Ceisteanna—Questions. Oral Answers. - Dublin Smog Levels.

16.

asked the Minister for Health the steps which are being taken to monitor the impact on health of the repeated excessive smog levels in Dublin; if, in view of the seriousness of the situation he will lift the £10 hospital charge for those most at risk from the smog; if he will ensure that additional resources are provided to enable district health nurses and community care workers to compile a list of those most at risk and keep in touch with them during the winter months; and if he will make a statement on the matter.

Data on both in-patient and out-patient attendances is collected by my Department on a regular basis and routinely monitored in terms of diagnosis, frequency and numbers of patients. As part of this programme data from the hospital in-patient inquiry in relation to admissions for respiratory type conplaints to Dublin city hospitals over 1985 and 1986 — the most recent period for which comprehensive data is available — is being examined in conjunction with smog levels for the period collected by Dublin Corporation to see if any patterns can be established.

As to the £10 hospital charge, I am satisfied that, given the existing categories of persons who are exempt from charges and that only persons who can reasonably afford to pay are liable, I do not propose to include additional exemption at this time.

Health boards are very conscious of the additional health problems which vulnerable groups, particularly the elderly living alone, may face during the winter months and community care teams make every effort to maintain regular contact with these groups during the period. In this context the public health nurses would be aware of the at-risk patients.

I am sure the Minister will wish to join me in congratulating the Minister for the Environment on the marvellous job he has done on the weather over the last few months. I am sure he will get international acclaim when it is realised he was responsible for it. I am disappointed that 1986 is the latest year for which the Minister has up to date data because I had hoped to get information in regard to last November when we had extraordinary smog levels for a long number of days in succession as a result of which, according to doctors, deaths have occurred. I understand that very substantial records are kept and that research has been done on this in St. James's Hospital, and I am sure other hospitals have similar records. Has the Minister any details of the effects since November last on people who have been admitted to hospital with respiratory problems as a result of that period?

I do not have any up to date figures on the position for last year. Indeed, we referred earlier to the hype by the Health Research Board who were responsible for collecting specific figures. I will communicate with the Deputy on the most up to date figures available as soon as I have them.

I quite understand why long term research was required for 1985, 1986 and 1987. Does the Minister keep in touch with hospitals in the city during periods of smog and subsequently to know its effect on admissions?

Yes. We keep in constant communication with the hospitals and my colleague in the Department of the Environment, because dealing with smog must be a joint effort between a number of Departments. We also keep in close contact with any area where there has been an outbreak of illness related to any specific environmental hazard or other cause.

Does the Minister intend to remove the £10 hospital charge?

No. As I pointed out, a number of people, including medical card holders, are exempted, and the chief executive officer of each health board has discretion in any case where it is believed that the payment of £10 would cause undue hardship to a patient.

That disposes of questions for today.