asked the Minister for Health whether, in view of the removal of health services from county councils, he will be prepared to make these services largely a national charge at least in respect of institutional services and thereby bring the financing of these services more into line with neighbouring administrations.
Ceisteanna—Questions. Oral Answers. - Financing of Health Services.
14.
As the figures given in reply to a question by the Deputy on 19th January, 1972, show, the cost of the health services is largely a national charge at present. As regards the Deputy's reference to the proportion of health costs ment from the rates under neighbouring administrations, I would point out that in any such comparison health services must be viewed as part of a general pattern allocating costs as between central and local authorities. Local authorities in Britain have to meet from the rates about half the cost of some important services—notably education and police services—which are almost entirely financed by the Exchequer in this country.
Does the Minister not agree with me that the proportion of health expenses met from rates in this country is higher than in England, Scotland, Northern Ireland, and most European countries?
It is very hard to make comparisons. First of all, in a number of countries they have different insurance schemes that enter into the picture of the total cost of health charges. The Deputy will be interested to know that in 1968-69 out of a total revenue expenditure of local authorities of some £4,000 million the cost of education in England and Wales was £1,450 million and the figure for police and fire was £294 million. So, you really cannot make comparsions.
Does the Minister not agree that when he speaks of educational expenses he is dealing with an entirely different situation in Great Britain? In this country a very large proportion of educational expenses is borne by individuals and private concerns.
That is what I was saying. It is very difficult to make true comparisons.
15.
asked the Minister for Health whether the figure of 26 per cent as contribution from rates towards health charges as stated in reply to a Parliamentary Question of 19th January takes into consideration the central subvention towards the agricultural grant; if he will state the amount of this grant and the percentage contribution from rates to health charges by elimination of the agricultural grant from such computation.
The percentage shown related to the estimated amount actually raised by the rates and did not cover moneys contributed by local authorities which they had received by way of Exchequer subvention in the form of agricultural grants. The percentages for the other areas similarly excluded Exchequer grants to relieve rates. The estimated total amount of the agricultural grants for the current financial year is £25 million, of which about £9 million is calculated as being attributable to the health services. I do not understand the last part of the question but the data I have given should enable the Deputy to work out the percentage he has in mind.
Does the Minister not agree that his claim about giving money through the agricultural grant which is used by two Departments, the Department of Health and the Department of Agriculture and Fisheries, is not quite fair in so far as this money does not help the local authorities? It is merely a help to certain sections of the agricultural community.
It does not help everyone in the community. Quite obviously it does not help people in the cities but it helps people in the agricultural community and in the rural areas. In some counties the cost of the health services is met to a degree of 80 per cent by the combination of the agricultural rate relief and a central subvention from the Government.
It does not help the local authorities.
16.
asked the Minister for Health the total national expenditure on health over the past decade giving under the appropriate headings the source from which the money was provided.
I assume that the question is related to the revenue expenditure on the statutory health services. As the reply is in the form of a tabular statement I propose with your permission, a Cheann Comhairle, to circulate it with the Official Report.
The statement is as follows:
|
Year |
Total Expenditure on Health Service |
Amount of Exchequer Grants to Health Authorities |
Charged to local rates |
Grants from Hospitals Trust Fund |
|
£000 |
£000 |
£000 |
£000 |
|
|
1961-62 |
21,241.2 |
9,614.1 |
9,614.1 |
2,013.0 |
|
1962-63 |
23,347.1 |
10,607.3 |
10,607.3 |
2,132.5 |
|
1963-64 |
24,790.9 |
11,241.6 |
11,241.6 |
2,307.7 |
|
1964-65 |
29,735.7 |
13,892.0 |
13,892.0 |
1,951.7 |
|
1965-66 |
32,721.9 |
15,495.7 |
15,495.7 |
1,730.5 |
|
1966-67 |
37,058.7 |
18,913.5 |
15,495.7 |
2,649.5 |
|
1967-68 |
40,476.1 |
20,531.9 |
16,596.3 |
3,347.9 |
|
1968-69 |
46,356.0 |
23,537.2 |
18,719.9 |
4,098.9 |
|
1969-70 |
55,033.7 |
28,311.8 |
22,517.2 |
4,204.7 |
|
1970-71 |
68,906.0 |
38,754.3 |
23,752.7 |
6,399.0 |
NOTE:
(1) Grants-in-Aid were paid from the Health Vote to the Hospitals Trust Fund as follows: 1968/69 £1,080,000; 1969/70 £2,750,000; 1970/71 £4,750,000.
(2) The accounts for 1970/71 and a number of those for 1968/69 and 1969/70 on which the figures in the table are based are subject to audit.
17.
asked the Minister for Health if, in view of the increase of £1.9m. in the demand of the Mid-Western Health Board on the local authorities in the region, he will state what contributions he intends to make to relieve the ratepayers of this onerous additional burden.
As the matter is still under consideration in respect of health boards generally, I am not in a position to say what levels of supplementary grant can be made available to reduce the contributions of the local authorities concerned to the MidWestern Health Board for 1972-73. I shall notify all health boards in this regard at the earliest date possible.
Question No. 18 postponed.