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

Strategies are not much good without budgets. I am not being flippant but this is important in terms of the governance structures being put forward. Who will be responsible for formulating the budget for 2013 and who will be the accounting officer with responsibility for oversight of the spending of the budget? I do not understand the situation. Will it be Mr. Tony O'Brien or Dr. Ambrose McLoughlin as the accounting officer for the Department of Health? The lines of demarcation are blurred. We had cases in recent weeks where claims were made that the HSE introduced the proposed cuts of €130 million. We were told subsequently by the HSE that it was a Government decision. It is critically important that in the coming months we learn who is responsible for expenditure and oversight of the budget and who is ultimately the accounting officer. There is not much point in my going into the Dáil blaming the Minister for Health if it is not his fault, if a decision has been made by the HSE and if its board is still making decisions. We must have such information.

I do not expect a comment on the broader issue of primary care but it is a critical part of the overall strategy to remove patients from acute hospitals and to work through the primary care setting to ensure patients are treated as close to home as possible. Where does Dr. McLoughlin envisage funding will come from for physical infrastructure in the future in terms of the capital infrastructural development required for primary care settings throughout the country? Does he expect public private partnerships to be involved in some way or will the development be funded through a capital programme from the State's coffers? Those two issues are important.