asked the Minister for Health the number of local authority officers engaged in health work prior to the establishment of the regional health boards; and the number so engaged since the establishment of the regional health boards.
Ceisteanna—Questions. Oral Answers. - Regional Health Boards.
5.
I presume the Deputy is referring to the number of staff at administrative and clerical level rather than medical and para-medical staffs. The total number of administrative and clerical staff below management level engaged in health work on 31st March, 1971 is estimated at 1,200. These staffs automatically transferred to the health boards on 1st April, 1971 and there was no increase in the number of posts attributable to the changeover. At management level there were 11 officers engaged full-time and 68 officers engaged part-time in the administration of the health services on 31st March, 1971. The total number of management posts authorised for the eight health boards is 47. Some of these posts have not yet been filled.
The Minister stated there were 1,200 employed on 31st March, 1971. Can the Minister give the overall figure after that date?
It is 1,200—the same number.
The Minister gave many other figures.
I was referring to administrative staff. I gave the Deputy the figures for what is described as "management" staff separately—programme managers and so on. The number of management posts authorised for the eight health boards is now 47 and they replace 11 full-time officers and 68 officers engaged part-time in the 27 health authorities that have been abolished. It would be impossible to make a comparison between the two.
I should need a pencil and paper to work out the figures given in the Minister's reply.
6.
asked the Minister for Health if he is satisfied that the regional health boards make for more economic health administration.
I am quite satisfied that the health boards will make for more economic health administration.
Is the Minister aware that in regard to matters relating to medical cards formerly one wrote to the county manager for the area concerned and received a reply from him? Now it is necessary to write to the county manager, he writes to the regional board, the regional board reply to him and ultimately the county manager replies to the person who wrote to him originally. I do not see how this makes for economy and perhaps the Minister would clarify this point.
There should be a system established whereby a Deputy should be able to make his appeal for a medical card to the officer delegated in a county area to deal with medical cards. It should not be necessary for letters to pass from one person to another. I would point out that the health board administrations have been in operation for three months only and it will take a considerable time before all these problems are straightened out. I should not imagine there will be a complete structure of the health boards until 1st April next year. There are still some vacant posts and there must be an examination of how to work in the new posts. The McKinsey Report on the administrative structure has yet to be examined in some areas.
I agree completely with the Minister in what he has said. However, the difficulty is if I write to the regional health board I do not necessarily get a reply. Heretofore I wrote to the county manager and received a reply within one week but now I must write to the Minister for Health, as he is aware, and he writes to the health board and I receive a reply. I would not get a reply otherwise.
The Deputy should give me an example of this. I have not received any complaints about Deputies not receiving replies.
The Minister has stated he is satisfied that the health boards will make for more economic health administration. Is this a guarantee that the health charges will not mean an increase on the rates in the years to come?
I did not say that.
What does the Minister mean?
The volume of health services is bound to increase. The health services will improve; we must look after 4 per cent more people going to hospitals every year. However, the fact that the health services cost more does not mean they are being run in an inefficient manner.
Leaving aside the necessary and normal increases in the cost of health services——
The question deals with administration.
Exactly. The Minister is replying to a different point. The Minister has said that the present set-up will lead to more economic administration. Is this a guarantee that the cost of administration, apart from the normal inflationary increases, will not be an extra charge on the rates in years to come?
I could not even say that. I should hope the Deputy would know enough about administration to realise that there can be an increase in the number of officials in any administration in order to secure more efficient operation of the services they operate——
They should be more efficient.
The Deputy is trying to discuss a matter it would be better to debate on the Estimate for Health. I have given the House an elaborate description of how the health boards will operate and the reason for their adoption.
Will the Minister not admit that instead of having a more economic health administration we will have a much more extravagant health administration? Further, would the Minister not agree that health charges this year will be increased from 30 to 50 per cent——
Question No. 6 deals with health administration. It has nothing to do with health charges.
At present the boards are doing nothing but appointing programme managers and so on.
I am calling Question No. 7.
There is not even an extra Aspro available for the patients.
I have called Question No. 7.
I know of people who should never have been on the boards——
Deputy L'Estrange must cease interrupting and allow questions to proceed.
The total number of management posts for the eight health boards is 47 as compared with the 11 officers engaged full-time and the 68 part-time officers in the 27 health authorities.
The boards are top-heavy. The Minister has gone on a spending spree.
I am calling Question No. 7.