Alan Shatter
Ceist:4 Mr. Shatter asked the Minister for Health and Children the steps, if any, taken by him to address the financial crisis affecting Tallaght Hospital, Dublin 24. [19016/98]
Ceisteanna — Questions. Priority Questions. - Hospital Services.
The Deputy will be aware the board of management of Tallaght Hospital has had discussions with officers of my Department with regard to the budgetary difficulties facing it. This issue is, in the first instance, a matter for the hospital. The Deputy will be aware of the determination process which is now in place in making allocations to all health agencies, whereby service plans must be submitted to my Department within approved levels of funding. The hospital is now saying it has cost more to open the new hospital at Tallaght than was envisaged when it submitted its service plan earlier this year and it has advised my Department of some immediate steps which it is taking to address the problem.
The hospital's outturn for the month of July 1998, which was its first full month in operation at its new site in Tallaght, showed a significant overrun against budget and the board of management, having been asked to review the figures, confirmed the hospital's budgetary difficulties on 24 September last. As Minister, I am extremely concerned at the degree of the projected deficit for 1998 which has been presented and the reasons given for the overrun.
I was pleased when the board of management set 21 June last as the opening day for the new hospital and every possible support was given by my Department and many of the health agencies in Dublin to support the hospital in achieving this date. I am particularly appreciative of the enormous effort made by the staff of the hospital at all levels to ensure the smooth and safe transfer of patients to the new hospital and the commencement of services at Tallaght.
However, it is vital that the hospital now establishes itself on a proper footing at Tallaght. It is for that reason I have initiated an independent review of the data recently submitted by the board of management. This review, which will be carried out in the context of the recent merger of the base hospitals and the move to Tallaght, will also examine the arrangements within the organisation for service planning and associated staffing and financial budgets. The review will also look at the process, systems and practices for reporting and control. It is expected the review will be completed within three weeks.
I am trying to work with the hospital's board of management in addressing its current difficulties and I acknowledge the positive attitude taken by the board, which is in full agreement with the review I have initiated. The board has also confirmed the full co-operation of the hospital in this review and I have agreed that the report and recommendations will be made available by me to the board.
The Deputy will be aware of the importance which I attach to ensuring this newest hospital in the health services is established quickly. The people of Tallaght and the catchment area have waited too long for this fine facility. I am sure the Deputy will appreciate it is critical that problems arising at this time are dealt with as early and as quickly as possible.
Will the Minister finally acknowledge that, as I stated to him in this House at the beginning of the year, the financial allocation made by him for Tallaght Hospital for this year fell short by about £20 million? Will he accept the chickens are now coming home to roost and that any difficulties being experienced by Tallaght Hospital derive from his failure to allocate sufficient funding to ensure the smooth running of the hospital and the transfer of the three hospitals to Tallaght? Will the Minister tell us the terms of reference given to Deloitte & Touche, which commenced its studies in the hospital last Friday?
I do not accept what the Deputy says. In February 1998 the hospital submitted a budget which was only £900,000 in excess of its termination budget of £53.7 million. The hospital was instructed to resubmit its plan within budget. It is vital to note that this original plan gave no indication whatever of severe funding shortfalls.
In regard to the terms of reference, the review will be carried out in the context of the recent merger of the base hospitals and the move to the new hospital at Tallaght and in view of the hospitals' projected major deficit and the current financial difficulties of the Adelaide and Meath hospitals, Dublin, incorporating the National Children's Hospital. The terms will be: first, to review the processes, systems and practices for top general management, reporting and control — for example, strategic planning process, performance measurement process, accountability process, that is, planning, budgeting, measuring, reporting and analysing — management information and supporting information systems; second, to review arrangements within the organisation for the development and determination of service plans and associated staffing and financial budgets; third, to review the data submitted and prepared under the agenda dated 1 September 1998; fourth, these reviews will require discussions with the top general management of the hospital and a review of all relevant information; fifth, the Department and the board have agreed to this review — in this context, a small facilitation group made up of selected officers of the board and officers of the Department will facilitate the review; and sixth, the study group will report to the Minister for Health and Children within a period of three weeks and will advise on appropriate action.
Why do those terms of reference not apparently direct Deloitte & Touche to consider the appropriateness of the funding allocation by the Minister's Department to the hospital for its first year of opening and the capacity of the hospital to operate at that funding level? Will the Minister confirm that he does not propose to take steps which could in any way undermine the voluntary nature of this hospital or its charter? Will he give an assurance to the House that neither he nor any political source close to him, as quoted in last week's The Sunday Times, will make any more public foolish comments that could undermine either public confidence in the hospital or those working in and administering it?
To take the last point first, I am not responsible for fantasy stories in the The Sunday Times or anywhere else.
Will the Minister deny the validity of the quote in that story?
Of course I do.
The time allocated for this question has expired and we must proceed to Question No. 5.
One of the main complaints of the media is that I do not talk enough to them.
It was one of the Minister's honchos who spoke to them.
It was not me, I do not play that game.
We must proceed.