Vol. 476 No. 7
15 Mr. Cowen asked the Minister for Health the implications of the latest cutbacks for the health services; his views on reports of an increase from £12 to £20 in hospital charges; and if he will make a statement on the matter. [8437/97]
(Limerick East): There are no adjustments planned in health funding which will involve cutbacks in the approved level of health services in 1997. There are no changes proposed in the current level of hospital charges.
The reduction recently agreed in respect of the Health Vote to assist in funding the costs of the nurses' pay settlement will be met through increased efficiency measures and other marginal adjustments spread over a number of programmes.
Will the Minister for Health confirm that the public position of the Minister for Finance is that he is seeking £50 million in cutbacks to assist in meeting the increased demands on the Exchequer as a result of the nurses' pay claim and other issues, that £25 million of that will come from social welfare savings and that some 0.5 per cent of an expenditure cutback will be required from every Department?
Some 0.5 per cent is approximately £11 million of the Department of Health's budget. When the Minister speaks of efficiencies in the service, is he suggesting he received £11 million more than he should have in his Estimates from the Minister for Finance or that he must find £11 million to meet that Minister's demands?
(Limerick East): The Government accepted in full the Labour Court's recommendations on the nurses' pay dispute. The full cost of implementing them is estimated at £80 million, the impact of which in 1997 will be £76 million. A sum of £27 million was set aside in the post-budget Estimates for supply services to meet the cost of the deal. That was the original portion of the cost for 1997. That leaves a shortfall of £49 million. In accordance with Government policy on public expenditure, the Government decided on 19 February to levy each Department on a pro rata basis to make up the shortfall. The Department of Health must pay approximately £8 million. In Estimates terms, it is a yield of £8 million in cash which is the equivalent of £8.7 million in expenditure terms. The savings will be achieved through the most efficient and effective use of resources and through marginal adjustments spread over a number of programmes. The reduction will be reflected in the major Votes in presented. The Deputy is aware that, with an approximate budget of £2.5 billion, it is possible for health boards and voluntary hospitals to show savings when they have an indication early in the year of what is expected of them. While there will be adjustments in expenditure on various programmes, the hospitals and the health boards will be expected to maintain services.
The media should note that, as we approach an election campaign, a cutback now becomes a marginal adjustment. Can the Minister confirm that, in making these marginal adjustments to expenditure on programmes, he will not impinge upon mental handicap services? The resourcing of the community care programme for people with a mental handicap must now be bolstered given the recent tragic double murder in Grangegorman. I am informed that, less than a fortnight previously, a break-in occurred at the residence where those dastardly murders took place and that the nurse in residence on that night was informed. Does the Minister agree it is important that no cutbacks take place in that service and that there should be a bolstering of resources, given the public outcry at the savage nature of those murders?
In terms of the marginal adjustments in expenditure, what part of the special budget package of £25 million announced on budget day will be affected? Will it be the cancer programme, the child care area or mental handicap services? Can the Minister be more specific about the changes which I am informed have already been made?
(Limerick East): There will be no reduction in the £25 million development fund package announced by the Minister for Finance on budget day in respect of child care, care of the handicapped, the cancer programme or waiting lists.
Has the Minister for Finance failed in that regard?
(Limerick East): No.
No interruption, please. The question has been put. Let us hear the reply.
I am seeking clarification.
(Limerick East): The adjustment is to be made on the major base funding which was in the pre-budget Book of Estimates. That will take small amounts of funding from across a range of programmes. I have been assured by health board chief executive officers that they will maintain services at 1996 levels which are the services on which the 1997 pre-budget Book of Estimates was constructed.
