Vol. 421 No. 5
8 Mr. R. Bruton asked the Minister for Health whether he has received reports from the various health boards on their capacity to live within the budget limitation imposed by him for 1992 without having to have recourse to prolonged bed closures or other interference with services; and if he will make a statement on the matter.
17 Mr. Bell asked the Minister for Health if he will outline the number of beds being closed in hospitals for the summer season in each health board area; and if he will make a statement on the matter.
I propose to take Questions Nos. 8 and 17 together.
The total allocation made available to health boards this year is £1,018.7 million. This represents an increase of 13.5 per cent over the original allocation for 1991. The financial provision for the health services represents a significant proportion of overall Government expenditure. Consequently the health service has a vital role to play in ensuring the success of the Government's medium term fiscal targets as set out in the Programme for Economic and Social Progress. The maintenance of strict control of expenditure must, therefore, be considered a vital element in the effective management of services by all health boards. The allocation of resources between the various service programmes is, of course, a matter for each individual health board.
As the information requested by the Deputies in relation to summer bed closures is in the form of a tabular statement, I propose to circulate it in the Official Report.
The Deputy will be aware that the organisation of hospital services is, of course, a matter for the voluntary hospitals and health boards concerned, having regard to their competing service priorities and the resources at their disposal. Some agencies have made provision for seasonal closures in their service plans for 1992. I should point out that seasonal closures are not unusual and, indeed, are part and parcel of the provision and organisation of hospital services throughout the country. This has been the case over many years. Seasonal closures are often planned to coincide when staff are on annual leave and when the level of activity at the hospital has traditionally decreased. All emergency and urgent services will, of course, continue to be provided.
The Deputy has expressed concern that seasonal closures will have an adverse effect on waiting lists for patients. With regard to waiting lists generally, it must be acknowledged by the Deputy, and by every Member, that waiting lists are a feature of all modern health systems. This is due to many factors, not least of which are the requirements of an ageing population and the development of new procedures and treatments. In other words, there are unlimited demands being placed on finite resources. That said, while there are problems in some areas, waiting lists in Ireland for most specialties are not excessive. The admission of a patient to hospital is, of course, a decision for the consultant in charge of the case. Priority is given to urgent cases and it is open to a patient's general practitioner to contact the consultant with a view to expediting matters if that is appropriate. I would, however, like to take this opportunity to assure the Deputy that my Department are closely monitoring the situation regarding seasonal closures and are keeping in constant touch with health agencies about this matter. Should it emerge that undue hardship arises, I have no doubt that the health authority concerned would take appropriate action with a view to alleviating the situation.
The following is the statement:
|
Health Board Area |
July |
August |
|
Eastern |
379 |
320 |
|
Midland |
40 |
40 |
|
Mid-Western |
131 |
131 |
|
North-Eastern |
171 |
168 |
|
North-Western |
147 |
147 |
|
South-Eastern |
55 |
55 |
|
Southern |
153 |
221 |
|
Western |
114 |
145 |
Many of the beds listed above will be closed for the part of the month only.
I am disappointed that the Minister continues to use longwinded replies. Is he aware that health boards in the first quarter of this year reported substantial overruns running to millions of pounds on their allocation? Is he also aware that they are blaming his Department in part for failing to deliver the demand-led schemes and the money associated with them? What instruction did he make to the health boards as to how they would deal with the 1991 overruns which are really at the heart of the difficulties many of the health boards are now facing?
Over the years health boards had no accountability as far as the Department of Health were concerned. They were given a budget and there was no strict accountability as to how they spent it. I accept that there have been overruns over the years. We have tried to compel them to live within their budgets. The demand-led schemes are something over which there is no control. We cannot say how many people are going to become ill or will require drugs. We are tackling the matter and trying to bring some kind of order into it. The health boards are conscious of the need to bring order and economy into this and I feel sure we can depend on their co-operation.
