Vol. 591 No. 2
6 Ms Burton asked the Tánaiste and Minister for Health and Children the steps it is intended to take to address the €20 million deficit facing the main Dublin teaching hospitals, which has arisen largely as a result of higher than expected spending on expensive cancer drugs; if it is intended to introduce a Supplementary Estimate to deal with the deficit; and if she will make a statement on the matter. [26333/04]
The quoted spending deficit for the Dublin academic teaching hospitals was €20 million for the period ended in July 2004. The position has improved over the months of August and September for the Eastern Regional Health Authority, ERHA, generally. The authority continues to work with individual agencies to manage the situation. In respect of the Dublin academic teaching hospitals, the ERHA is working with the agencies and believes it will achieve a break-even position by the end of the year. This year, an additional €4.6 million was allocated to the ERHA specifically to address service pressures in oncology and haematology, including oncology drug treatments in acute hospitals in the region.
I got the impression from the Minister earlier that she was claiming credit for the success of the economy but I presume she was not making that outlandish claim. The issue at hand concerns the economies of specific hospitals in the Dublin region which are already in difficulties and experiencing particular pressure in the accident and emergency departments. Does the Minister not accept that if there are increases in the throughput of patients in the hospitals, it will add to their budget requirements? Does she not accept that there is a difficulty in terms of the increasing cost of drugs and greater patient pressure? The population is growing and the budgets for the hospitals are simply not keeping pace. What does the Minister intend to do about it?
The Taoiseach has promised that there will be 900 extra beds in the system by the middle of next year. How many actual beds will be provided in this timeframe and how many of them will be in the hospitals in question? How many of them will be staffed? The staffing needs will add to the budgetary requirements of the hospitals, which are under pressure and cannot even manage within their existing budgets. How will the Minister resolve this? Will she please state how many inpatient beds — acute beds that are needed — will be provided from the figure of 900?
Successive Governments from all parties, including Deputy McManus's, can take credit for our economic success.
Exactly.
However, many of the policies on taxation and enterprise that are supported by the parties in Government have probably played a greater role in our economic success than those that have the opposite effect. We have different perspectives but shared ambitions. I am certainly not arrogant enough to claim full credit for our economic success. The same applies to the health service which requires many people working at every level.
On beds, I answered a question by Deputy McManus yesterday. She has the breakdown so I will not——
That does not give me the information I seek. It is not specified whether the beds are inpatient acute beds or otherwise. Of the promised 900 beds to be provided by mid-2005, how many are inpatient beds that will relieve pressure in hospitals and how many are day care beds, including couches, trolleys and recliners?
I assure the Deputy than none of the 900 beds is a trolley, couch, armchair or whatever the Deputy is suggesting. They are beds.
They are not.
Yes, they are beds.
They are not.
We do not call a couch a bed.
I am sorry, but the Minister does.
I beg the Deputy's pardon but——
The Department of Health and Children has provided the information.
I spent considerable time talking about this to my officials yesterday after the Deputy made her incorrect assertion.
It is correct.
Hospitals must live within budgets and the new hospitals office will insist that they do. We cannot plan anything if people do not live within budgets. That will have to be the way as we go forward. Otherwise, nobody can plan for the circumstances that will arise.
On new beds, there is a proposed new hospital for the Mater. As of now, it is not proposed to have any additional beds therein. We need to reconsider this. Clearly, if we are providing new, state-of-the-art facilities, we must use them to increase the bed capacity in the Dublin area. I certainly wish to pursue this in conjunction with my colleague, the Minster for Finance, in the context of our Estimates. We may argue about how many we need but the bed capacity strategy suggested 3,000 between now and 2011. Clearly, if we need more beds, we must provide them through the projects that are under way.
The intention is that when the Health Service Executive, HSE, begins, it will do so with a clean balance sheet and not with a debt from this year. We will insist upon this.
I agree with the Minister on the new hospital at the Mater but surely she cannot say that there will be no additional beds in the meantime. It is quite clear that if one goes to the accident and emergency department — I recommend that one does — one will see the additional capacity that has been provided very quickly therein. A resuscitation area has been provided in prefabricated units. Surely the Minister is not saying the hospital will have to wait for a new building before it can have additional acute beds. That is a question of policy.
Technically it can be done within a very short time if staffing and funding is in place.
As Professor Miriam Wiley from the ESRI said, faster turnover even by one day and earlier discharges of those who do not need to be in an acute bed would provide substantial capacity. The issue of bed capacity is being examined in the context of what I said earlier. We must examine what our resources will allow us to do in that context. Planning on a national perspective through the new HSE will make it easier to have a more integrated co-ordinated approach in this area.
7 Mr. Timmins asked the Tánaiste and Minister for Health and Children her plans for legislation, similar to the Good Samaritans Act in the USA, to give legal support to members of the public who give assistance to a person who gets ill; and if she will make a statement on the matter. [26285/04]
The Government has no plans at present to introduce legislation to give an indemnity to persons who render assistance in emergencies. The need for such legislation has not been demonstrated. To initiate a claim for compensation against a person who rendered assistance in the course of an emergency, a plaintiff would have to establish that the person concerned owed a duty of care to the person who had been taken ill and that this duty had been breached resulting in loss or injury. This is virtually impossible under Irish law. The clinical indemnity scheme provides indemnity cover for professional staff employed by health agencies covered by the scheme for good samaritan acts. This decision was taken to facilitate suitably qualified and experienced staff in coming to the assistance of people involved in medical emergencies. I am considering having the scheme extended to cover volunteers who have been recruited and trained by health boards to operate portable defibillators in remote areas which might otherwise lack such a service. These initiatives are sufficient to deal with all reasonable needs for indemnity cover.
I thank the Tánaiste for her reply. I am pleased she is considering extending the scheme. When will the scheme be operable because many communities are waiting to get started?
Will she agree to discuss the matter with the Minister for the Environment, Heritage and Local Government, the OPW and the Department of Justice, Equality and Law Reform with a view to providing defibillators to community-based projects?
Last week the Deputy spoke to me in the corridor about this issue, for which I would like to give him credit. It is not something I had been advised of. I will discuss the matter with the relevant authorities to see if we can provide more extensive coverage of what I believe works very well in Wicklow, to which the Deputy referred.
Will the clinical indemnity insurance scheme be extended to cover these people?
I am awaiting advice on the matter and I will revert to the Deputy as soon as possible. I hope the scheme can be extended.
Will all health care professionals such as nurses and doctors be covered under the clinical indemnity scheme? Will it include junior doctors and all staff who work in the health service?
I have been advised that it covers professional staff. It does not use the word "all". I will check on the matter.
Has the Tánaiste written to the hospital consultants giving them the guarantee she gave verbally at their conference that no patient or doctor would be left uncovered against legal action?
I communicated with the consultants today.
In writing.
Yes. There are significant legal issues involved but I am determined to ensure that no patient or doctor will be left uncovered, which would be very unreasonable. There are serious legal issues involved and, therefore, we must move forward cautiously.
Are the consultants' contracts still tied in with the Tánaiste's views on the historical liability issue?
I look forward to discussing a number of issues with the consultants. These are key to the reform agenda in the health service. My strong view is that we should sit down within a timeframe and discuss all the issues together. I have assured them that I will be fair and business-like in the manner in which we deal with them. However, we cannot have an open-ended agenda where no one knows where they stand. That would not be satisfactory.
If the consultants took a case against the MDU would the Department of Health and Children be prepared to indemnify them?
That is one of the issues I am discussing with the Attorney General. I understand the MDU appeared before a Dáil committee last week and I note it did not answer the question as to whether it had taken consultants in the UK off cover. There are many issues involved from the Irish taxpayers' point of view which must be resolved fairly. I am in discussions with the Attorney General on the matter. I do not expect that patients will not be covered or that consultants will be left exposed.
