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Dáil Éireann debate -
Wednesday, 26 Apr 1989

Vol. 389 No. 2

Private Notice Questions. - Southern Health Board Funding.

andMr. Yates asked the Minister for Health if his attention has been drawn to notice issued to 6,000 employees of the Southern Health Board today, stating a probable deferment of salary payments commencing at the end of this month; if so, the action he proposes to take immediately to avert this cash crisis and disruption of staff; and if he will urgently meet the board to resolve the matter.

andMr. Wyse asked the Minister for Health if, in view of today's decision by the Southern Health Board to freeze the salaries of staff because of the cash crises they are enduring, he will outline as a matter of urgency the steps he proposes to take in relation to the deterioration in the health services in the Southern Health Board area.

asked the Minister for Health if his attention has been drawn to the announcement made this morning by the Southern Health Board that staff salaries are to be frozen from the end of this week and 200 temporary staff laid off; if, in view of this announcement and the clear threat of a total collapse of Southern Health Board services within the next few days if these proposals go ahead, if he will indicate the steps he intends to take to meet his statutory obligation to ensure that health services for the people of the area are maintained; and if he will make a statement on the matter.

I have only just got a copy of the letter that issued. I might say that it surprised me that such a letter was issued in view of the fact that arrangements had already been made for an officer of my Department to visit Cork. It was arranged for that officer to go to Cork this afternoon to meet officials of the Southern Health Board tomorrow. It is understood from the finance officer that salaries due to be paid at the end of April will not be deferred. An officer of the Department's finance unit, as I said, will be in Cork for discussions with management tomorrow, Thursday, 27 April, on the overall financial position of the board. The Department will consider the appropriate funding arrangements consistent with the approved allocation for the board in the light of the officer's report.

Arising from the Minister's reply, is he aware that this will have very grave legal implications? Has he considered the consequences? Does he now consider that this action will be very injurious to staff morale? Would he say what legal precedents there are for such a very grave decision by the health board to stop people's pay to which they are entitled? I know the Minister has ensured that the payments for this week will not be deferred but what will happen in the months ahead?

Will the Minister make the extra money available?

Please, let us hear the Minister. A question has been asked.

In reply to Deputy Creed, I might make the point that the original allocation to the Southern Health Board last year was £127,320,000 and that the allocation this year is £132,600,000. In reply to Deputy Burke, the question does not arise at this point. I have been informed that the finance officer stated that salaries due to be paid at the end of April will not be deferred. An official of my Department is in Cork——

It could happen next week.

—— and he will report back to me after he has discussed the position with management of the board. We can then, within the approved allocation, see what needs to be done.

Is the Minister aware that supplementary welfare allowances are paid by the Southern Health Board who come under the aegis of the Department of Social Welfare? Can he guarantee that people will be paid their supplementary welfare allowance tomorrow, not to mention next week? Those are the most destitute people at present who will suffer unless immediate action is taken by the Minister. I am glad the Minister is taking certain steps now but can he guarantee that those people, who are in the most urgent need in the Southern Health Board area at present, will be paid their supplementary welfare allowance immediately?

The question raised by Deputy Wyse is a very serious one. I would like to know from the Deputy if there is any information that such payments will not be made. If so, it would raise very fundamental issues about the Southern Health Board.

A number of Deputies are offering. I will call Deputy Sherlock next, then I will call Deputy O'Sullivan and a final supplementary from Deputy Yates.

A Cheann Comhairle——

Please, Deputies, if you want to debate this matter you should put down a motion.

Would the Minister agree that the increase in the allocation to the Southern Health Board this year is barely in line with the rate of inflation? The level of service which was below an acceptable level in 1988 is disastrous this year. Would he also agree that, whereas the chief executive of the health board is obliged under the Act to operate within the budget that has been allocated, the Minister has a statutory obligation to increase the allocation so that the services he has a duty to provide under the Act must be provided within the Southern Health Board area?

As I have said, the original allocation in 1988 was £127,320,000 and the allocation for 1989 is £132,600,000. I accept that in real terms it is not the same as last year. The Southern Health Board were treated with equity in line with every other health board but there were some significant differences, one of which is that the members of the health board — and Deputy Sherlock is a member — not alone refused to pass the budget but also refused to put up alternatives to management. Every other health board who were in the same position as the Southern Health Board were able to come up with alternatives so that they could operate within their allocation.

What alternatives? The closure of hospitals and beds?

Even the health board in Deputy Farrelly's area were able to pass their budget. In the letter of allocation that was issued to the health boards it was stated quite clearly — and the Government were insistent on this — that most of the savings this year should come from savings on supplies, which cost the State £125 million, and also on contracting out work. They were not to come particularly from the pay side. The Southern Health Board members — not the Fianna Fáil members but those on the Opposition side — walked away from their responsibility to come up with alternatives which would enable them, like every other health board, to operate within their allocation.


The Minister knows what happened in our health board area.

I want to tell Deputy Farrelly and others who are creating this commotion that if this matter does not proceed in an orderly fashion, it does not proceed at all.

The Minister is——

Deputy Farrelly, if you persist and cannot listen to what the Minister is saying you have a way out. There are many exists from this Chamber and I advise you to take one.

The Minister said he did not have prior notice regarding the non-payment of salaries. Was he informed about the 200 temporary staff who were to be laid off and the consequences of these job losses? It will not now be possible to deliver the service to the health board area by virtue of the fact that these 200 people were to be taken from right across the board. I would look in particular at the area of community care. If the proper back-up staff is not available the service cannot be delivered. I would like to know if the Minister received prior notice that there was to be a loss of 200 jobs in the health board.

I have been aware only in the last day or two that the health board were considering laying off 200 persons. As I have said, one of our difficulties with the Southern Health Board is that they were asked to provide a cash profile to the Department so that the Department could finance them within their approved allocation but that cash profile has not been forthcoming. On the question of savings being made right across the board, this comes back to the fact that the Southern Health Board members refused to do what the other seven health boards did, that was to plan their programme and their services within their approved allocation.

A brief question from Deputy Quill and a final question from Deputy Yates.

Would the Minister accept that the position is now so critical in the Southern Health Board region that he ought to take the matter in hand and go to Cork with a view to coming up with some kind of strategy to put the health services and their delivery on some kind of reasonable footing for the remainder of this financial year? There is no way that the services——

I think the Deputy has made her point.

——can lurch from crisis to crisis as has been the case since the start of the year. It is no consolation——

Sorry, Deputy, let us not embark on a speech at this stage.

——to be told that the blame is placed on the board, on the executives or on the Minister. The matrons of hospitals——

Deputy Quill, please.

——and the patients want a certain standard of care and it is the Minister's responsibility to see that it is provided.

If the Deputy persists I shall have to call Deputy Yates.

I am satisfied that an allocation of £132.6 million is sufficient to provide an adequate and proper service for those in need in the Southern Health Board area. I might add that on three occasions since the allocations were made I met the chairman and the management staff of the Southern Health Board once in Cork and twice in Dublin to discuss their position with them.

Did the Minister listen to what the chairman of the health board said?

Please, Deputy Creed.

I accept what Deputy Quill said, that they do have a financial problem. That is the reason we keep in very close contact with them, why we asked them to provide a cash profile, which has not yet been provided, and why we arranged a week ago that an official from my Department would be in Cork to discuss the matter with them tomorrow.

The Minister should go to Cork himself.

Order please. Deputy Yates, a final question.

Is the Minister aware of a recent statement by the chairman of the Southern Health Board — a member of his own party — Councillor Healy-Rea, that there was a cash crisis in the Southern Health Board?

And that people would die.

Secondly, would the Minister agree that his own policy of neglect and of allowing the situation to drift has been very seriously wrong and has resulted in a worsening of the position? Will he take positive steps to ensure that adequate moneys are made available to run Mallow and Tralee hospitals and pay for the staff requirements of this year if extra money is required?

I am well aware of the statements made by the chairman of the board. Deputy Yates was not here last night when we dealt very effectively with Tralee hospital and compared what was happening there with Castlebar. A sum of £8.5 million has gone to Tralee while Castlebar only obtained £6.6 million. Castlebar hospital had 12,000 admissions last year, the same figure as Tralee. There are 19 maintenance people in Tralee and two n Castlebar. Who is looking into those matters? I do not accept that there has been neglect of the health services over the last two years.

There have been different diagnostics.

In the last two years health boards and agencies have been forced to live within approved allocations. Do not forget that 20 per cent of Exchequer funding is being spent on our health services.

The old, the sick and the poor are suffering.

Most of the problems were caused by the £55 million over spending allowed by the Coalition Government.


Who overspent?

The Minister of the day allowed the health boards to over spend and I intend to discharge my responsibility as long as I am in this House.


What does the Minister propose to do about the cuts?

That is the end of questions for today.