asked the Taoiseach in view of his reported comments in the Irish Independent of 18 September that some decisions made by the health boards were pretty perverse, if he will elaborate on it.
Ceisteanna—Questions. Oral Answers. - Health Board Decisions.
3.
Non-capital allocations from the Exchequer to the health boards in respect of their direct expenditure have increased from £665 million in 1982 to a proposed £827 million in 1986. This represents an increase of £162 million or 24 per cent over that period. The 1986 allocation of £827 million (which is subject to further adjustment) is an increase of over £81 million or 8 per cent on the corresponding 1985 provision in a year in which inflation has risen by 3½ per cent. Because expenditure on health services accounts for such a high proportion of Government expenditure, accounting for over 19 per cent of non-capital expenditure in 1985 and because successive Governments have been spending in this area more than the capacity of the economy can sustain, it is essential that the health services share in the efforts of the Government to secure a more effective and efficient delivery of services.
I am glad that the health boards generally have co-operated fully with the Government in securing reductions in the costs at which essential health services can be delivered. They realise, as the Government and objective informed opinion realises, that limitations on financial resources call for the most effective and efficient use of these resources. They have generally faced up realistically to deciding how their expenditure should be maintained within the 1986 allocation while maintaining essential services. In some cases, however, health boards undoubtedly have tended to highlight their financial problems unduly in an effort to secure increased allocations of Exchequer finance. I have no desire to prolong controversy or to give any credibility to these cases by referring to specific examples here but Deputies on all sides will be aware of the type of cases to which I am referring.
Is the Taoiseach aware of the anxiety caused by his statement that petty perverse decisions were made by the health boards? Does he accept that it was intemperate language for the head of State to use? Does the Taoiseach further accept that the real problem facing the health boards is the deficit of £30 million as a result of insufficient funding by him and the Government? I am also concerned about administering the health boards by edict, when a Minister states in the House that eight hospitals will be closed down without consulting the health boards. When the Taoiseach quoted figures, did he realise that there is no dental or optician service for adults?
The Deputy misquoted me. When I spoke as head of Government — not head of State — I said that some decisions seemed pretty perverse, not petty perverse. With regard to the inadequacy of resources, I pointed out that the amount provided for health boards this year is an increase of 8 per cent on last year, in a year in which inflation has risen by 3½ per cent. Simple arithmetic will show that this involves a 4½ per cent increase in the real value and volume of resources to health boards. That is a very significant increase in a year of extreme financial difficulty. Some people might even regard it as an imprudent level of increase in present financial circumstances. The Government, in endeavouring to help the health boards, provided them with that increase in the volume of resources, going well beyond the level of inflation. It is a matter for health boards to use those extra resources to the best of their ability and for the best purposes. Most of them have tried to do so in good faith although there have been problems in some areas and Deputies are well aware of them.
The words the Taoiseach used were "petty preverse". Could the Taoiseach now give examples of such decisions, what health boards made them and who was responsible?
I do not wish to particularise and induce further conflict in the area. During the course of the year most health boards did a very good job and those who did not tackle the problem in a positive way in the earlier part of the year have come to realise the desirability of taking a more positive view because of the increased resources which the Government have provided. The problem may resolve itself if left alone, I have no desire to stir it up by criticising any particular health board.
If the Taoiseach is not prepared to give me more information regarding these decisions I should like to raise the matter on the Adjournment.
I will communicate with the Deputy.