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Dáil
‹ Ceisteanna—Questions. Oral Answers. - Health Budget.

Medical and non-medical health spending

Summary

Colley sought figures on health-budget spending and cuts by medical and non-medical category. The Minister said the accounting systems could not reliably distinguish those areas, described efforts to spread staffing reductions, and noted that 2% of health-agency staff worked in administration at regional headquarters, with a further 8% in administration.

asked the Minister for Health (a) the percentage of the total health budget which is spent on non-medical areas; (b) the percentage of reductions in expenditure in the present financial year on non-medical areas; and (c) the percentage reduction in expenditure in this financial year in medical areas.

Comment on this
Rory O'Hanlon Minister for Health (Dr. O'Hanlon) Fianna Fáil

As I explained in reply to a question by Deputy Michael Keating on 21 May 1987, the financial systems in place do not allow for the apportionment of full costs over specific categories of staff. Moreover, any attempt at delineation of medical as opposed to non-medical areas must be open to question.

However, if the Deputy is concerned that there may be an imbalance in the application of allocations by the health agencies in 1987, I should like to state that these agencies have been directed to make every effort to spread any reductions in staff over all grades and to retain front line staff where possible. From the reports I have had of the measures being taken to effect necessary economies, I have found no evidence that my direction is not being followed.

Comment on this

If it is not possible to decide which parts of the health services are administrative and which provide medical services, how can the Minister say that only 10 per cent of the health service expenditure goes on administration? He said the health cuts were supposed to have been spread throughout the service — I am looking at the speech he made on the Private Members' Motion introduced by the Progressive Democrats two weeks ago — and he named three methods of reducing numbers in the health services. I submit that those three areas affected are, almost exclusively, front line health servicing personnel and not administration. I am quoting from this speech——

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Seán Treacy An Ceann Comhairle Independent

The Deputy must surely be aware that quotations at Question Time are not in order.

Comment on this

I will not quote.

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Seán Treacy An Ceann Comhairle Independent

You may not proceed along those lines.

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Could the Minister confirm that the non-filling of some vacancies, the reduction in the number of current temporary employees and the reduced scale of locum cover almost exclusively affect personnel providing medical cover?

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The definition of medical and non-medical areas in the health services is open to a very wide interpretation. For example, on the pay side, the strict interpretation might refer to the cost of doctors only, while a liberal interpretation might include porters and domestics employed in hospitals, mentally handicapped homes, et cetera. On the non-pay side, certain foods could be medically prescribed for a patient. Two per cent of the total staff employed by the health agencies are involved in administration at the various regional headquarters. A further 8 per cent of the total staff are in administrative categories engaged in the direct delivery of service to patients either in the institutions or in community care.

As regards reductions in the number of persons working in the health services, 9.2 per cent of the total number of reductions are in the clerical and administrative area which is broadly representative of the number working in the area of the service.

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