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

I wish the Minister and his colleagues from the HSE and the Department a happy Christmas.

We are here because at the same time last year we pointed out that there were deficiencies in the budget arithmetic. I do not know how the Minister came to those conclusions, but he did and it was obvious from as early as March last that the budget was in rag order and was deficient in terms of trying to provide services. The Minister referred to demand led schemes, the increase in the number of medical card holders and other issues that could not be foreseen. However, as early as March this year the former chief executive officer, CEO, of the HSE, Mr. Cathal Magee, said that the budget arithmetic was no longer valid and that the premises on which it was based were also no longer valid. That is an indication of why we are here this evening, because it was identified last March. In fact, when one looks at the aspirational nature of the budget arithmetic last year, it was evident that unless Government decisions were made and legislation was passed early in 2012 the budget would be in difficulty from the start. I can point to a few issues such as hospital consultant pay, price referencing, generic substitution, agency staff and private health insurance recoupment. None of those issues was dealt with comprehensively or in a meaningful way by the Minister, the Department or the HSE by bringing forward the proposals that were a critical component in the arithmetic of the Estimates the Minister presented to the House last year. It is for those reasons we have always maintained it was a flawed budget from the start.

We are now ramming through a €360 million budget overspend. Only a couple of months ago people with intellectual and physical disabilities were outside the gates of Government Buildings protesting at cuts that were miserly in terms of the overall budget. If the budget had been reined in, as had been warned in the previous March, they would not have had to be there and the Minister could have gone about his business in a more orderly fashion, without forcing people to take to the streets to hold onto their basic rights.

Actually, it was not just their basic rights. We were not asking for much, only for people to retain their special needs assistants, SNAs, home care packages and home help hours. Overall, the figure amounted to approximately €40 million in a full year.

What savings have accrued from the reduction in home help hours and what contribution have they made to the budget overrun? Tonight, we will pass a €360 million Supplementary Estimate. This is the key issue. The overrun was forewarned. It is not as if the Minister woke up in mid-October and realised that there was a budget overspend. While there was an increase in medical card applications and other demand-led schemes where judging demand proved difficult, that there would be an overspend was pointed out to the Minister as early as March.

We have heard this before. Some €45 million is being clawed back from the Medical Defence Union in a one-off payment. We are clawing back an upfront payment from health insurers to bring those moneys into this accounting year and to ease pressure so that the Supplementary Estimate is €360 million as opposed to €500 million. However, we are only buying time. There is no point in any of us pretending that next year will be rosier. The fundamental principle of any budget is that it must be sustainable from the outset.

Distasteful cutbacks have been announced. There were other options, yet there was inactivity in the renegotiations with the Irish Pharmaceutical Healthcare Association, IPHA, and a reversal in a commitment under the programme for Government. Just one line long, that commitment was made with a great deal of fanfare by the Minister, namely, a reduction in hospital consultants' pay.

The issue of agency staff was also identified. There is no point in the Minister claiming that he did not anticipate the number of people who would retire. Some 4,700 people left the health services. Of course a large body of people would retire. It had been well flagged for a year in advance. The Minister made great claims that many people would leave without services being disrupted.

For all of these reasons, it is difficult to believe that we will not be back here again this time next year. The Supplementary Estimate must be introduced, but the disruption endured by the many people who have been required to protest and advocate for their basic rights was unnecessary. I do not blame the Minister for every element, but he has stated that he is accountable. People are struggling to hang onto home help hours, SNAs and home care packages.

This is a false accounting exercise. The Minister has stated numerous times that the point is to move people from the acute hospital setting to step-down facilities or their homes as quickly as possible. However, all of the recent policies that the Minister has announced to try to address the budget deficit are contrary to what he has been advocating.

We are debating passing a budget of €360 million, yet we are already starting 2013 on false budgetary arithmetic. Consider the issues of price referencing and generic substitution. The €400 million was announced with fanfare, yet the saving in the three-year period will only be €190 million because of the deal on high-tech drugs and the quid pro quowith the pharmaceutical industry.

It is difficult to support the Supplementary Estimate knowing full well that we identified this budgetary approach as being flawed almost 12 months ago. It remains flawed and, unfortunately, we will be undertaking the same discussion this time next year because of smoke-and-mirror-type budgetary exercises.