First, a Cheann Comhairle, I thank you for granting me permission to raise this matter on the Adjournment and I thank the Taoiseach for coming into the House at this late hour to deal with it. Today during Question Time I asked the Taoiseach, in view of his reported comments in the Irish Independent of 18 September that some decisions made by health boards were pretty perverse, if he would elaborate on that statement which he made at a rally of Fine Gael in Clondalkin on 17 September. That was rather intemperate language, not the sort of language one would associate with a Head of a state. It caused a lot of anxiety to members and staffs of health boards as they believed that the Taoiseach was pointing the finger at them. What I would have liked the Taoiseach to tell me today was which board or boards he was pointing the finger at and to give us examples of the perverse decisions they made.
The Taoiseach in his reply quoted mainly statistics as to the increased allocations made to the health boards over a four year period, a 24 per cent increase in the non-capital allocation. While on all sides of the House we would be concerned at the high cost of health care — 19 per cent of non-capital expenditure in the current year — I do not think that the remarks of the Taoiseach were justified.
The Taoiseach quoted a figure of an increase of 24 per cent in the non-capital allocation between 1982 and 1986 but in answer to a question in this House, Question No. 496 on 19 February 1985, the Minister for Health stated that there was a real decrease in every health board area, except in the Eastern Health Board area, in the period from 1982 up to and including 1985. The only reason the Eastern Health Board area did have a small increase is because they operate in a rapidly growing area with a rapidly growing population and because they provide a wide range of services nationally. The situation is that the health boards had a real decrease and this has been admitted by the Minister for Health. Yet, the Taoiseach tells us that there has been a 24 per cent increase and that they should be satisfied with that.
The estimated deficit this year between the eight health boards is between £25 million and £30 million some of which has been carried over from last year. In fact, only one health board area last year had a credit balance. Some of the boards are in a very serious situation. The South Eastern Health Board, the Southern Health Board and the Eastern Health Board, for example, have very serious problems with their deficits because of a lack of funding by the Government. All the health boards have problems. There are problems in the acute hospital service where wards have been closed down, where there are long delays for outpatient services and where people are being discharged earlier than they normally would be discharged. In the community care services there is no dental service available for adults who have medical cards. In many parts of the country there is no optician service. In our constituency, a Cheann Comhairle, I recently met a widow on the lowest income in the land going off to the credit union to see if she might borrow the money to enable her to attend a dentist as there was no dental service available to her under the health services.
The health boards have a statutory obligation to provide a service and because of insufficient funding by the Government they are unable to do so. It was wrong of the Taoiseach to blame the health boards and at a party rally to state they were making pretty perverse decisions. I would submit that the perverse decisions have been made by the Government and imposed on the health boards by edict. The Government, apparently on the eve of the budget, made the decision to close eight hospitals. There was no reference whatsoever to the health boards and on 30 January the Minister for Health on behalf of the Government announced that eight hospitals were to be closed. That was the first anybody knew that these hospitals were to close. Included among those hospitals were St. Dympna's in Carlow and St. Patrick's in Castlerea, both of which are psychiatric hospitals. This caused great anxiety not alone to the members and staffs of the health boards but also to the patients, the patients' relatives and public generally. It was stated in this House that those hospitals were to close by the end of June. In fact, they are still open. Much unnecessary anxiety has been caused to the people and the health boards by that decision of the Government which I would consider a perverse decision. Certainly, it was not made by the health boards because they did not know anything about it. There had been no consultation whatsoever with them.
While Beaumont is not a health board hospital there have been a number of U-turns by the Government, including one to reverse a decision of the previous Government, that the consultants be allowed build their own private outpatients' hospital on the site. Apparently that decision has since been reversed and the consultants are to get that permission. The Minister in a reply to a question in this House stated that work was to commence on a nurses' home in the autumn of 1984 but then he announced that a nurses' home would not be built there. One of the problems the health boards have is that they do not know what is happening. It is not that the health boards are making perverse decisions but they are in a critical position because they do not know the direction the Government are taking or their policies.
At regular intervals the Minister promised to introduce a Green Paper on the health services but in reply to a question on 15 May he said that he did not now intend to publish a Green Paper. He told the House on that occasion that he intended making submissions to the Government. Today in Questions Nos. 281 and 282 tabled by me I asked the Minister, about an extraordinary statement by the Secretary of his Department at a meeting of the World Health Organisation at Dromoland Castle where he said that it was the first time a policy direction had been announced publicly. He produced a 39-page document outlining the future policy. I do not know if he was articulating official Government policy or the policy of the Fine Gael or Labour Parties. In answer to those questions the Minister said:
I have now decided that this preliminary statement should be developed into a consultative document for dissemination to all concerned with health in its broadest terms. This will be available shortly.