Limerick East): I propose to take Questions Nos. 90 and 101 together.
It is a universal feature of health care systems that the cost of acute care in general hospitals exceed the rate of inflation in the general economy. Those costs are created by a number of factors including the rapid advance of technology in the health sector, greater demand on the system by patients and pay increases in a system which in Ireland has two-thirds approximately of its overall costs accounted for by pay. Demographic changes such as a greater number of elderly persons in our population also contribute to the increased demand and costs.
To control general hospital costs it is critical that the number of beds in the system is managed and that optimium use is made of the available resources. In this connection the number of general hospital beds has fallen significantly in the past ten years. In 1986, for example, the number of beds totalled 14,500 approximately, the current figure is now 12,500. The reduced number of beds are being used on a more intensive basis for example, there are many more day-care beds in the system than ten years ago and this allows for a considerable increase in patient care.
My Department and the health agencies have been involved for some years in value for money programmes which cover both the hospital and non-hospital areas. Those programmes have been very useful in ensuring that value for money is obtained in the relevant areas. These programmes will continue and intensify with increasing co-operation between health boards and public voluntary hospitals.