Ceisteanna — Questions. Oral Answers. - Health Boards Funding. – Dáil Éireann (26th Dáil) – Thursday, 24 Oct 1991

Ceisteanna — Questions. Oral Answers. - Health Boards Funding.

Michael Ferris

Ceist:

3 Mr. Ferris asked the Minister for Health if, having regard to his commitment given in Dáil Eireann in February 1991 to (1) maintain services at 1990 levels, (2) maintain acute bed numbers at 1990 levels and (3) meet the health boards costs of overruns on demand-led schemes such as the disabled persons' maintenance allowance and drug refund payments, he will outline when payments will issue to health boards to honour these commitments and help relieve existing serious budget deficits in health boards throughout the country as reported at 31 July 1991; and if he will make a statement on the matter.

Gerry Reynolds

Ceist:

8 Mr. G. Reynolds asked the Minister for Health if he will outline the projected overrun in the 1991 Health Estimate; the areas where the overrun occurred; and if he will make a statement on the matter.

Jim Mitchell

Ceist:

37 Mr. J. Mitchell asked the Minister for Health the way in which the health boards spending is proceeding relative to budget; and if he will make a statement on the matter.

Michael Ferris

Ceist:

47 Mr. Ferris asked the Minister for Health if his attention has been drawn to the serious budget deficits in all health boards; if he will list the deficits in each health board area at end June 1991; if these deficits in revenue budgets include health board debts for goods and services supplied but not yet paid for and if he will outline the consequences of these debts on the ability of health boards to deliver health care services in 1991 at 1990 levels.

Dr. O'Hanlon

I propose to take Questions Nos. 3, 8, 37 and 47 together.

In accordance with the undertakings I have given in relation to health services in 1991, the non-capital allocations of health boards will be adjusted to take account of approved increases in expenditure, including pay, increases in the rates of allowances and certain services-related items.

Health boards are now generally aware of the order of these adjustments. Despite this it is not possible at this stage to project what overrun, if any, may occur in the Health Estimate in 1991. The budgetary position under each board tends to vary from time to time throughout the year. The information available to my Department indicates that a number of boards are having to take corrective action in order to ensure that their overall expenditure will not exceed their revised allocations.

As the Deputy will be aware, all agencies were notified in their letter of allocation for 1991 that expenditure must be contained within the limits of the allocation, as revised from time to time throughout the year. Any expenditure excess arising in 1991 will be a charge against the 1992 allocation. This position has been reinforced in meetings with the agencies throughout the year and I have again drawn specific attention to the difficulties which will arise for any agency carrying a deficit into next year. Indeed, I have met with the chief executive officers of health boards earlier today to emphasise the vital importance of achieving agreed service targets within the budgetary limits.

The cash which is transferred to health boards on an ongoing basis is tailored, with the agreed level of bank overdraft, to match the approved level of non-capital expenditure. This level of expenditure is geared to enable boards to deliver the approved 1990 level of service in 1991.

Mr. Ferris

First, I would like to confirm that the Minister made this commitment in the House on 26 February. Would the Minister not agree, having made that commitment, that in the discussions that are now taking place to which he has referred he has changed that commitment — he misled the House to believe a commitment was given — and that the health boards are not able to meet their ongoing commitments? As these schemes are outside their control, I would ask the Minister to live up to the commitment he gave. All the information available to me suggests that he is not living up to it and is now talking about paying half these costs. All I am asking him to do is to stick to the commitment that he gave in the House and to the health boards. Would he agree that that is what he said and that is not what he is doing?

Dr. O'Hanlon

No, I would not agree. We are dealing with two areas, first, the service area. Sufficient funding was provided to ensure that the level of service delivered in 1991 would be maintained at 1990 levels. With regard to the question of open-ended schemes, the drug refund scheme in particular always causes a problem. Indeed, I told the House before the summer recess that it was projected there would be a £22 million overrun which we will certainly look at. What we did for the health boards with regard to the drug refund scheme was that we introduced a revised scheme which will have benefits for the health boards. We also took a number of measures to reduce the cost of drugs in the current year. It is unreasonable therefore to suggest that we have been unfair to the health boards in that regard because we have put in place mechanisms to reduce the cost of drugs. As I have often said in the House before, no patient should be denied the drugs or medicine they need for their particular illness. I think everyone in the House would accept that both in terms of the volume of drugs and brand of drugs prescribed there are opportunities to save. For example, less expensive drugs which would be equally as efficient and effective could be prescribed instead of the more expensive drugs.

Mr. Ferris

What about the DPMA scheme? These are statutory entitlements. The health boards have no control over them. The Minister promised that he would fund them but now he is telling them that he will not. This is contained in the minutes from health boards all over the country. If they cannot meet their requirments under statutory schemes they have been let down by the Minister. All I can say is that every health board in the country feels that they have been let down.

Dr. O'Hanlon

The Deputy is being unreasonable, three-quarters of the way through the year, in coming into the House to say we have not honoured our commitments.

Mr. Ferris

Look at them. They are all over the place.

Dr. O'Hanlon

I take the Deputy's point that the DPMA scheme is an open-ended scheme. I have requested full up-to-date information from each of the health boards on the number of patients in receipt of DPMA now as compared with the number at the beginning of the year. I am awaiting that information.

Dáil Éireann díospóireacht -
Thursday, 24 Oct 1991