Returning to more mundane matters, it would be fair to say less than a week after the presentation of the budget that it was a non event. It was the first time I listened to a budget being presented inside this Chamber although I had been in the public gallery when previous budgets were being presented. I can truthfully say that last week there was very little atmosphere in the House. There was no excitement or buzz which is usual on budget day. Perhaps this was due in part to the leaks to the media in the weeks before the budget resulting from competition between the two parties making up the Government. There was keen rivalry between them to see who would leak most and each tried to indicate their influence on the budget. Obviously, pressure was exerted by the smaller party, which has three Ministers in Government, to have some influence on the shape of the budget. However, I do not see much evidence of the influence of the smaller partner in Government, apart from the Minister for Finance's proposal to increase VAT charges on the supply of electricity from 5 per cent to 10 per cent on 1 March. I will deal with this matter more fully later.
In presenting the budget the Minister for Finance spoke for almost two hours. Is it a record for a Minister for Finance to speak for so long without making any reference to the provision of housing, the restoration of our county roads and the promotion of the tourism industry which is of vital importance to the economy of the west? I welcome the indication that that famous longstanding rod licence dispute may be settled this week. However, I will say no more about that matter now.
The Minister in his speech hardly gave a mention to agriculture, with only a passing reference to the refund of VAT. However he did refer to the health services in detail. This is a major topic, yet nothing was provided to improve our health or hospital services. What about the patients in the corridors and those being discharged too soon? What about the elderly who have to wait for years before being called for operations, such as hip replacement and cataract operations? What about the nursing staff who find themselves under severe pressure and the conditions in which they have to work with beds in corridors? There is nothing in the budget for them. Neither has anything been provided to shorten the waiting lists, and to open beds in hospitals, such as Merlin Park in Galway where 230 beds are closed and University Hospital where there are beds in the corridors? No indication was given that more doctors and nurses will be employed. In other words, there was nothing in the budget which would lead to a restoration of public confidence in the Minister for Health.
Last June the Taoiseach said that he did not realise that there were such problems in the health service. Do we now find ourselves in the same position with the present Minister? The Taoiseach and the Minister for Health should realise that there is a crisis in the health service. I have been keeping in close contact with the service in my own area and I have visited University Hospital in Galway on a number of occasions since January where I spoke to doctors, nurses, patients and their relatives. What I found there was very disturbing. I found extra beds in the wards on a regular basis, beds taken up in the day room and beds in the corridors. I am not speaking from hearsay but from what I found on my visit to the hospital. For example, the day ward should be reserved for admissions for minor operations, biopsies etc., but it is being constantly used for medical patients. This is completely against good nursing practice, and I am aware of that because my wife is a nurse. It leads to dangers of cross-infection, and all the extra beds put additional strain on the staff as there is no extra nurse to cater for them.
Those extra beds in the corridors are putting great stress on the nurses in having to face patients and relatives under those circumstances, and they are causing a serious risk to the health of patients in that now if there is an emergency the necessary equipment cannot be got into the wards quickly enough because of the beds in the corridors. Often in such cases seconds are vital. God only knows what would happen if there was a fire on any of the floors. You could forget about University Hospital, Galway, if there was. I have witnessed patients going back to corridors after a general anaesthetic. Again, this is intolerable. There is no emergency equipment in such areas and sometimes not even a plug is available to plug in emergency equipment when it can be got. If that is not putting patients' lives at risk I do not know what is.
The Minister for Health, Deputy O'Hanlon, blames the influenza epidemic at Christmas for all this over-crowding but I am informed reliably that very few of the patients admitted at that time were suffering from influenza when they came into the hospital. However, many of them were suffering from influenza when they left the hospital as a result of being left in beds in corridors in draughts. That is not fiction; that is fact. I witnessed one case where a family had to put coats on the end of a bed of an elderly patient in the corridor to keep away the draught.
Because of the pressure on the beds patients are being discharged too soon with nobody at home to look after them. This is a vicious circle. It is putting pressure on the hospital for beds and patients have to be put out in order to make room for new patients.
I am aware of a case, and I have the permission of the family to use all details of this case where necessary, where on 1 January an elderly man from Connemara was admitted to University Hospital, Galway, for tests and he was considerably worse on 2 January than when he went in. He was unable to walk or talk at this stage yet on 3 January his relatives were telephoned and told their father was fit to be discharged. Two of the family came in and when they saw their father they thought he was not fit to be discharged. One of the girls asked how they could bring home their father when he was not able to walk. The junior doctor in charge told her not to worry, he would be brought to the car in a wheelchair. That happened and he was put into the car and driven 30 or 35 miles home to Connemara. When his wife saw him she was very alarmed and sent for her own doctor who insisted on having the patient readmitted that night to the hospital. He was readmitted on 3 January, the day he was discharged. He remained in a bed in a corridor outside St. Gerald's Ward for one and three-quarter days. He died two weeks later. I am not saying the treatment he got was a factor in his death but it is no way for a 74-year old patient to be treated in any of our hospitals.
I discovered on my visits to University Hospital that about a year ago the domestic staff were replaced by contract cleaners. Previous to this there were three domestic staff on each floor in University Hospital, one in each ward and one working between the wards. Now contract cleaners come in in the morning, prepare the breakfasts, clean the toilets, etc., wait for two hours and then they are gone. This breaks up continuity for the patients. Previously the same domestic staff brought breakfast, dinner and tea to a patient but for a patient staying a week or two in the hospital that pattern is broken. The domestic staff are lost to the nurses because they were always a help to the nurses in rearranging beds where patients were discharged or died. That service is not there now and that is a deterioration.
There is no use in being critical about the hospital services unless we can offer a solution. I think there is a solution to the problem in Galway which I am sure would apply in other areas. We have Merlin Park Hospital and we have another hospital under the auspices of the Western Health Board in the region. The solution to the overcrowding in University Hospital is the reopening of Merlin Park Hospital which has many units closed. Unit 9 with 20 beds, unit 8 with 40 beds, unit 1 with 50 beds and unit 10 with 122 beds are closed. If these 240 beds were brought back into operation it would alleviate the problem of pressure on beds in University Hospital and would lead to improved hospital services. This is a simple solution staring the Western Health Board and the Minister in the face.
Lest anyone should think it is not possible to do that, I quote from a press statement from the Minister for Health after he met the CEOs on 8 January 1990. He said that in all such situations local management and health boards and public voluntary hospitals have whatever flexibility is necessary to deal with the problem, and this was normal practice whenever there were unforeseen demands on the service such as those arising from major accidents or epidemics. That was the Minister telling the CEOs they have it in their power to do those things. If the Minister or the Western Health Board cannot see their way to reopening units at Merlin Park, I demand that at least one unit should be open immediately to alleviate the problem.
There is another solution. Why not lease the units in Merlin Park to some of the nurses who are made redundant? I know they are willing to take them. Eight or ten nurses could run those units on a commercial basis. The wards, equipment, kitchen equipment, emergency equipment are all there. It is the best setting in the country. It could be leased to nurses who could provide a service and charge for it. They would be able to run it as a viable proposition and I have no doubt it would be full of the type of patients who are now being shunted out of University Hospital to Merlin Park and back to University, Hospital. Those patients could be catered for long-term there and patients after short stays in hospitals convalescing from operations etc. Could stay for a few weeks in Merlin Park before going home. This would be the solution to the problem where people are sent out of hospital before they are ready to go home. I ask the Minister to consider that. If it is successful there it could be tried in other hospitals such as the closed part of Castlerea Hospital, Roscommon Hospital or any other hospital where there is demand for this service.
People are now living longer, and families are different from what they were ten or 20 years ago. Often both husband and wife are working with nobody to look after old people in their homes. The Minister in his budget speech made great play of what he called the carer's or the prescribed relative's allowance, but he failed to say it is almost impossible to qualify for this allowance. To qualify for the prescribed relative's, now the carer's allowance a person would have to be looking after someone of pensionable age and be living with that person. The person cannot be in receipt of any other income. If the carer has an income from farming or any other source then he or she is disqualified. Even an income from social welfare disqualifies. The Minister for Finance said this allowance would be increased from £28 to £45 and he indicated details would be announced by the Minister for Social Welfare. I listened very carefully to the contribution of the Minister for Social Welfare in the budget debate last Thursday. He said very little by way of explanation except that the increase from £28 to £45 will be for full-time carers, which had already been made clear by the Minister for Finance in his Budget Statement. I quote:
I am increasing from £28 to £45 per week the payment made in respect of certain relatives who care on a full-time basis at home for such persons.
The Minister for Social Welfare did not expound further on the matter except to say that the allowance is for full-time carers, is means-tested and will come into operation from 1 October 1990. The Minister praised the work of dedicated carers to whom the community owed a debt. I could not agree more but let us cut out the lip-service and get down to drawing up a realistic carer's allowance scheme for which it is possible to be eligible. At present a farmer with ten or 15 acres of land with ten or 15 cattle who is caring for his father, mother, grandmother, grandfather, aunt or uncle would not qualify for the carer's allowance on the grounds that he had an income from farming. In a year when he would have made a loss from keeping his ten or 15 cattle, he still would not qualify for the carer's allowance because he would not be considered to be a full-time carer, as he would have had to leave his house to count his cattle or throw them a bale of hay. It is ridiculous that he or she could not be regarded as being eligible for the carer's allowance.
To make a big play of increasing the allowance from £28 to £45, without making it easier to qualify for it defeats the purpose of the scheme. In other words it is a pretence. This is a very important scheme in rural areas, in particular, and in urban areas where families mind their old relatives in their homes thus keeping them out of high cost institutional care. I strongly urge the Minister to make it easier to qualify for the scheme. The present allowance, announced by the Minister for Finance in the Budget Statement is only a cosmetic exercise. We have to advise a realistic carer's allowance which would be a beneficial saving to the State in the long term. For example it costs in the region of £350-£450 per week to keep a patient in institutional care. If people could qualify easily for a carer's allowance of £100 per week there would be no difficulty in keeping a number of those people at home where they have lived all their lives with a member of their family looking after them. This would be a great saving to the State.
The Minister also made provision for an increase of £3 million for orthodontic treatment. I say "good on him" because at present this service is a sick joke. I will outline the situation in County Galway. At present children on the 1982 list are receiving treatment. It has taken one and three quarter years to clear the backlog of the 1982 list and at that rate of progress it will be 15 to 18 years before children on the current waiting list are seen. That defeats the whole purpose of orthodontic treatment. The Government have decided to make a further £3 million available to the health board dental service. I am asking the Minister to appoint a full-time orthodontist to cover the 2,000 children on the waiting list in County Galway. At present an orthodontist from Dublin visits the Shantalla clinic two days a fortnight on a Thursday and a Friday. If a full-time orthodontist was appointed the backlog could be cleared up in two to two and a half years, which is long enough to be on a waiting list.
When referring to child benefit payments, the Minister said, and I quote from his Budget Statement:
... and most importantly, I am increasing monthly child benefit payments across the board by 5 per cent or 75p for each of the first four children.
A child would have to go very easy when putting the jam on the bread if the 75p was to last the full month. Whoever wrote that sentence in the Minister's speech certainly intended to draw attention to the payment of 75p per month; perhaps it was a deliberate mistake but I do not think one should draw attention to such a payment.
The Minister has indicated in the course of his speech that pensioners over 80 years of age will be allowed to retain their free electricity entitlement when people come to live with them. With respect, I suggest that a relative coming to live with an old and infirm person long before they reach 80 years of age and I think we could realistically reduce the age to 70 years and that cases could be treated on their merits. The free electricity allowance should not be discontinued in cases where a relative comes to live with an elderly person. I do not accept that the qualifying age of 80 is appropriate in this regard. When referring to the fuel allowance, the Minister says:
The allowance is also being extended to persons in receipt of smallholders' unemployment assistance who live alone.
Why should not a smallholder with five or six children on unemployment assistance be entitled to a free fuel allowance? In fact the mother of that family would have to have dinners ready at different times for children coming in from school, would have to dry their clothes in this type of weather and would have to provide light and heat when the children were studying. In fact I think that they should be entitled to free fuel. There is no point in having the scheme and then discriminating against the people who would benefit most. This anomaly should be redressed and thus smallholders with a number of children who are in receipt of unemployment assistance would also qualify for the fuel allowance. In fact they might be more in need of the allowance than a person living alone.
The Minister is allocating an additional £1.3 million for developments by voluntary housing associations. While this is a very welcome provision it draws attention to the current housing situation which the Minister did not refer to in the course of his speech. Members who are also members of local authorities will know that local authority housing is in a state of crisis. There was provision in the Book of Estimates for £6 million plus the sum realised from the sale of houses to tenant purchasers. This compares with an allocation of £120 million which was provided for housing in the mid-eighties. To put matters in perspective I will outline the situation in the local authorities on which I serve. For example there are now 275 families who have been approved for houses on the Galway Corporation housing list. Yet we have built no houses in the corporation area since 1986, with the exception of 20 flats which were completed this year in the inner city area.
I will now compare the allocation for housing in the years since 1983. In 1983 we were allocated £3.5 million for the provision of local authority houses by the Fine Gael/Coalition Government and we were able to build 85 houses; in 1984 we received £4.32 million and we were able to build 122 houses; in 1985 we received £2.6 million and we built 72 houses; in 1986 we received £2.13 million and we built 68 houses; in 1987 our allocation was reduced to a miserable £210,000 by the new Government and no houses were built; in 1988 we received £500,000 to complete schemes, but no new houses were built; in 1989 we received £750,000, which in the main was for the provision of halting sites. What is the Minister saying to the 275 families who are on the current waiting list? Is he telling them they will have to emigrate or else put up with the conditions in which they are living? The situation is no better in County Galway. In 1986 we received an allocation of £4.45 million and 219 houses were built; in 1987 we received £1.734 million and 107 houses were built; in 1988 we received £212,000 and we built 20 houses; in 1989 we received £527,000 and we had 20 new starts, but that sum of £527,000 included moneys for the provision of a halting site in Ballygar. As I have already said the provision for housing in the Book of Estimates this year is £6 million plus the money from the resale of houses, but this compares with an allocation of £200 million in 1985/86.
Those people able or prepared to provide homes for themselves have had another blow struck at them in the provisions of this year's budget. It is true to say that the average mortgage repayment has risen — as a result of a 4 per cent increase in interest rates — by approximately £100 per month. There has been yet another blow for such people, namely the reduced income tax relief on the life assurance content of mortgage endowment policies which increases their monthly repayments by approximately £8 to £10.
I will deal now with the increased VAT on electricity charges, from 5 per cent to 10 per cent from 1 March next. The Minister say this will yield £11 million this year and £18 million in a full year. According to the Minister that cost will be absorbed by the ESB. I contend that will not be possible. Who does the Minister think he is fooling? I am sorry the Minister for Energy is not present to hear what I have to say. What is the point of imposing an additional 5 per cent VAT on electricity charges, contending that the cost will not be passed on to the consumer when the ESB are already in debt to the extent of £180 million to £190 million? I contend that inevitably the £18 million in a full year will be passed on to the consumer; there is no other way out of the predicament. It must be a serious blow to the Minister for Energy to have that passed on to him by his colleague, the Minister for Finance.
There is also the introduction for the first time of a 10 per cent VAT imposition on telephone and related services from 1 July next. Indeed, the Minister in the course of his remarks on that subject did not appear to be so sure that that charge would not be passed on to the consumer. He said:
I am confident that this initiative can be implemented without increased costs to telephone users, both households and VAT-registered businesses ...
He would not appear to be nearly as sure about that charge not being passed on. This will do untold damage to the recent good work done in the provision of telephone services particularly for people in rural areas who had been encouraged to apply for such services.
Under the heading National Environment Action Plan the Minister indicated the provision of an additional £20.1 million to meet the costs of that plan in 1990 announced by his colleague, the Minister for the Environment the previous week. Again, to quote from the Minister for Finance's Budget Statement, he had this to say:
This plan sets out the action the Government are taking to protect and enhance Ireland's natural environment and to improve the quality of life. I am providing an additional £20.1 million to meet the costs of this plan in 1990, of which £13.6 million relates to expenditure and £6.5 million relates to a taxation measure which I will deal with later.
I welcome the provision of this money to meet the costs of this newly announced plan. Indeed, it would be my hope that the Minister for the Environment could utilise some of those funds to sanction the Galway city sewerage scheme accompanied by full secondary treatment works, thus protecting Galway Bay from the serious pollution there at present. I was a member of the deputation from Galway Corporation who met the Minister for the Environment last week on this matter when we impressed on him its importance and the enormous concern of the people of Galway, and indeed tourism interests in the west generally. We impressed on the Minister the need to sanction this new sewerage scheme and secondary treatment works straightaway to allow Galway Corporation to design immediately a scheme for the secondary treatment works. Indeed, such work will become essential by the year 1998 under an EC directive which stipulates that major seaside towns instal secondary treatment works before discharging sewage.
I have drawn attention to only certain aspects of the budget in the time available to me. The longer the interval since the introduction of this budget, the more time people have had to analyse the Minister's remarks and their implications, the more they realise it leaves much to be desired. There is much work remaining to be done on ironing out various aspects of its provisions. I have dealt with some only, such as the carer's allowance, free fuel schemes and so on. I will endeavour to tease out such matters with the relevant Ministers when the necessary legislative measures come before the House. It is all very well for a Minister for Finance to use flowery language in introducing the Budget Statements, contending that this or that will be done, that it is the intention to do this, that or the other, or contending that this or that tax will not impose any additional burden on the taxpayer, but, when one gets down to working out the implications of such measures——