Mr. Tony O'Brien:

The strategic framework referenced earlier contains a specific commitment to increase the age range for BreastCheck to encompass the 65 to 69 age range. The framework envisages it happening before 2015. I think it will be in 2014. A number of questions concerned the connectivity between what we might loosely called cutbacks elsewhere and the impact on emergency unit attendances. The number of attendances at the emergency unit reported relate to a period that predates the impact of the recent cuts so it is unlikely there is a direct connection. In other jurisdictions, particularly our neighbouring jurisdictions, there is an increase in emergency unit attendances, presentations and admissions. There is a great challenge for health services in Europe in respect of emergency unit avoidance measures and how to redirect to an appropriate alternative persons whose best care may not be in an emergency unit. That is a priority for us as we examine the resources available to us and the increasing utilisation of emergency units. What is more important is that those who present at emergency units are dealt with expeditiously and appropriately. This is why we have a focus on reducing the number of people recorded on trolleys as awaiting admission. Significant progress has been made this year although we are not satisfied that we are where we need to be. In the coming year, in particular, we will focus on the reduction of the journey time through emergency units in order that the great majority of patients are either sent home or admitted within six hours. In other jurisdictions they managed to reduce it to four hours but they have been working on this for longer than our programme has been under way.

With regard to the questions on financial matters, one question concerned procurement, another referred to cost saving measures and a third referred to the make-up of outstanding insurance claims. I ask Mr. Liam Woods, the director of finance, to address these. The overrun reported in the month of September in community schemes was, in a straightforward manner, the cost of the increased number of medical cards over and above the numbers provided for. The sum of €29 million is part of a cumulative figure of the year to date to the figure of €180 million to the end of September. There are no measures available to us to curtail costs because they are demand-led schemes. The cost containment measures are outside that area and I will ask Mr. Liam Woods to address that also.