Dáil Éireann díospóireacht -
Wednesday, 13 Feb 1952

Vol. 129 No. 3

Committee on Finance. - Vote 67—Health.

Minister for Health (Dr. Ryan)

I move:

That a supplementary sum not exceeding £835,000 be granted to defray the Charge which will come in course of payment during the year ending 31st March, 1952, 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.

The original net Estimate for the Department of Health was £3,907,600. It is now calculated that net expenditure during the year will amount to £4,742,600. It is, therefore, necessary to seek a supplementary Vote of £835,000.

The increased provision is required under sub-head H of the Vote for this Department—Grants to Health Authorities. Payments under this sub-head are made to health authorities in accordance with the provisions of the Health Services (Financial Provisions) Act, 1947. This Act provides for the payment to each health authority from State funds of the amount by which its expenses in each financial year on the running of recognised health services exceeds its expenditure on those services in 1947-48—the standard year— until such time as current expenditure is twice the expenditure in the standard year. Beyond that limit half the health authorities' expenditure will be recouped from State funds.

The original estimate of the grants payable to health authorities during the current year was £4,022,000. The revised estimate of these grants is £4,872,000, which is £850,000 above the original figure. Approximately £480,000 of this £850,000 is due to increases in salaries and wages which were granted to local employees with effect from the 1st November, 1950. The balance of approximately £370,000 is attributable to increases in the cost of food, fuel, medicines and generally of the goods and the services necessary to maintain the existing health services.

Appropriations in aid are expected to bring in an additional £8,000, and it is expected that a saving of £7,000 will be made under sub-head A—Salaries, Wages and Allowances. The net sum is therefore £835,000.

Dr. Esmonde

I would like to ask the Minister if he would consider, as a forerunner of the health scheme, expending some of these sums in establishing ante-natal clinics which are so badly needed in the provincial towns throughout the country?

We know, of course, that it is the intention of the Minister eventually to introduce an improved medical scheme for the country and a general improvement in all health services. Of course, we must accept the fact that at the moment our services, in so far as they relate to the care of mothers and children in this country, are totally inadequate. I would submit to the Minister that it would be a very good time to begin now to expend some of the money that is being voted for his Department in starting ante-natal clinics in the different country towns. I do not suggest that he should start them immediately in every country town, but I would suggest that he should start in a small way, at all events moving in that general direction. We could easily establish an up-to-date clinic in any town in the country for a sum of about £3,000 or £4,000.

I should like also to point out to the Minister that the dispensaries in rural Ireland have stood as they are at present for a great many years. In the rural districts, anyway, there are practically no up-to-date facilities. Very few dispensaries have light, heat, or hot or cold water. The majority of doctors when dispensing for their patients have to use the very primitive method, when making up a bottle, of filling the water from a jug, and the water is often of very doubtful quality. I think that the money which the Minister is seeking now would be very well expended if he moved in the two directions I have suggested, namely, to provide these ante-natal clinics or, at least, to make a start in that direction, and also to provide decent up-to-date dispensary services.

Dr. Ryan

I am very anxious, indeed, to carry out the proposals made by the Deputy and I have been urging local authorities to provide these clinics in towns and to provide dispensaries in the more rural areas. I do not know if the cost of these clinics will be as modest as the Deputy mentions, although I have been using every endeavour to keep the cost down. I am at the moment issuing a memorandum on the building of dispensaries to local authorities and suggesting plans—of course, the decision is theirs—for dispensaries for rural areas which should not cost more than £1,000 to £1,200 each. It should not be a very big burden on local authorities to provide these particular buildings.

Clinics, of course, will vary a great deal according to the size of a town. In a big town, the cost of building a clinic may run to much more than £3,000 or £4,000. It will depend on what exactly we want to provide. Some local authorities have in mind the provision of buildings suitable even for minor operations, such as the removal of tonsils, dental work and other minor matters of that kind. Of course, if they do provide for these operations in their clinics, naturally they will cost a great deal more. I do not say that I am altogether in agreement with them on that but, on the other hand, it is their job and if they insist I am not going to oppose them. I think, however, that there is no necessity to duplicate services that are being provided by the county and district hospitals and especially there will be no necessity to provide these services in a clinic in a town where there is already a hospital. Generally speaking my inclination, and what I have been pursuing, is to urge on local authorities to provide these clinics and at the same time to keep the cost as low as possible.

Vote put and agreed to.

Estimates reported and agreed to.