The House will now hear two minute statements on matters appropriate to the Minister for the Environment and the Minister for Health.
Adjournment Debate. - Environment and Health Matters.
Thank you for allowing me to raise this very important issue. I hope for a positive reply from the Minister. A committee have been working hard for a decade or more for the establishment of a swimming pool in Cavan town. The raising of this matter tonight is not a begging bowl attempt to get funds. I am calling on the Minister to make a commitment to the people of Cavan who have themselves made a very serious commitment to the establishment of a facility which is available in most other counties. To that end the people of Cavan have contributed no less than £280,000 in local subscriptions. This fund is in place awaiting the Minister's approval of a grant to allow works to start.
The hard working and dedicated committee have met the Minister on a number of occasions. On 1 February 1990 a deputation met the Minister. He pointed out that commitments for the financial year 1990 had already been made for the refurbishment of pools which had been allowed to fall into disrepair through the lack of viligance of the managing committees. He indicated that in 1991 he hoped grant aid would be available. On 14 November 1990 this dedicated committee accompanied by the county manager and the secretary of Cavan County Council again met the Minister. He lauded their efforts and was prepared to be photographed with them outside this House. He clearly indicated that grant aid would be made available in the forthcoming budget. Seven months later we have not heard from him. This is unacceptable.
The people have made their contribution and they have given a further commitment, which has not been given by many other groups, that the pool when established will be self-financing. Large numbers of people daily and weekly use pools in Navan, Monaghan and Enniskillen because the facility is not available in their own county. These journeys are organised by community groups and teachers at considerable cost.
The Minister does not seem to be aware of County Cavan's geographical location. I would point out that it is an inland county far removed from the sea. We depend on a swimming pool to provide us with a facility which is naturally available in coastal counties. The least the committee can expect is a positive response in view of the efforts they have made.
I am well aware that the Cavan Swimming Pool Committee have raised a considerable amount of money towards the cost of a pool. The present arrangements for the financing of new swimming pools provided by local authorities allow for a grant of up to 80 per cent of the approved cost. However, before approving any project, we must consider the overall availability of capital.
A sum of £1 million from national lottery surplus has been provided in my Department's Vote for 1991 for the provision and refurbishment of swimming pools. The bulk of this allocation will be required to fund existing commitments on the swimming pools programme, leaving very limited funds available for new works which could start later this year. I can assure the Deputy that the Cavan swimming pool project will be treated as sympathetically as possible, having regard to the limited funds available and the competing demand for those funds from other local authorities.
It is outrageous that the Department are still refurbishing pools which have been neglected by committees which did not look after them.
The Ballyhinnaught group water scheme was formed in 1976 and was taken over by the council in 1983. Limerick County Council have carried out refurbishment works over the years. In recent times the water main has been consistently breaking down. In 1990 the main road from Bruree to Kilmallock had to be dug up more than 20 times because of breakdowns. This is very inconvenient for motorists using this busy road and it is especially inconvenient for the 20 households and farms who need an on-going water supply.
The county council have estimated the cost at £38,000, requiring 1,600 lineal metres of water mains. Limerick County Council submitted the project to the Department of Environment in 1990 and 1991 under the small capital schemes heading. To date the Department of the Environment have refused to sanction the grant. I urgently request the Minister for the Environment to approve the finance for Limerick County Council to have this much needed work carried out.
Under the 1991 small schemes programme, grants totalling £3.3 million were allocated for small schemes for the abatement of pollution and the improvement of water supplies. Grants of £154,000 were allocated to schemes in Limerick city and county.
In all, proposals for 482 schemes costing £19.5 million were submitted by local authorities. As a result, only high priority schemes could be considered for funding in the current year. The scheme approved in County Limerick — the Adare water supply — was number one on the council's list. The Ballyhinnaught scheme was number six. The schemes approved in the city were also top of the corporation's list. All of the funds available at present for small schemes have been allocated. I regret that further grants cannot, therefore, be allocated at this stage. It is open to the council to resubmit it for consideration next year.
In regard to all these schemes we go by the priority list submitted by the local authority. We have to accept the views of the local authority as expressed in a list they prepare.
The House will now hear a two-minute statement on a matter appropriate to the Minister for Health.
Is the Minister for Health here?
No. He has another engagement. I will be dealing with the matter and I assure the Deputy I will give a very comprehensive reply.
I regret this very much.
There is no obligation on anybody to be present other than a representative of the Government. I ask the Deputy to proceed with his two-minute statement.
This is a serious part of the business of the House which I consider to be as important as any other. It gives an opportunity to Deputies to air grievances which are of importance to them. I am sick and tired of coming into the House at this hour of the night to find that Ministers with other briefs are answering questions. The Minister has a prepared reply, not knowing what I am going to say. It is a charade which makes the whole contribution meaningless.
The Southern Health Board have £6.5 million in outstanding bills to contractors in their area. A number of suppliers have been in contact with me expressing concern that their companies have difficulties because of the board's failure to pay their liabilities. I am concerned that some companies who are suppliers of the Southern Health Board will suffer because of the board's failure. Companies both small and large and small contractors are awaiting payment of outstanding bills. A problem has arisen because of the total failure of the Minister adequately to fund the Southern Health Board.
The board's operation is in a shambles. They cannot pay their creditors. They have legal obligations towards the people in their area which they are not meeting. Essential equipment in some of our hospitals is breaking down. I would ask the Minister to give an immediate cash injection of at least £4 million to the Southern Health Board so that they can meet their obligations to their suppliers and the people they are supposed to give an adequate health service to. They are failing in their obligations on all counts at present. Even though the Minister met the chairman and chief executive of the board recently he has failed on a number of occasions to meet the elected members, and I regret that very much. I would ask the Minister to immediately intervene to save companies in the area from potential job losses.
In reply to Deputy Allen, let me put the record straight. The net non-capital allocation for the Southern Health Board in 1991 is £149.026 million. The equivalent figure for 1990 was £143 million, giving an increase of 4.2 per cent measured year on year.
We heard that before.
At the beginning of this year a cash profile was established for each health board based on the approved allocation. The Department of Health pays cash to the boards on a weekly basis——
This is a joke.
There is no obligation on you to stay.
This is rubbish. It is a joke and it should not be tolerated.
My Department pay cash to the boards on a weekly basis within these profiles. As I have pointed out recently in this House the timing of issue of creditor's payments is then a matter for each individual board to decide. The amount outstanding to creditors on any particular date is related to the timing of payments rather than indicating financial performance.
The Deputy has drawn the conclusion that a given level of held cheques represents a shortfall in the Southern Health Board's allocation. I can only reiterate the commitments given by the Minister on 26 February last when he clearly stated the Government's position on the issue.
The services in the current year will be maintained at not less than the 1990 approved levels. To this end we have undertaken that costs of certain demand-led schemes will be identified in a separate subhead, relieving the boards of the need to make savings elsewhere should the schemes run over budget. In addition, we are well down the road in supporting health boards and other agencies in implementing an enhanced value for money programme. I regret that Deputy Allen left the House.
The idea of the proposed sale of Merlin Park Hospital and lands was first floated at a Western Health Board meeting in December by Minister of State, Deputy Frank Fahey, a member of the board. I opposed it then and I oppose it now. At a recent meeting of the health board a proposal to sell 74 acres of the grounds of Merlin Park was carried.
The Minister for Health, Dr. O'Hanlon, visited Galway on 31 May and in an interview with Galway Bay FM said that Merlin Park Hospital would close eventually. Minister of State, Deputy Frank Fahey, said that this was nonsense and that the hospital would not close. Now, however, we have the first step in the move to sell Merlin Park Hospital and lands.
However, I have news for the Minister and for Deputy Fahey. No way will the people of Galway stand for this. It was fortunate that this draft proposal was brought up during the local election campaign because candidates from all parties are getting the message at the doors: "hands off the hospital units and grounds at Merlin Park." So clear is the message in Galway that at a meeting of the Galway Borough Council last night there was unanimous support for a proposal to stop any attempt by the Western Health Board or the Minister to sell any part of the hospital or the 130 acres of the grounds of Merlin Park. The motion last night was strongly supported by the Government party members of the council. Fortunately for us and for the people of Galway city and county the beautiful woodlands of Merlin Park are zoned open space and amenity in the recently adopted city development plan. I can tell the Minister for Health and the Minister of State, Deputy Fahey, to forget this proposal to sell off this asset because this council or whoever is elected to the new borough council, will resist on behalf of the people of Galway any attempt to rezone this land for any other purpose except its current use. It would be like selling off part of the Phoenix Park to sell off Merlin Park Hospital.
I would ask the Minister for Health and the Western Health Board to show their concern by reopening the closed units in Merlin Park and bringing onstream again the 200 hospital beds lost there in the past three years thus alleviating the overcrowding and waiting lists at the university hospital in Galway.
While I welcome Minister Connolly here, I very much regret the fact that Deputy Fahey, the Minister from the constituency, was unable to come into the Dáil tonight despite being able to go on Galway Bay FM today to speak about the motion I was bringing up here tonight. I regret very much that he is not in the House now to hear the contribution I had to make as he is floating this idea of selling the lands at Merlin Park. I can tell Deputy Fahey, if he is listening to this, that he will not get away with this because neither I nor the people of Galway will so allow him.
I am glad the Deputy has raised this matter. University College Hospital, Galway, is an extremely busy hospital providing acute hospital care to a large catchment area within the Western Health Board area. I am particularly conscious of the exceptional demand for services which the hospital has been experiencing in recent months and I am anxious to do what I can to relieve the pressure on ward accommodation and back-up facilities as quickly a possible. The Western Health Board have recently made a number of proposals for improvement of ward accommodation, additional theatres, improved accident and emergency facilities and additional X-Ray requirements which they propose to finance through sale of land at Merlin Park.
I wish to congratulate the board for the imaginative and resourceful manner in which they have approached the problem. During a recent visit to Galway I proposed, subject to the agreement of the board, the setting up of a joint working group of officers of the board and of my Department to examine the priority requirements at the hospital; to outline ways in which these requirements can be financed and to ensure that the developments proposed for the short and medium term will not jeopardise the long term development plans for the hospital. My intention was that the group should convene immediately and report to me as quickly as possible.
I am expecting a formal response from the board within the next week.
A new pilot project for the care of the elderly in County Mayo is in grave danger of collapse because the Western Health Board has only been allocated enough money by the Minister for Health to pay £25 per week towards each patient's maintenance.
The new scheme is known as the boarding out scheme but should in fact be properly titled the boarding in scheme. Under the scheme 60 elderly pensioners in County Mayo live in family situations with non-relatives. The patients themselves contribute £40 each week from their old age pensions and the Western Health Board contributes £25 each. The Western Health Board has not increased its subvention since January 1990.
The scheme is a perfectly good scheme. I know four of the ladies who operate it. They are conscientious and extremely caring. They give a special quality of care which has a distinctive human and personal touch which one cannot get or indeed be expected to receive in welfare homes because of the high staff/patient ratio. I have also spoken to some of the elderly residents who benefit from the scheme. They value the feeling of family they enjoy in being integrated into domestic households for 7 days each week.
To keep an elderly person in a health board welfare home costs a minimum of £200 per week. Yet this scheme which caters for 60 patients, all of whom would be in the Sacred Heart Home, Castlebar or one of the welfare homes is supposed to operate on a mere £2.30 per day from the Western Health Board.
These ladies who operate the scheme are supposed to cook, wash, provide heat, transport to the doctor and other necessities for a mere pittance. It simply cannot be done and I do not blame the individuals in question who have now decided because of economic reasons they simply cannot carry on with the scheme. Unfortunately, the only option open for the elderly patients in such cases is to go into the already overcrowded homes run by the health board at a cost of £200 per week.
It is a shortsighted, socially regressive and economically daft measure. The Minister has the embryo of a good nationwide scheme but if people start pulling out from the scheme at pilot project stage then irreparable damage will be done to the concept. There is no use in the Minister giving the House the pat reply that the Western Health Board gets its budget and has discretion as to how it allocates it. The Western Health Board is literally on its uppers. This week the female surgical ward in the new £15 million hospital in Castlebar is closed because of cutbacks. The gynaecological section closes next week. The Western Health Board has not got the money. It should get the money. Otherwise the scheme will collapse.
Let me say in conclusion, without any disrespect to the Minister of State — and we cherish his versatility in this House — this slot here has been rostered for six weeks, and if the Minister could not be here the Minister of State at the Department of Health should have been here.
In reply to Deputy Higgins, at present in the Western Health Board a boarding out scheme is operated in each of its three counties. A full assessment is carried out on each patient and a careful assessment is carried out on each carer by the Geriatric Assessment Committee. This committee are multi-disciplinary. A public health nurse inspects the household prior to a placement and the fire officer and the Environment health officer also inspect the premises. Patients are placed for social reasons, for example, living in isolated areas, bad housing, lack of transport.
Seventy three elderly people are in the scheme at present. The public health nurse visits the household once a month and a senior public health nurse visits approximately every six months. A grant of £25 per week is paid per patient to the carer. In addition, it is recommended by the health board that the person being boarded out pays the carer half the OAP per week. Therefore, the carer is receiving £53 in respect of each elderly person.
The carers must arrange their own insurance cover; they may administer drugs under the supervision of a public health nurse. Only single storey buildings are used in the scheme. The health board guarantee to take back the person if their health or mental state deteriorates so that boarding out is no longer suitable.
There are no regulations governing boarding out at present and the current arrangements have been developed by each health board to meet local situations. The Health (Nursing Homes) Act, 1990, has provided for a scheme of boarding out. Regulations under the Act will be made later this year which will: govern the standards of accommodation, care and welfare of people being boarded out; govern the amount of the contribution to the costs involved by the health board; provide for inspections and interviews with the persons being boarded out and any staff; and provide for the numbers to be accommodated in any household. These regulations will harmonise the approach by the various health boards to the option of boarding out.
The regulations will provide that the grant payable by a health board in respect of each person being boarded out shall be a sum not exceeding half of the maximum single rate of non-contributory old age pension. At the new 1991 rates this would permit an increase of approximately £3 per week and further increases when social welfare rates are revised. As stated earlier, this grant is in addition to the agreed sum paid by the elderly person to the householder.
The Western Health Board are happy with the scheme and plan to expand it.
The Dáil adjourned at 9.25 p.m. until 10.30 a.m. on Wednesday, 12 June 1991.