Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I welcome Dr. McLoughlin and wish Mr. Tony O'Brien all the best as director general designate of the HSE. The health system is going through a transformative stage in terms of governance of the HSE; in effect, it is bringing it back closer to the Department. The HSE will be challenged with significant difficulties this year in terms of a further budget reduction of €700 million to €750 million, which will have an impact on the capacity of the HSE to deliver health services.

It is important that we get clarity on the issue. I accept legislation is in place on governance structures and the current lines of demarcation. The HSE is facing a budget. Last year's budget has not lived up to the profiling of expenditure and the outturn to date. As far back as last March it was evident that the budget was not sustainable. At a meeting of the Committee of Public Accounts last June Mr. O'Brien's predecessor was adamant that the premise on which the budget was based was no longer feasible in terms of revenue-generating measures such as insurance, cost reductions, price referencing, generic substitution and agency staff. Budget difficulties in terms of sustainability were evident from an early stage. At the same time claims have been made that a profiling system is in place which allows the HSE to monitor its expenditure on a monthly basis and to know which hospital budgets have overrun and when difficulties arise, whereas previously such information was only available on a quarterly basis. One could ask why it took until September to make any effort to address the overrun. It is said that, traditionally, it was the case that when the HSE overran its budget supplementary support was always available at the end of the year.