I move:—
That a supplementary sum not exceeding £447,770 be granted to defray the Charge which will come in course of payment during the year ending the 31st day of March, 1950, for the Salaries and Expenses of the Office of the Minister for Health, and certain Services administered by that Office, including Grants to Local Authorities, miscellaneous Grants and a Grant-in-Aid, and certain charges connected with Hospitals.
The original Estimate for the Department of Health was £2,020,420. It is now expected that net expenditure in the year will amount to £2,468,190, allowance being made for an increase in the estimated Appropriations-in-Aid of £3,000. It is, therefore, necessary to seek a Supplementary Vote of £447,770. The sub-heads under which this Vote will be accounted for are: sub-head E—expenses in connection with international congresses etc.— additional sum required, £1,770; sub-head H—grants to health authorities— additional sum required, £442,000; sub-head J—national blood transfusion service, Grant-in-Aid—additional sum required, £7,000.
The main increase arises under sub-head H, grants to health authorities. The additional money is required to meet the arrears of grants payable under this sub-head in respect of the year 1948-49 and payments in excess of the figures on which the original Estimate was framed, which fall to be made in the current year. As has been explained to the House on previous occasions, grants are paid under this sub-head to recoup each health authority up to a certain limit the amount by which the running expenses on its health services in each financial year after 1947-48 exceeds the local expenditure on those services in that year.
The calculations on which the provision in the original Estimate was based were made by the health authorities and my Department before the commencement of the current financial year and it is not surprising that the overhaul and expansion of the health services, which is being carried out as rapidly as possible, has resulted in the need for additional provision. To a great extent the rapid expansion and improvement of the tuberculosis services is responsible for increasing the original Estimate of the cost of the service during the current financial year by approximately £250,000, while almost a further £140,000 of the additional sum now sought is required to pay to health authorities arrears in respect of expenditure on the tuberculosis services in the year 1948-49. Altogether 1,136 new beds have been provided for tuberculosis patients since 1st April, 1949. This naturally adds considerably to the total cost of the maintenance and treatment of patients under this service. The X-ray service has also been extended to provide free examinations for patients of private practitioners.
A number of tuberculosis medical officers were sent on study courses abroad and publicity was given in newspapers circulating in each health authority's area to the facilities available under the tuberculosis service. The cost of the service was increased to a lesser extent by the grant of increases in remuneration to officers and employees and the provision of improved conditions of employment, including adjustment of working hours and expenditure on repair work which had been suspended or reduced while materials were scarce. I am quite satisfied that this increased expenditure on tuberculosis was necessary. It will pay dividends in the future by reducing the loss caused by this disease to the economic potential of the country. If any money is well spent, this is, and I do not think the House will begrudge it.
There was also an increase in the cost of the public assistance services, caused mainly by an improvement in the working conditions of officers and employees. The cost of maintenance allowance for persons with tuberculosis, or other infectious diseases, was also higher than at first expected. These increases were to some extent balanced by savings on other services.
Of the £1,770 additional provision sought under sub-head E, expenses in connection with international congresses, etc., £1,720 is required to meet a supplementary contribution which it was necessary to make to the Working Capital Fund of the World Health Organisation. This is an organisation many members of which are unable to pay their annual contributions before the second or third quarter of each year because of the different fiscal years and legislative processes. The executive board of the organisation decided in 1948 to institute a Working Capital Fund of 1,650,000 dollars which would be used to cover expenses incurred in advance of the receipt of the bulk of annual subscriptions. In practice, this has been found to be inadequate and at the Second World Health Assembly, which was held in Rome last year and at which this country was represented, the fund was increased to 4,000,000 dollars for the year 1950. Certain other credits which were available to the organisation were merged in the fund and this had the effect of reducing to approximately 1,449,000 dollars the supplemental sum which member countries were required to contribute to the increased Working Capital Fund for this year. In common with other member countries of the organisation, Ireland's share of this sum, 4,949 dollars, was calculated on the basis of a special scale which had been agreed upon during the First World Assembly and which fixed the contribution of this country at a relatively satisfactory level. The balance of £50 required under this sub-head is needed to meet the expenses of the delegate who attended the meeting of the Second Mental Health Assembly held at Geneva in August, 1949. The actual expenses of the delegate amounted to £70 but, as there is a saving of £20 from the provision made for the Food and Agriculture Organisation of the United Nations, the amount required is reduced to £50. No provision was or could reasonably have been made in the original Estimate for these two items of the sub-head.
As regards the additional provision required under sub-head J, National Blood Transfusion Service, Grant-in-Aid, it will be recalled that in my speech on the Estimate for my Department for the year 1949-50 I referred to the setting up of the National Blood Transfusion Association. This association, which is a company limited by guarantees, was established for the purpose of organising a national blood transfusion service and it is expected it will be in a position to start operations about a month hence. The Grant-in-Aid of the association, amounting to £18,000, was included in my Department's Vote for the current year. This sum included provisions for alterations and repairs to buildings, and £5,710 for equipment. On the basis of revised estimates of expenditure, which have been received from the association and which I am satisfied have been estimated as conservatively as possible, the sum needed for alterations and repairs to buildings requires to be increased by £7,780 and that for equipment by £641. On the other hand, the original provision of £7,750 for ordinary revenue expenditure has been reduced by £1,421. This leaves the net total increase now required in the Grant-in-Aid at £7,000.
