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Dáil Éireann díospóireacht -
Thursday, 27 Mar 2003

Vol. 563 No. 6

Adjournment Debate. - Hospital Services.

We are witnessing the serious and growing damage being done by Government cutbacks to our hospital services. Yesterday, the Mater hospital announced the closure of 115 beds. Today it has emerged that this hospital will be forced to reduce patient admissions by 3,200 this year. The level of planned activity in St. Vincent's Hospital will be reduced by 20% this year. University College Hospital in Galway will be forced to reduce activity by 7,500 fewer treatments this year. St. James's Hospital is already facing a shortfall of €20 million. Beaumont Hospital is threatening to reduce treatment for cancer and dialysis patients.

Patient care is now suffering an unprecedented assault from the Government. The year 2003 will see reduced hospital activity while demand is growing for hospital services. Waiting lists are not being reduced and even seriously ill cancer patients are being forced to wait up to four months for treatment.

This crisis can be traced directly back to the abject failure by the Minister for Health and Children to focus investment where it is needed most. While he tries to hide behind the health boards and blame them for the crisis, he holds ultimate responsibility for the chaotic situation that has been allowed to develop. Health boards are bloated by an ever-growing number of administrators. As recently as today, the Southern Health Board is justifying a new management post while at the same time cutbacks are being made in hospital services in that region. Hospital ward closures, nurses laid off and operating facilities left idle are the hallmarks of this Minister's stewardship.

There is a new anomaly introduced into the health service. The Minister is funding private hospitals in Ireland and Britain under the treatment purchase fund for patients who are generally less in need but who have been waiting a long time, while more serious but shorter-term patients are left waiting because of cutbacks in public hospitals. Now the closed wards will be used for less urgent cases under this fund.

What he intends to do about the mess he has created is impossible to fathom so I welcome this opportunity to ask. The Minister for Health and Children is so swamped by reports and recommendations from review groups, committees and working groups that he is suffering a paralysis which extends to an inability to tell this House and this Deputy how many such reports and groups have come into existence since Fianna Fáil took office in 1997 and how much they have cost the long-suffering taxpayer. At the beginning of February I sought this information by way of a parliamentary question in the name of Deputy Costello but I did not get it. I sought it again by way of another parliamentary question and to this day I am still waiting. This is in direct contravention of the rules of this House and I demand that the Minister hand over this information immediately.

He also promised that the major reports on reforms in the health service would be published in February and then in March. When will these reports be published? They have been extensively leaked but those of us who depend on the health service have a right to know what the Government is going to do to face up to the challenge of meeting our needs on the basis of equality, excellence and value for money.

As the Deputy is aware, the Eastern Regional Health Authority is charged with responsibility for commissioning health and personal social services on behalf of the population of the region, and also on behalf of those outside the region who are referred for specialist treatment.

The approved level of spending nationally for health services in 2003 is in excess of €9 billion. This level of expenditure represents an increase of almost 9% on the figure for 2002. This level of funding is significant and it is recognised that the authority and the health boards have had to take some difficult decisions in the current year on their service provision and priorities. Nevertheless, it must be recognised that even in the prevailing economic climate the health services have once again received the highest increase in funding across all Departments, a clear indication of this Government's commitment.

The Eastern Regional Health Authority has a total of €1.154 billion available to purchase acute hospital services in 2003. This figure includes additional funding of €9.45 million to support the consolidation of acute hospital services agreed and funded in recent years. This is the basis upon which the authority developed and agreed its own 2003 service plan with the Department. Members of Deputy McManus's party agreed the service plan with the Department.

Additional funding will be allocated among the service providers to assist in meeting increased costs and to fund service developments initiated in 2002. Further funding of €4.5 million has been provided to meet the cost in 2003 of developing the new national lung transplant programme at the Mater Hospital and funding has also been provided to meet the costs associated with the recruitment of additional consultants.

The authority accepts that 2003 will be a difficult year for the acute hospitals sector, as increases in funding over last year will be limited.

That is the understatement of the year.

There is a clear need for tight management of cost and activity in 2003 in the context of working within available resources.

The authority has emphasised that, at a minimum, the same total level of services which the ERHA approved for the Dublin academic teaching hospitals last year will be provided by the hospitals this year.

It has already said it cannot do it.

The information I have states otherwise.

I appreciate the Minister of State is being put on the spot – he clearly did not read the speech before he replied – but we know the hospitals are cutting back. There will be 3,000 fewer treatments in the Mater Hospital alone.

Due to the fact that acute hospital activity in 2002 was significantly above the approved level, there will be a percentage reduction in some services this year to enable the hospitals to live within their 2003 funding levels.

In other words the Government is blaming patients for seeking treatment.

We are not, we are trying to ensure there is appropriate funding in place and that services are provided on the basis of the service plans adopted by all groups, including the Labour Party.

Developments have taken place in the Mater Hospital and more are planned for the campus. There is a tremendous commitment on the part of the Government to improve the provision and delivery of hospital services. I met geriatricians today and I am now aware that a decision was taken by the Mater without consulting my Department or the area health board. There is a need for a clearer blueprint so service providers and statutory authorities know exactly what is being provided and can work within the agreed framework. People broke frameworks last year and are now being asked to operate with the parameters that have been agreed for 2003. That is the prevailing position.

That is correct. They are being asked to make cutbacks in patient services.

The Labour Party signed up to the agreed services.

Will the Minister of State ensure that the Minister answers the parliamentary question that was asked in Deputy Costello's name four weeks ago? That it has not yet been answered is in contravention of the rules of the House but the Ceann Comhairle has already said he cannot deal with it. I am concerned that a question is left unaddressed in this way.

I will be happy to do that.

The Dáil adjourned at 5.20 p.m. until 2.30 p.m. on Tuesday, 1 April 2003.

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