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Written Answers — Department of Health: Health Services Staff (8 May 2024)

David Cullinane: 631. To ask the Minister for Health the awards made following a tender process to external non-medical consultants, by firm, by his Department in 2016 to 2023 and to date in 2024, inclusive, in tabular form; the purpose and a brief description of the awards; the value of the awards and the total amounts paid; the timeline or timeframe of the contracts; and the desired or completed output....

Written Answers — Department of Health: Departmental Contracts (8 May 2024)

David Cullinane: 632. To ask the Minister for Health the awards made without a tender process to external non-medical consultants, by firm, by his Department in 2016 to 2023 and to date in 2024, inclusive, in tabular form; the purpose and a brief description of the awards; the value of the awards and the total amounts paid; the timeline or timeframe of the contracts; and the desired or completed output. [20820/24]

Written Answers — Department of Health: Health Service Executive (8 May 2024)

David Cullinane: 633. To ask the Minister for Health to outline, in tabular form, all HSE expenditure on outside firms, including outsourcing of care, assessments, recruitment, diagnostics, legal, professional and consultancy fees and any other service delivered for the HSE by a non-HSE organisation (not including Section 38 organisations) for the years 2016 to 2023 and to date in 2024. [20821/24]

Written Answers — Department of Health: Health Services (8 May 2024)

David Cullinane: 634. To ask the Minister for Health to outline, in tabular form, all expenditure by each Section 38 organisation on outside firms, including outsourcing of care, assessments, recruitment, diagnostics, legal, professional and consultancy fees and any other service delivered for that organisation by a non-public organisation for the years 2016 to 2023 and to date in 2024. [20822/24]

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: We were asked to email in, so I emailed in a couple of issues and they were covered, to be fair. Maybe there was an oversight somewhere along the way.

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: I welcome the witnesses. I will start with Mr. Watt. I have a lot of questions and may not get through them all. First, I am looking for a straight answer and a figure, if he has it, on spending for the first four months of 2024. Is it at profile, behind profile or ahead of profile? Is there a figure?

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: That is €500 million in additional spend. What is driving that?

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: We were told by the Minister there was a performance management review. There is a structure in place to achieve efficiencies. Mr. Watt spoke of productivity and savings, so people will be surprised. Figures have been put in the public domain concerning savings that will be achieved in agency spend. A recruitment embargo is in place, and I do not agree with that. There were savings to be...

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: A less diplomatic answer would be the health service did not get the budget it needed for 2024 and we are now seeing the fruits of that. Four months in and it is already €500 million short of profile. Is it at this point a racing certainty there will be significant Supplementary Estimates in health by the end of the year?

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: Will it be close to €1 billion or more than €1 billion? What is the estimated figure?

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: I know that.

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: I make the general point I have raised at this committee and publicly that funding for existing levels of service for health in 2024 was grossly underestimated. The deficit for last year was quite significant and very little of that was put into the base for 2024. It was always going to be the case we would quickly see spending ahead of profile in health, and that is what we are seeing. It...

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: Would Mr. Watt take my point-----

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: Would Mr. Watt take my point about the south east as an example?

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: Does Mr. McCallion want to come in quickly on that issue?

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: As a general point, while there is a logic in the small hospitals framework, a commitment was given to build a centre of excellence in Limerick. Closing three emergency departments and having one emergency department servicing the region clearly has not worked if we look at all the issues that have arisen. Of course we need additional capacity in Limerick. We need to broaden our horizons...

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: What I am saying is that we are now in May. I have been contacted by healthcare trade unions and have met many hospital managers in recent months and the issue of pay and numbers has come up. Staff in the health service are becoming increasingly frustrated with the recruitment embargo. It is having an impact. When I talk to people on the front line, including hospital mangers, nobody...

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: Is this caught up in tension between the Department of Public Expenditure, National Development Plan Delivery, and Reform, and the Department of Health?

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: What is the next stage then? There is a paper with the Minister. Mr. Watt is saying there are a number of options. What next? Does it go to Cabinet?

Joint Oireachtas Committee on Health: Implementation of Sláintecare Reforms: Department of Health and HSE (8 May 2024)

David Cullinane: I will finish by saying it is unsatisfactory that we are into May and we still do not know what the pay and numbers will be for the health service. No manager can plan and we cannot hold anybody to account. We do not know what the final outworking of it will be regarding additional recruitment. I have a quick final question. The figure of 2,200 of net additional increase has been put...

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