asked the Minister for Health the number of patients who are turned away each year from the bone marrow transplant unit in St. James's Hospital, Dublin 8, because the unit has insufficient funds to cope with the demand; the amount of money it costs the State to have these patients treated abroad; and the amount of money it would cost to have them treated at home.

No patient is refused a bone marrow transplant in St. James's Hospital on financial grounds. I am aware that there are restrictions on the number of transplants performed which is entirely due to the physical capacity of the unit. The hospital are at present examining the bed distribution which will pertain when the new in-patient facilities come on stream next year. It is hoped that the capacity of the unit can be extended in this context.

The average cost of a bone marrow transplant at home or abroad is approximately £25,000.

With respect, I do not think that the Minister has answered the question. I asked if he would agree that it is wrong to say that nobody has been refused on financial grounds when the very physical restrictions about which he talked and the lack of staff are a matter of finance which is causing people to be turned away from this unit. How many people have been sent for treatment abroad?

I do not have the number of people who were sent abroad for treatment.

That is the question.

I do have the number of cases treated in St. James's Hospital. In 1986 there were 16 cases treated, in 1987 16 cases and in 1988 an increase to 18 cases.

Will the Minister agree that people have been sent abroad because there were not sufficient facilities available at St. James's Hospital to treat them?

This is repetition.

I understand that people have been sent abroad. As I pointed out, the position at St. James's is limited by the physical space available and this situation will remain unchanged until the in-patient element of Ward 1c is opened. Even then there may not be additional space available as the ultimate location of the new bone marrow transplant is to be in phase two of St. James's, the building of which has not yet commenced.

Did the Minister indicate that the cost of having a bone marrow transplant is the same abroad as it is here? In other words, the cost to the State is the same in St. James's as it is in a hospital in England.

Yes, it would be approximately the same.

The Minister indicated in his reply that there may not be extra capacity even when phase two is completed. In view of the fact that numbers of people are being sent abroad and the Minister's concern, will he consider giving priority to the development of this site?

The bone marrow transplant unit will be in the new phase of the hospital and it has not yet been started. As the Deputy is aware, the 450 bed hospital is built and part of it has been opened, including the X-Ray Department. The out-patients' unit will be opened later on this year, the equipping of the major hospital with 450 beds is taking place and I hope it will be opened early next year. The bone marrow transplant services are difficult to organise because of their complexity and because of the fact that there are so many different disciplines involved. For example, St. Luke's are involved in regard to total body irradiation and the Children's Hospital, Crumlin, are also involved. We are anxious to ensure that everyone in this country can avail of a service but at present there is no total body irradiation for children and we are trying to rectify that position. Recently a new linear accelerator was installed in St. Luke's Hospital for that purpose.

The Minister said that the cost was approximately the same for treatment at home and abroad. Is he saying that the out-of-pocket expense to the Exchequer is the same in both cases or is he talking about the average cost per patient treated being the same in the British and Irish systems? Is he saying that the marginal cost of treating a patient in Ireland is £25,000 and that the figure is the same for treatment in England? It is surprising if that is the case.

I do not have a breakdown of the costs in each case but my understanding is that the sum of £25,000 refers to the cost to the Exchequer.