DAIL DEBATE

Vote 33 Department of Health and Children (Supplementary)

Take Number: DD

Next Take Number: EE

Forum

DÁIL ÉIREANN

Sitting Time

Sitting Date

18:20

1 December 1998

Mr. Kelleher: I welcome the opportunity to speak briefly on the emotive issue of hospital waiting lists. This is not a new problem and it is disengenuous of Opposition Deputies to suggest that it was created by the present Government.

Mr. McCormack: The list has grown by 600 in the past three months.

Mr. Kelleher: The problem was inherited from the previous Government and I compliment the Minister on acting positively, on putting procedures in place to analyse the problem and on targeting funding to alleviate the problems associated with long waiting lists. We must examine the efficiency and cost effectiveness of our hospitals. Some are very efficient and perform admirably within their budget constraints while others are not. The issue of efficiency must be addressed. We must examine the number of procedures carried out in each hospital each year and how much each procedure costs. The number of procedures carried out in various hospitals appears to vary greatly. One wonders if mechanisms are in place to monitor the efficiency of hospitals. The problem of doctors making inappropriate admissions to accident and emergency units must also be addressed. I am convinced that some doctors admit almost every patient who arrives at their hospitals.

Minister for Health and Children (Mr. Cowen): I thank the Deputies who contributed to the debate and I apologise once again for the delay in distributing the text of my speech. This was due to a technical difficulty which arose at the last minute and was not within my control. Reference has been made to the difference in the amounts of the Supplementary Estimates of two weeks ago and now. The net original figure was £5.5 millon. I obtained agreement that the issue of consultants' pay be dealt with in the context of the Supplementary Estimate. This allows for an increase of £10 million. I have also arranged an additional £4 million for aids and appliances. This amount of £14 million added to the original figure of £5.5 million gives the present figure of £19.5 million. Under the new contract, consultants are being paid on an ongoing basis by health boards, authorities and agencies. Making this money available now rather than carrying it as a cash flow item to be dealt with next year will assist voluntary hospitals and health boards.

The extra money for aids and appliances will assist the physically disabled. Last year, for the first time, a significant grant was given for aids and appliances. The measure proved very effective and was welcomed. This year, I have been able to make provision of £4 million in the Supplementary Estimate for aids and appliances for the physically handicapped. Health boards already have names of disabled people who will benefit from these appliances. The money will be forwarded to the health boards and will be passed, by way of grants to various organisations, to the individuals who need them. That method allows for individual needs to be met quickly while maintaining strict accountability. The Supplementary Estimate has not substantively changed from two weeks ago.

Questions were asked about the waiting list initiative. Waiting lists are not strictly relevant to the Supplementary Estimate. However, I can say that improvements in waiting times in a number of specialties are already evident. These validated results have only become available in the last few days. The allocation of funds to the waiting list initiative next year will depend on this year's case mix figures and the cost information under those figures. I will be seeking to reserve money as an incentive to hospitals who improve their throughput. These hospitals may receive a second allocation during the course of the year. The problem has been that a hospital was allocated funds on the basis of a long waiting list. That is not the best way to solve the problem. Consideration must be given to the publication of waiting times in all specialties in hospitals so that general practitioners may be encouraged to change their referral patterns and public patients will know where they will receive treatment most quickly.

Section to follow:

Section EE follows.

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