Dáil Éireann díospóireacht -
Thursday, 10 Oct 1996

Vol. 469 No. 7

Written Answers. - Health Services Staff.

Séamus Hughes

Ceist:

100 Mr. Hughes asked the Minister for Health his views on the fact that since 1980 administrators and management staff in the Irish health services have increased by 32 per cent while the number of medical and dental staff fell by 1 per cent; whether he has satisfied himself that there are currently 1.68 administrators per medical staff member as against 1.25 in 1980; and whether this increase in administration costs is a substantial component in the 50 per cent real increase in Irish public health expenditure since 1990. [18205/96]

Minister for Health (Mr. Noonan,

Limerick East): The management/ administration grade category is a broad designation which encompasses many functions in the health services and includes: community welfare officers, patient services officers, medical records staff, medical, surgical and out-patient appointments staff, health centre receptionists, consultants' secretaries, secretarial and clerical back-up to community care and other services. The vast majority of the people in this grade category are involved in tasks which directly relate to and impact on patient care. It is also the case that the vast majority of these staff are at relatively low grades with obvious implications for costs.

Any enhancement of existing health care services and the introduction of service initiatives necessitate the provision of clerical and administrative support as an integral part of the development, as medical and dental staff cannot operate in isolation. When service developments are being examined in the Department, any additional administrative posts are subjected to particular scrutiny to ensure that only essential needs are being addressed. Apart from new developments health agencies have discretion in regard to the allocation of posts within a global ceiling approved by the Department. There are no grounds for believing that the health system is currently over-managed. Changes in the method of collecting data on health service numbers have meant that the figures for 1995 are not directly comparable to 1980 data. The first date for which directly comparable figures are available is 31 March 1987, at which time the ratio of management/administration staff to medical staff was 1.60 to 1. The current ratio — 1995 — is 1.72 to 1, which indicates that the rate of increase is not as high as the Deputy's question suggests. In the period 1990 to 1995 the numbers of medical staff increased by 15 per cent, while the numbers of management/administration staff increased by 19 per cent. This period has seen many developments in regard to revenue generation and enhanced accountability requirements which have a direct bearing on administrative and clerical support.