing an amendment of section 65 of the Health Act, 1970, under which the age limit for free milk is fixed at five years and the other conditions of eligibility are laid down. Therefore, there is no need for the issue of a directive on the lines suggested by the Deputy.
Is the Minister aware that in the case of one health board at least there was a proposition from the management to the board to reduce the age limit from five to three years?
I am so aware. A suggestion on those lines was put forward in the initial stages by a programme officer, but it was never entertained seriously by the board.
Since such a proposal could be put forward because of the inadequate allocations from the Minister to the health boards, would he not consider it advisable to issue a directive on the lines suggested in the question?
This does not arise since the health board had no intention of putting the proposal into operation and even if they had any such intention I would not be prepared to sanction it. There is more money available in this regard this year than there was last year.
3.
asked the Minister for Health if he is aware of a proposal of the Eastern Health Board to reduce the level of financial assistance to the Board for Employment of the Blind; and if he will make a statement on the matter.
The Eastern Health Board have not submitted any proposal to my Department in regard to reducing the level of financial assistance made available by them to the Board for the Employment of the Blind.
Is the Minister aware that a proposal to reduce the level of financial assistance to the board was put forward by the management to the board as one of a series of proposals for economies. In view of this, does he not consider it necessary to make a statement to the House outlining what is the position in regard to the level of financial assistance to be given to the board this year so that the fears regarding the future of the board and their ability to provide employment for those in need of it may be allayed?
There is no necessity to give such a guarantee because as I explained before and also in regard to the last question, this is one of the tentative proposals which in my view were too simplistic and were rejected. Therefore, the question of my giving a guarantee does not arise.
Can the Minister give an indication of what will be the level of financial assistance in 1976?
It will be £35,000.
Can the Minister relate that to what the Board for the Employment of the Blind indicated as their requirements for this year?
I have no information as to what were their requirements. All I can tell the Deputy in this regard is that the Eastern Health Board propose to pay £35,000 this year to the Board for the Employment of the Blind.
Is the Minister satisfied that that amount of money will be adequate to enable the board to carry out their normal level of activities during the coming year?
I believe the board are so satisfied.
Should it transpire that this amount, as many people fear, will not be adequate, will the Minister be prepared to intervene and ensure that this very important social service can continue at an adequate level during 1976?
Yes.
4.
asked the Minister for Health if he is aware that health boards have in mind raising the level above which the cost of medicines are refunded to persons in the limited eligibility category and that this will deprive many persons of their basic medical requirements; and if he will make a statement on the matter.
It has been suggested that certain changes should be made in the scheme for refunds of the cost of drugs for persons with limited eligibility for health services so as to align with changes in price levels which have taken place since the original levels were fixed in April, 1972. This would require an amendment of the regulations made under the Health Act, 1970. I am considering the suggestion and will announce my decision soon.
Is the Minister not prepared to admit to the House that the proposal to increase this level is inevitable and that a letter of 3rd March, 1976, from the Secretary of his Department to the Eastern Health Board indicated clearly that the level will increase? Is the Minister not prepared to admit honestly that this is the position and that when he was opposing a resolution from this side of the House seeking to improve eligibility for general medical service cards, one of the arguments he used was that this assistance was available? Is it not a very serious matter that the level is to be increased as now proposed?
I wonder whether the Deputy is serious when he refers to the seriousness of a change in this regard? The suggestion came from the Eastern Health Board and I am entertaining such a proposal because the limits were fixed as far back as April, 1972. Due to increased costs and inflation since then, it may be found appropriate to effect a change in the amounts that can be refunded on the purchase of drugs and medicines.
Does the Minister recall that when he was resisting a very reasonable proposal from this side of the House—that the eligibility for general medical service cards should be widened—one of the main planks in his argument was that this facility was available to persons who had not got medical cards? He relied very much on the fact that this service was available, that anybody who had to pay more than £4 a month for drugs could get the excess refunded to them. In view of that would he not now refuse to raise this level? Furthermore, does he not recognise that the raising of this level on a very hard-pressed section of the community will simply have the effect that many of those people will not be able to get the medicine and drugs which they vitally need for their medical attention and care?
Is the Deputy suggesting it should be left at the same level it was fixed in 1972?
I suggest that in present circumstances it is a retrograde anti-social step on the part of the Minister to raise this level.
5.
asked the Minister for Health if economy measures in the use of hospital services being undertaken by health boards such as referral of patients in the first instance to health board hospitals or other institutions and reductions in the number of patients being sent to outside hospitals may have very serious and in some cases fatal consequences; and if he will issue an immediate directive to cancel all such measures.
I have had inquiries made from each of the health boards. None of them has undertaken an economy measure such as is described by the Deputy.
Is the Minister aware that a proposal exactly along the lines of the proposals outlined in this question was put before the Western Health Board by the management. of that board as an economy measures? This was forced on the board by the inadequate allocation made by the Minister to the board for 1976.
The only information I have about the Western Health Board is that eligible patients may be referred by general practitioners to Portiuncula Hospital, Ballinasloe, without charge. If they attend Dublin voluntary hospitals without the agreement of the health board they may be charged 50p a day for public ward treatment. I am informed that, if they do that, the imposition of the 50p is never invoked.
Unfortunately I am not allowed to quote at Question Time. If I were permitted to quote I could quote from a report submitted by the executive officer of the Western Health Board to his board proposing exactly the sort of measures which I have outlined in my question, namely, economy measures in the use of hospital services being undertaken by health boards such as referral of patients in the first instance to health board hospitals or other institutions and reductions in the number of patients being sent to outside hospitals, as positive economy measures. If the Minister is not aware of that report I will undertake to get the report and submit it to him.
I have quoted from the information I have. This is a matter for the general practitioners. If the patient elects to go to a hospital of his choice, apart from the health board hospitals, he may be charged 50p a day. That is more theory than practice. If the GP decides that he should go to one of the outside hospitals, say a voluntary hospital in Dublin, that will be allowable for those who are eligible for free hospital treatment.
Question No. 6.
Is the Minister aware of a proposal put forward seriously by the executive officer of the Western Health Board to the board——
I am sorry, Deputy. Could I dissuade the Deputy from repeating supplementaries? I am afraid we are having repetition.
This is a point which the Minister is not clear on. From his answer it appears to me that he does not understand the exact point I am endeavouring to make by way of question. Is he aware that the executive officer has seriously suggested to his board that, as an economy measure, general medical practitioners under the general medical service be restricted in their freedom to refer to certain hospitals? Would he, as Minister for Health, approve of such a restriction?
They can go to outside voluntary hospitals if they want to. Will the Deputy not take my word? He is dragging out all those questions, getting a lot of political mileage out of the matter. I said I have had inquiries made from all the health boards and there is no proposal to change the present system.
I want to suggest to the Minister that his inquiries have not been complete.
Will the Deputy please proceed by way of a question?
I have seen in writing this report made by the executive officer of the Western Health Board to his board making this proposition.
We are having a statement. Question No. 6.
Will the Minister agree that the CEO of the Western Health Board has to put forward certain proposals? He is a man who gives a very conservative estimate. He has to find £500,000 by way of savings. Therefore, he has to put forward the economy measures referred to if he is to live within the estimate.
The Deputy is embarking on a statement rather than putting a precise supplementary question.
I have not seen the detailed estimates of the Western Health Board.
The CEO of the Western Health Board has to work within the limits of the money he is provided with.
I have made inquiries and I am informed that it is not the intention of any of the health boards to change the present practice despite what Deputy Haughey says.
That is not so. They are short of money in the Western Health Board.
6.
asked the Minister for health if he will issue a directive to each regional health board stipulating that no new limitations on the issue of general medical cards are to be introduced in this year.
Decisions on the grant or refusal of medical cards rest, under the Health Act, 1970, with the chief executive officers of the health boards. I do not think it would be necessary or appropriate for me to issue a directive on this to the chief executive officers.
Does the Minister not recall that on a number of occasions in the House he has expressed pride in the fact that under his jurisdiction the number of people in receipt of medical cards has increased and that the percentage of the population in receipt of general service medical cards has increased? In view of that does he not think it is rather hypocritical of him now to wash his hands of this matter by saying it has nothing to do with him if the executive officers are reducing the level of eligibility? Does he not think he has a responsibility to ensure that medical cards are not taken from people who have them and that the levels of eligibility are not reduced or disimproved?
The guidelines as laid down are adhered to by chief executive officers. When I came into office I discovered that the guidelines varied from health board to health board. I discussed the matter with the CEOs and suggested that there should be common guidelines for the health boards over the whole country. They adopted this. In addition, in consultation with the CEOs, I suggested there should be a review twice a year in order to decide whether or not the guidelines could be eased. This was done. I do not remember putting it forward as a boast when I spoke in a debate here. I put it forward as a fact that there was a big increase in the number of medical cards from the number in 1973 to that in 1975.
The Minister took credit for it.
As far as taking credit for it is concerned——
Does the Minister not acknowledge that on a number of occasions in the last six months he has taken credit for the fact that, as Minister for Health, the number of persons in receipt of general service medical cards increased under his jurisdiction? In those circumstances does he not think that there is now an obligation on him to ensure that the proposals which have been put forward in the different health board areas for a reduction in levels of eligibility should be set aside?
What proposals?
In the case of the Southern Health Board, the Eastern Health Board and in the case of many other health boards positive proposals have been put forward by the executive officers of the boards to reduce eligibility for general service medical cards.
I am not so aware. The guidelines will be adhered to and they will be reviewed in June next.
To take an example, why does the Minister think the Eastern Health Board felt it necessary to pass a resolution to the effect that when the current medical card scheme is reviewed the basis of eligibility be not worsened? Why does he think the executive officer of the Southern Health Board put forward a positive proposal to reduce the levels of eligibility and, in particular, to take medical cards off old age pensioners?
That is wrong.
Is the Minister aware that the officials of the Southern Health Board are under strict instructions not to take representations from public representatives into account when considering eligibility for medical cards? Is he also aware that the officials of the Southern Health Board were informed that they are not to refer to representations from public representatives in making acknowledgements and to refer to inquiries only? Furthermore, is the Minister aware that it now appears that the elected representatives of county councils within the Southern Health Board region are no longer allowed to forward cases in favour of applicants for registration in the general medical services register, directly as a result of instructions from his Department and directly as a result of instructions to the CEOs?
This is a very long question.
Is the Deputy suggesting I told the CEOs not to accept recommendations from public representatives?
I am informed that members of the Southern Health Board were told by the CEO, as per instructions from the Department of Health, that he is not to take into account representations from them or from public representatives, and that public representations so far as he is concerned, and so far as the Department of Health are concerned, are only eyewash.
Brief questions, Deputy.
I am not so aware. I would assume that any CEO is bound to accept recommendations from any public representatives whether Dáil, Seanad or local bodies.
Deputy Leonard.
And officials as well.
Order. Deputy Leonard has been called by the Chair.
That is what is happening in the Southern Health Board area.
Deputy O'Leary, please obey the Chair.
Is the Minister aware that limitations are imposed at present? Heretofore the health boards assessed farmers' applications on the poor law valuation. Now they are assessing them on the farmers' means since the eligibility was increased.
I am not aware they were ever assessed on the rateable valuation. On the notional income, yes.
Is he further aware that they are assessing the income per cow at £120 in the case of milk suppliers? In many cases this is very high. Compared with the national average in milk production it is very high. Is the Minister aware of that?
I am not so aware. I am not denying what the Deputy said, but I am not aware of the details he has just given.
In view of the reports which all of us are aware have emanated from all the different health board areas, will the Minister take it on himself to investigate this matter and give us an assurance that, in these very hard times, persons who are entitled at existing levels of eligibility to general medical service cards will not be deprived of them as economy measures?
I will give the Deputy this assurance for about the 95th time. The guidelines will be adhered to by the CEOs.
Question No. 7.
The Minister knows there is far more to this than guidelines.
What is the Deputy suggesting?
There are family circumstances.
This is leading to argument. Deputies will have a further opportunity of ventilating their grievances on the health services on a measure which is before the House.
I have already spoken.
7.
asked the Minister for Health if he is aware that a major Dublin voluntary hospital has informed its staff that because of a shortage in the funds allocated to it the management has had to decide among other measures to eliminate completely summer locums, to abandon training courses, to curtail maintenance work and the purchase of equipment and to control tightly the use of drugs and emergency calls and that similar measures are being taken in many other institutions; and if he will make a statement on the matter.
I am aware that measures on the lines referred to by the Deputy are being taken by several Dublin voluntary hospitals. The detailed economy measures to be taken by each voluntary hospital in order that expenditure levels in 1976 will not exceed the approved allocation is a matter for determination by the authorities of the hospital, having regard to the need to ensure that hospital services are satisfactorily maintained throughout the year. I do not think that economy measures such as those mentioned in the Deputy's question are unreasonable in present circumstances and, indeed, I would commend the hospital which I believe the Deputy has in mind for its realism in facing up to the economic situation.
Is the Minister satisfied that a reasonable level of service can be provided to the genereal public and to the inmates of these hospitals under this sort of drastic economy regime which is being introduced into the hospitals? Does it not terrify him?
It does not terrify me.
Is he not afraid people will die as a result?
The Deputy has been pretty successful in scaring people so far as the health services are concerned.
Does the Minister think it is legitimate to try to slide out of his responsibility for the medical care and attention of these people by making attacks on me? I am simply endeavouring to explore, for the benefit of this House and the general public, what the situation is and I will continue to do that.
I am not making personal attacks on the Deputy any more than he is making personal attacks on me, if he gets the message.
The Minister has responsibility.
I have responsibility.
8.
asked the Minister for Health if he is aware of the serious disquiet which exists among the staff of the James Connolly Memorial Hospital, Blanchardstown, County Dublin; and if he will make a comprehensive statement about the future of the hospital.
I am not aware of any serious disquiet amongst the staff of the James Connolly Memorial Hospital, Blanchardstown. The Government's decision on general hospital development in the Dublin area provided for three major general hospitals in North Dublin. These are, the Mater Hospital, James Connolly Memorial Hospital, Blanchardstown, and a new hospital at Beaumont.
It is envisaged that the James Connolly Memorial Hospital will be expanded to cater for a catchment area in the north-west of County Dublin and some areas in south County Meath which have traditional ties with the Dublin hospitals. All hospitals, including the James Connolly Memorial Hospital, have been consulted regarding the procedures to be followed for the systematic planning and implementation of the programme and general agreement has been reached. As a result of this, a working group from the Department of Health and Comhairle na nOspidéal were established to advise on the allocation of specialities between the major Dublin centres and I am awaiting their report. Discussions will then be held, inter alia, with the James Connolly Memorial Hospital to reach finality on the hospital development which would be appropriate to serve the needs of its catchment area.
Does the Minister recognise that, whatever may be his long-term intentions for this hospital, in the short term there is very serious disquiet and worry among the staff, first, as to their future employment at all and, secondly, as to the conditions under which they have to work? Is he further aware that the hospital is rife with notices of dismissals?
I cannot hear the Deputy.
I am sorry. Is the Minister aware that among the staff of this hospital there is very serious disquiet first of all about their future in the hospital, and secondly about the conditions under which they have to work, longer hours, no leave, no substitutes, and so on?
I am not so aware. I may have misunderstood the Deputy's question with regard to future development. I am not aware of any disquiet as far as the staff are concerned. I will undertake to make inquiries in accordance with the allegations the Deputy has made. I was concerned in this reply with the future building and the services to be provided in the James Connolly Hospital.
Information rather than allegations.
I accept that. I did not mean to be disrespectful when I used the word "allegations". I used it in the pure sense.
As a long standing Member of the House the Minister is aware that it will be impossible to put down a further question on this matter for a limited period. Will he communicate with a number of Deputies from that area as to the result of his examination of the present position? Perhaps he might let some of us know.
Does the Deputy mean disquiet among the staff?
I thought the Minister said he would investigate it.
I undertook to look into it in accordance with the allegations or suggestions Deputy Haughey made.
Having looked into it, if the Minister finds the statements made by Deputy Haughey are true, what action does he intend to take?
That is a hypothetical question. I am not satisfied that there is the disquiet which has been mentioned.
9.
asked the Minister for Health the amount provided in the Estimate for his Department for 1976 under subhead G.2. for the voluntary hospitals; how this compares with the total of the budgets submitted by these hospitals; and if the allocations made to them are sufficient to enable each hospital to carry on throughout the whole year providing a full and satisfactory service to the general public.
10.
asked the Minister for Health if he will now provide in subhead G.2. of the Estimate for his Department an amount for voluntary hospitals which will enable them to continue to maintain an adequate and satisfactory level of service to the general public during the whole of 1976.
I propose, with the permission of the Ceann Comhairle, to take Questions Nos. 9 and 10 together.
The total grant allocation provided for public voluntary hospitals in 1976 is £53,745,000, which represents an increase of £6,433,000 or about 13.5 per cent over the revised final allocations for 1975. The allocations notified to the different hospitals were related to the revised allocations which had been made available for 1975 and included additional provision as referred to above to provide as far as possible against certain anticipated cost and other increases in 1976.
As in the case of health boards the voluntary hospitals were requested to frame their detailed budgets within the allocations made available. The question of providing for increased allocations does not arise. It is accepted that in order to maintain services at 1975 levels the hospital managements will require to ensure that all reasonable economies are made. I understand that while most hospital managements will be able to achieve the target set some of them are experiencing difficulty. Discussions are taking place with the authorities of those hospitals.
Is the Minister aware that in the case of practically every voluntary hospital there is serious disquiet about the level of services they will be able to provide during the year? For instance, in the case of one hospital the management have informed the staff that they are short by an estimated £160,000, that they will not be able to maintain the services at their present level for 1976 and they have elaborated a number of economy measures. Does the Minister not agree that this unsatisfactory situtation derives from the inadquate level of allocation which he has made of £53 million? Will he not seek from the Minister for Finance and from the Government an additional allocation that will enable these essential hospitals, which have a great tradition, to be maintained at levels that prevailed during the years, and which will provide the general public with the services they need during 1976?
I am assured that so far as patient care and the general running of the hospitals are concerned the allocations to most of the public voluntary hospitals will be adequate to ensure that the care for patients during 1976 will be the same as it was in 1975. I have said that some of the hospitals will find themselves in difficulty and, in order to provide for economies, discussions are going on between the hospitals and the Department of Health. The boards are agreed that the 1975 levels can be maintained. Some have difficulties and discussions are being held with those hospitals.
Does the Minister accept that in the case of many of those hospitals there are very serious difficulties? Does he not agree that the way to deal with the difficulties is not to seek further economies which will interfere with the running of the hospitals but rather to make an additional allocation available to them? Is the Minister aware that in the case of one hospital the shortfall is £160,000 and that that can be repeated throughout the hospitals? There is a real need for additional allocations to rectify the situation.
I think the Deputy will admit that there is also a need for economies.
Will the Minister state why the practice of receiving estimates from the voluntary hospitals was discontinued this year? They were just given a blanket coverage of a certain precentage increase over their outlay last year. There is a voluntary hospital in Waterford that had a deficit of £28,000 in starting 1976. Will the Minister state if there is any possibility that this problem might be considered? Those hospitals have given a good and genuine service during the years.
If every Minister for Finance were to accept estimates from the various Departments and semi-State bodies it would cost many millions of pounds.
Will the Minister state if he has been informed that one voluntary hospital in the city—it is one of the oldest, and it is also a teaching hospital—will not be able to keep open the wards during the coming summer unless they get more money? Not only will the patients suffer but the young doctors and nurses being trained there will also suffer because of a lack of tutorial study.
Will the Deputy please put a brief question? There should not be any speech-making at Question Time.
The board of govenors of the voluntary hospital cannot keep the wards open unless they get more money from the Department.
I have not heard any suggestion to the effect that any ward will be closed. I do not know the name of the hospital the Deputy has in mind but if he gives it to me I will have the matter investigated.
I shall certainly do that.
I am calling Question No. 11.
Will the Minister give them more money?
If the Deputy wishes to put a supplementary question he should rise in his place and be acknowledged by the Chair. He may not put questions while he is seated. I have called Question No. 11.
11.
asked the Minister for Health if he will arrange to have the capitation rate payable by health boards in respect of eligible patients in private hospitals, homes and similar institutions increased immediately.
The capitation rates payable by health boards in respect of eligible patients in private hospitals, homes and similar institutions have in general been increased by 10 per cent with effect from 1st January, 1976.
Will the Minister state if he regards the existing levels as satisfactory? Does he think that the levels of capitation rates payable to these homes are fair and reasonable?
A 10 per cent increase is being given with effect from 1st January last and this has been included in the allocations to the boards. The capitation grants very as between the voluntary and the private hospitals. I am quite satisfied that the increase given will bring the capitation grants to a figure that will be adequate in the case mentioned by the Deputy.
Is the Minister aware that the existing levels are: category A, £4.40 per day and category D, £1.95 per day and that these are totally unrealistic levels of grant? Has he received representations from the association of private hospitals and homes on this matter, pointing out that even at his own level he has granted increases of 13 per cent and 14 per cent across the board to compensate for inflation but in the case of these homes and hospitals he has granted only 10 per cent? How does the Minister explain the difference between the 13 and 14 per cent and the 10 per cent—not that even 13 per cent is adequate?
It will not be 13 per cent across the board. I said 13 per cent in respect of the estimate for last year in the full allocation. The Deputy had a question last week with regard to the general medical servoces. In that case they did not get 10 per cent or 13 per cent; they got 19 per cent to ensure that the GMS would be adequately covered. So far as the private hospitals are concerned, I forget the actual figures mentioned by the Deputy but I think the capitation grant in most cases is £4.40 per day.
Does the Minister not accept that if the grants were raised to a realistic level it would encourage persons to avail of the facilities of these homes and hospitals to the advantage of the public hospitals? The appalling admission queues to the public and voluntary hospitals would be considerably reduced if he were prepared to make grants at a reasonable level available to the private hospitals. Does the Minister not consider it would be good business to do that, and that it would be in the overall interests of the health services?
I think anyone who goes into a private hospital and who also gets a capitation grant can be covered by voluntary health insurance. We are not talking of really poor people, or even of people of modest means in the middle income group.
The Minister should forget his class consciousness.
The Deputy is not forgetting his class consciousness.
Incidentally, the Minister's heroine, Barbara Castle, is in a private nursing home at the moment——
The Deputy's heroine is Margaret Thatcher.
Does the Minister not recognise that most people in this category have the option of going to a private hospital or nursing home, to a public hospital or to a voluntary hospital? Would it not be good, sensible administration for him to make it realistic and practical for as many of them as possible to opt for the facilities available in these private hospitals? This would reduce the stress and strain on the public hospitals.
The facilities in private hospitals are not comparable with the range of services provided in the public voluntary hospitals.
These people are prepared to go to them and should be encouraged and enabled to do so. The Minister needs to mobilise all the resources at his disposal.
They can get it through the Voluntary Health Insurance Board if they want and still get a capitation grant.
The Minister is letting doctrinaire considerations interfere with good administration.
No comment?
It is not worthy of a comment.
12.
asked the Minister for Health if he will allocated the necessary funds to enable the training centre for adult mentally handicapped persons at Bawnmore, Galvone, County Limerick, to open in April as planned.
Because of the priority which has to be accorded in the allocation of funds in present circumstances to the maintenance of existing services, I regret that it has not been possible to make an allocation for the opening of this unit in April.
When is it proposed to open it?
I am afraid I cannot tell the Deputy that yet.
Is the Minister aware that there is a huge waiting list of people who have been waiting a long time to get into this institution?
I am so aware.
Is he aware that it has been built at considerable cost? Would the Minister explain to the House the economics of using a large amount of public money to erect a badly needed institution such as this and then to let it lie vacant when there is such a tremendous need for it?
Frankly, the reason is money. I do not wish to be dishonest or to try to cod the Deputy. To run this hospital for a full year would cost more than £500,000 and that sort of money is just not available now. I am sure the health board would not have it available to them from their own resources.
Is the Minister not aware of the fact that throughout the country there are several such institutions which have been built at enormous public expense and are now lying idle because he is unable to provide the normal finances necessary to operate them?
The Deputy must confine his remarks to the subject matter of the question, the Galvone centre.
I accept that but, in the interest of the good business of the House, I put down a question on this hospital as illustrative of many others.
The Chair cannot condone an extension of the question on a national basis.
I wish to ask one supplementary. Is this not a further indication of the total neglect by the Minister, and his Department, in recent years of the entire mentally-handicapped population?
No.
They are the first people to be punished in an economy drive.
No. In the last three years about 700 extra beds were provided for that type of patient. In relation to the Deputy's concern I should like to state that while he was Minister for Finance he was not so generous to the health services. Is that not so?
They were never short of money.
They were short of money.
Will the Minister accept from me that never, while I was Minister for Finance, had we the absurd spectacle of health institutions being built and not being opened because the money for the running expenses could not be provided?
The Deputy devoted very much less of GNP to the health services than we did.
Never mind the GNP.
The Deputy was mean and niggardly as far as the health services were concerned.
Was there ever an example of a hospital being built at huge cost to the taxpayers and not being opened because of lack of money when finished?
Such a situation never when arose.
It never arose because the country was never bankrupt before and that is the reason why it is happening now.
13.
asked the Minister for Health if he is aware that a number of inmates who are old and infirm are being forced to leave St. Joseph's Hospital, Ennis, County Clare; and if he will take immediate action to prevent this taking place.
The discharge of patients from St. Joseph's Geriatric Hospital, Ennis, is a matter primarily for the Mid-Western Health Board. I have made inquiries, however, and am informed that no patients are being forced to leave the hospital. Patients are not discharged unless the medical officer, matron and nurse liaison officer are satisfied that they can be accepted back into their homes without undue difficulty.
Would the Parlimentary Secretary acknowledge in at least one case about which I have documentary evidence—because of the rules of this House I am not entitled to quote from it—a patient of 80 years of age was orderd out of a home simply as an economy measure?
That is cod.
May I have the permission of the House to quote from a letter I have in relation to the matter.
That would not be in order.
The letter is signed by D. Hurley, manager of the special hospital programme, Mid-Western Health Board, and the case is that of Mr. Patrick Keary.
The names of persons outside the House should not be mentioned.
I apologise and I withdraw the name. I will call the person Mr. K.
If the Deputy gives me the specific information he has in his possession, I will have the matter investigated and communicate with him.
The Parliamentary Secretary has already stated that, arising out of his investigations, no such case occurred.
That is my belief.
The Parliamentary Secretary has examined the case and found that no person was discharged under the circumstances?
I have not examined any specific case. No such patients are discharged unless the medical officer, matron and nurse liaison officer are satisfied that they can be accepted back into their homes.
Would the Parliamentary Secretary accept that in this case the nurse liaison officer arranged accommodation for Mr. K. in the town at a very reasonable cost? That is the sort of situation we have come to.
I have told the Deputy that when he gives me the details of the case I will have the matter investigated.
Who decides when a patient is to be discharged?
The medical officer.
It is not the CEO. It is a medical opinion.
It is an economy measure and the Minister should not try to hide behind medical opinion.
The facts were given and the Deputy will not accept them. It is the doctor who decides; it is a medical opinion.