asked the Minister for Health if, in view of the increase in the cost of the health services resulting from the setting up of the regional health boards, he will increase the State subsidy to local authorities.
Ceisteanna—Questions. Oral Answers. - Local Authority Health Subsidies.
8.
I do not accept the implication in the Deputy's question that the establishment of the health boards has in itself been responsible for any increase in the cost of the health services. The estimated net cost of the recommended management organisation of the health boards is approximately one-quarter of 1 per cent of the net health expenditure of the boards. It is only marginally greater than the cost of management under the former health authorities. If, as is to be expected, the new managers make a real contribution to the effectiveness and efficiency of health care services, then this cost is a small price to pay.
With regard to Exchequer contributions, grants to meet one-half of the approved net revenue expenditure of the health boards will, as hitherto, be made available from the Vote for my Department. The extent to which supplementary grants will be made available will be determined following examination of the boards' estimates of receipts and expenditure and in the light of the Exchequer position generally.
Is the Minister now saying that, in the event of overspending of our estimate, we will get a supplementary grant?
I did not say over-spending. The position is that the financing of the health boards is the same as it was with the exception, as the Deputy knows, that county councils have to agree on their contributions towards the total expenditure, failing which an arbitrator is appointed. Every year the Government have given something in excess of 50 per cent as a further contribution over and above that dictated by previous legislation. As the Deputy also knows, at the end of the last financial year there were huge increases in remuneration and in the cost of drugs and the Minister for Finance and the Government, before the present estimates were published, agreed that they would defray the entire extra cost to the tune of something like £5 million or £6 million. This could have been 50/50 between the State and the health authorities. The Government effectively saved the health authorities from further increases in rates to the tune of 3s. in the £. I cannot guarantee that every year the Government will treat the matter in that way but they decided to do that last year at least.
Would the Minister now assure the House that, in the event of an increase in our health estimate, he will supplement the amount under-estimated by the Minister and his Department, bearing in mind the fact that, when the health authorities were originally formed, the then Minister for Health assured us that the health services would not cost more than 2s. 6d. in the £ on the rates? We now find it has increased to the enormous sum of something like——
The Deputy is making a speech.
I want an assurance from the Minister on this. I have had experience of these boards for the past 24 or 25 years and I know what I am talking about. I want an assurance from the Minister that, first of all, if we have overspending——
The Deputy may not make a speech. We cannot discuss the financing of the health services on this question.
I want an assurance from the Minister.
The Deputy has already asked that.
Will the Minister recoup the Western Health Board for the overexpenditure to which we are already committed?
I could not possibly commit myself in an answer to that question. As the Deputy knows, increases in the old health board expenditure were not attributable to increases in remuneration. Increases in the cost of drugs were frequently accepted deliberately by the health authorities and the amount was added to, and had to be the subject of, an additional rate in the following year. It is impossible for me to answer a specific question——
Further arising——
The Deputy will appreciate that there are 359 questions on the Order Paper. Therefore, will he please resume his seat and allow questions to continue. He may not monopolise the time of the House.
I am asking questions which concern the health of the people.
May I ask the Minister——
I am calling Question No. 9.
The question asked concerned increases in the cost of health such as the increase resulting from the setting up of the regional health boards and I assumed that the Deputy meant the management course. If the Deputy will kindly put down a specific question I shall answer it next week. Is that not fair enough?
I think the Minister will agree with me——
We cannot discuss this question all evening.
The Minister is side-stepping the whole issue.
The answer given today is much more honest than the promise given by the Government some years ago that they would not increase the charge on the rates for health services.
Could we move on to Question No. 9?
Perhaps the Deputy would read the White Paper.
(Interruptions.)