With your agreement, a Cheann Comhairle, I shall share my time with Deputy Moynihan.
Adjournment Debate. - Tralee General Hospital Funding.
Is that course satisfactory? Agreed.
I am grateful for the opportunity to raise the matter of the difficulties faced by Tralee General Hospital. There are two aspects to the matter. First, there is the question of the overall level of expenditure within the conditions of the Southern Health Board and, second the inadequate level of service available to persons in County Kerry.
Several problems have been highlighted recently by the staff of the hospital. Some of them are very physical problems in that they relate to the equipment required. I urge the Minister to consider the issue on a personal basis, because in Tralee we have what I would describe as a very fine hospital — I am sure that the Minister is fully aware of the facilities available there. Regrettably, one-third of the hospital is not in service because of financial difficulties; but we do have a tremendous facility. The staff are coping in very difficult times but, unfortunately, they are now being confronted with inadequate funding from the health board itself. I am always conscious of the level of funding provided to the regional hospital in Cork, which obviously has a much wider range of services available. I do point out to the Minister, however, that several areas put considerable strain on the level of health services available.
The citizens of County Kerry have helped out in no uncertain way in fundraising to help the hospital but, unfortunately, the contributions raised have not been reciprocated by either the health board or the State. The most recent example of that attitude occurred when laparoscopic equipment was required by the hospital and was funded by public contributions and fundraising activities in the town of Tralee and the county at large.
There are shortages in other areas. There is a tremendous shortage of minor surgical staff, there is inadequate stomach and mastectomy care and there is a big question about the care of dangerous drugs.
The issue of junior anaesthetic staff has been a problem in the hospital for several years. Hospital consultants advise that there is a danger of disaster in that area because the staff in the anaesthesia department cover all kinds of situations, there is no back-up service and there is the danger that when someone is on duty he or she will be required in another part of the hospital.
The position is serious, if not verging on alarming, and I ask the new Minister for Health to consider the issue and to have discussions with the health board about the proper funding of what is a very valuable service to the community.
Deputy Spring has outlined the basis of the concern and the complaints of the hospital staff.
I am delighted that the new Minister is in the Chamber tonight. I wish him well. It is pleasing to note that he has professional expertise, training and knowlege that will enable him to perhaps make a better judgment on medical matters than would a lay person.
To say that the issue is of very deep concern is to understate the case both in relation to the inadequacy of equipment and in relation to the inadequate levels of staff. The matter is very serious when it comes to a hospital the size of Tralee General Hospital.
I ask the Minister to come to Tralee to meet the hospital consultants. They are most anxious to make a direct case to him and portray their problems and the problems of the patients they are endeavouring to serve. Such a gesture would create a most harmonious relationship between the Minister, hospital staff and the hospital patients, who are so dependent on the staff.
It is felt that there has been inadequate health board funding over a long period. Not only is it considered that Kerry receives inadequate funding, but also that we are not getting a fair share of funding. The Minister should thoroughly satisfy himself on that matter. It is felt by the people of Tralee that our hospital does not get a fair share of funding in comparison to the Cork Regional Hospital in terms of the volume of work done.
I appeal urgently to the Minister to come to Kerry and meet the consultants, who would be delighted to sincerely bring this serious matter to his attention with a view to some rectification.
I should like to say that I am glad to have a chance to address the House on the question of health funding so soon after taking up my responsibilities in the Department of Health. I am very pleased that the Deputies have brought the matter to my attention because it is only in that way that I am becoming more fully aware of what is happening. The Deputies serve a very good cause in doing so.
As Members will know, there has been much debate in recent years about the appropriate level of resources that can be committed to the health services. I have clear views on the way in which the Government should go about getting the best value possible from the very large investment made by the State in health services. The current health budget exceeds £1.5 billion.
The Deputies referred to what they feel is an inadequate level of funding for Tralee General Hospital. I must confess that I was writing about that issue for a long time. I am well aware of the inadequacies and I do know that part of the hospital is not in use.
For the Deputies' benefit, I shall give a few details. The Southern Health Board's allocation for non-capital expenditure in 1992 is £166.8 million. It will be agreed that that is not an inconsiderable sum by any measure. The allocation represents an increase of 11.9 per cent over the original allocation for 1991. The original allocation and the outturn are very different, I do have to admit that.
An the back-up.
I am awaiting explanation on that point. I consider that it is important to emphasis that. As well as the £166.8 million, another sum of £350,000 has been allowed for specific service developments, including the establishment of an ENT service at Tralee General Hospital, which has been identified as a priority by the health board and the consultants at Tralee General Hospital. Discussions on the start-up date for that service will be finalised with officials of my Department in the immediate future and I shall certainly stress the need for urgency.
I am sure that the Minister will.
If there is any unnecessary delay, I shall expect the Deputy to bring that to my attention.
The last health board stated that it would not happen this year.
I now personally give the Deputy a promise on that, because I consider the service to be very important. I shall move heaven and earth to make sure that that is done.
Yes.
The Southern Health Board were notified of their 1992 revenue allocation by my predecessor. The board and their management team are currently drawing up a comprehensive service plan that will show the way in which they intend to spend their allocation, with priorities within the budget to be determined according to local needs.
I say this because of what Deputy Spring has said: I feel that Kerry must be represented and must get its fair share. It is very important to realise that the money is not just for one Cork area, there are other areas. I should hope that Kerry representatives on the health board would press that point. I also feel that the board have to manage their affairs to bring budgetary expenditure in line with their allocation. The board have been established to do that and the local representatives on the health board are the best placed people to decide just how the money should be spent. I would not have the power to direct the health board on the way in which they should spend their money. The Deputies know that health boards jealously guard their powers. I was on the Eastern Health Board and I understand it has not been the practice of any Minister for Health to interfere in the budgetary priorities of health boards. I have not the right to do so now, or I would have you all on my back.
You have the power.
Expenditure of Tralee General Hospital in 1990 was £10.3 million and the latest projected expenditure for 1991 is £11.6 million, which represents an increase of 12.6 per cent over 1990. I understand that funding for the current year will be in excess of £12 million. The Southern Health Board have not yet determined their service plans for the current year. I will study what Deputy Spring and my friend have said and I will see what we can do. There are some aspects which I had forgotten about, and I hope to look at them again and contact the Deputies.