Dáil Éireann díospóireacht -
Thursday, 24 Jun 1993

Vol. 432 No. 8

Adjournment Debate. - Psychiatric Nurse Training.

Mr. M. Kitt

I thank the Chair for allowing me to raise this matter and the Minister for coming in to reply. This is the fourth Minister for Health who will hear this story from me in relation to the question of recommencing the nurse training in psychiatric hospitals in the Western Health Board. Nurse training in psychiatric hospitals in the Western Helth Baord was a permanent feature up to 1987 but because of the cutbacks this was stopped.

I particularly refer to St. Brigid's Hospital which has accommodation and a tutor for nurse training. Since 1987 St. Brigid's Hospital, Ballinasloe, has had no students. Three psychiatric hospitals are involved, Castlebar, Castlerea and Ballinasloe. Ballinasloe hospital usually had 20 students per year. In 1987 there were only 15 students in the nurse training school. Two years ago An Bord Altranais approved the recommencement of student training and a regional committee was set up in 1988 which formulated a policy for regional training. I understand it was envisaged that the theoretical work would be done in St. Brigid's Hospital, Ballinasloe, and that the practical training would be done in the other hospitals. The Department of Health asked the Western Health Board to provide funding for nurse training but it would cost in the region of £30,000. That would go towards improvements to the teaching room, library facilities and accommodation and money for student allowances. The Western Health Board do not have the money for this and cannot fund student training from their own resources. I am asking the Minister for Health here this evening to provide the requisite funding and allow nurse training to recommence.

Mr. Howlin

I thank Deputy Michael Kitt for affording me the opportunity to respond to the specific question of psychiatric nurse training at St. Brigid's Hospital, Ballinasloe, County Galway.

My Department approved an intake of 15 psychiatric nurse students for the Western Health Board region in 1992. All student nurse training intakes for all disciplines are approved on the basis that the costs arising from their recruitment can be met within the total allocation approved for the relevant health board or voluntary hospital. That is the normal practice not only in the case of the Western Health Board but also in every other health board nationwide. The same position obtains this year in that it is open to the Western Health Board to recruit an intake of psychiatric students next October. However, the funding for that intake, as in the case of all other health boards and training hospitals, is a matter for the board itself to undertake within the approved allocation of funding for 1993.

I appreciate that the Western Health Board, along with other health agencies, faces difficulties. In fact I had a deputation from that region today, and another yesterday, on different service initiatives they want to take. I am aware it is a progressive health board that wants to develop its services. However, it must face the demand for additional services and resources on the same basis as every other area. Given the firm restrictions on overall public expenditure within which the Government has to operate, there is no scope — and I have to be honest about it — for additional resources being allocated to the funding of existing health services over and above those already provided for in the Health Vote this year.

In fact, I should point out also that the Western Health Board did better proportionately than any other health board on the waiting list initiative, in respect of which in excess of £2 million additional money was provided to them for that purpose. The onus rests on each health agency to apportion its allocation so as to maximise the service benefits and overall value to the local population from that expenditure. Frankly any other approach would be unworkable. In particular, I predict there would be very little support for any suggestion that, as Minister, I or my Department should be obliged to provide additional funding on an ad hoc basis for items which quite clearly can be anticipated when priorities for spending are being determined locally at the beginning of the financial year. This would not alone be anathema to any sense of prudent financial management but would also question the whole raison d'etre of the health board structure as an instrument of local decision-making, taking account of locally-determined priorities for the allocation of available resources for their respective areas.

In summary, the question of funding an intake of psychiatric students in the Western Health Board is, in the first instance, a matter for that board. While Deputy Kitt mentioned a sum of £30,000, in the context of the total allocation of over £150 million made to that board this year, it is a matter for it to establish its own priorities and to distribute the money accordingly.