Brian Lenihan Jnr (Dublin West, Fianna Fail)

This increase was above average. The Deputy refers to cutbacks in the context of a budget which was increased by 13.6%. The chief executive officer's introduction to the board's 2004 service plan acknowledges that the increased funding is substantial. He is correct. The increase represents the third highest increase provided in 2004. The Minister recognises the pressures on the board due to demographic shifts, maternity service demands and the increase in the numbers of non-nationals receiving services. Nevertheless, the increase in the board's funding base since 1997 has been significant by any measurement. The overall increase in funding for all health boards between 1997 and 2004 was €5.2 billion or 196%. The comparative figure for the North Eastern Health Board was €383 million or 231% which has been the largest increase in day-to-day funding of any health board. The next highest increase was219%. In part, the increase represents an acknowledgement of the Deputy's point concerning the lower base level of funding in the North Eastern Health Board in 1997.

It is generally recognised that a major reason for the low funding base has been the board's rate of referral to acute hospitals in the Eastern Regional Health Authority area. This is the highest rate of any board for in-patients, elective in-patients only and day cases. In the case of day patients, the referral rate from the North Eastern Health Board is twice as high as that of the next highest, the South Eastern Health Board. This statistic has an obvious impact on the allocation of funding to the board. The Eastern Regional Health Authority's hospitals carry a significant financial burden for the treatment of patients from the North Eastern Health Board.

I wish to outline some of the service issues addressed by Ministers since 1997. Acute hospital funding has allowed for a 26% increase in patient discharges, more than 10% of which relate to in-patients. Day cases recorded an increase of 86%. This compares with a national average increase of 23% in discharges overall, with 4% in-patients and 64% day cases. Additional funding of more than €24 million has been provided for services for older people including in particular provision for nursing home subventions and home-help services. Cancer services received increased funding of more than €9 million to support the 130% increase in admissions since 1997. Cardiovascular services have received additional funding of almost €5 million to support a 32% increase in admissions since 1997. The North Eastern Health Board's employment numbers increased considerably in recent years. Between 2002 and 2003, an additional 1,782 posts were approved giving a staffing complement of almost 7,000 posts at end of 2003. Some 780 additional staff have been approved for the region's acute hospitals since 1997, of which more than 100 were consultant posts.

These are some of the more significant issues addressed over the past years. It remains the position that the board has been more than fairly treated in the period in which this Government has had responsibility. The Minister and his officials have always and will continue to work with the board to seek solutions to emerging problems. A record of increased services supported by a now significant funding base is testimony to this. The objective for 2004 is to again work with the board to achieve a quality service for its clients while utilising the funding base efficiently and effectively.

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