I move:
That a supplementary sum not exceeding £24,978,000 be granted to defray the charge which will come in course of payment during the year ending on the 31st day of December, 1977, for the salaries and expenses of the Office of the Minister for Health (including Oifig na Ard-Chláraitheora), and certain services administered by that Office, including grants to Health Boards, miscellaneous grants, and certain grants-in-aid.
The original Vote for Health in 1977 amounted to £298,400,000, including a sum of £10 million by way of a capital grant-in-aid of the Hospitals Trust Fund.
The Supplementary Estimate is for a sum of £24,978,000 comprised of a net sum of £21,448,000 for non-capital services and £3,530,000 for capital purposes.
The gross extra sum required for non-capital services is £22,398,000. From this there has been deducted a sum of £950,000 representing an increase in income from appropriations-in-aid. This leaves a net requirement of £21,448,000. This total extra expenditure arises as follows:—Staff Costs, £18,308,000; Increases in the rates of cash allowances, £1,500,000; Price increases, £1,500,000; Increase in Social Welfare Contributions (employer's share), £540,000; Increases in capitation payments to special residential homes for children, £550,000.
The estimated increased income of £950,000 from appropriations-in-aid is expected to be derived from health contributions (£750,000) and the recovery of cost of health services provided under regulations of the European Economic Community (£200,000).
The additional grant requirement for staff costs is £18,308,000. The additional expenditure arises under three main headings:—
—National Pay Agreement, 1977;
—Miscellaneous pay awards;
—Additional staff employed by health agencies in 1977.
Under the terms of the National Pay Agreement, 1977, pay increases were payable in two phases—generally from April and November. The general rate of increase for each phase was 2.5 per cent of basic pay plus £1 per week (subject to certain minimum and maximum levels of increase). The additional sum required to meet costs arising here is £7,435,000.
The amount required to cover additional expenditure arising from Labour Court recommendations and arbitration award comes to £2,023,000. This is made up as follows: clinical teachers and nurse tutors, £130,000; revisions of salary scales and service conditions in a number of grades, £86,000; general trained nurses, £406,000; certain grades of psychiatric nurses, £291,000.
The above items were approved following on Labour Court recommendations and arbitration awards.
The remaining areas where special increases applied were: decisions on equal pay, £800,000; increases in travelling and subsistence expenses, £310,000.
The amount needed to meet the additional cost of extra staff recruited by health agencies during the year is £8,850,000.
The cash allowances on the Health side which were increased following the 1977 Budget were: disabled persons allowances; maintenance allowances to persons suffering from specified infectious diseases; blind welfare allowances.
The allowances were adjusted in two phases—from 1st April, 1977, and 1st October, 1977. The total grant requirement in 1977 to meet the additional cost arising is £1,500,000.
The amount of supplementary provision now sought for price increases —£1,500,000—is to offset the additional costs incurred by health agencies during the year because of higher prices on items such as purchases of medicines and drugs, the cost of heat, light and power, maintenance work, replacement of worn-out equipment and so on.
The employer's share of the weekly insurance stamp was increased with effect from 1st April, 1977. Health agencies in common with other employers had to meet the additional cost involved. As this expenditure was not covered in the original allocations it is necessary to supplement the allocations of health agencies to cover the cost involved. The amount of grant required for 1977 is £540,000.
A number of the special homes which cater for children were experiencing severe financial difficulty earlier in the year. It became necessary to approve of considerable increases in the rates of capitation payments made by health boards to the authorities of the homes concerned. The rate which applied at the beginning of 1977 was £18 per week. This was increased to £30 per week. The additional grant required to meet the extra expenditure incurred by health boards in 1977 is £550,000.
The additional amount required for capital services is £3,530,000. These funds are required to meet the cost of a special programme which could not be accommodated within the original allocation. The programme enabled a commencement to be made on projects such as a new pathology laboratory at St. James Hospital, Dublin, a new centre for the mentally handicapped at Ballybane, Co. Galway and welfare homes at Navan Road, Dublin, Athlone and Edenderry.
I would ask the House to agree to the voting of the necessary supplementary funds for 1977—£24,978,000.