Dr. Ambrose McLoughlin:

I want to be clear that my immediate predecessor and I have at all times acted on the advice of the Attorney General in dealing with this issue. We report to the Minister on it and I am sure the Ombudsman would recognise my duty of care for the resources of the State. These are the taxpayers' resources and I cannot and will not create precedents which would subsequently expose the State to high levels of payments that could not be justified.

To the best of my knowledge, approximately 240 cases relate to fees paid on private nursing homes. I understand we are predominantly dealing with the estates of individuals rather than actual clients. The clients or their estates are entitled under the Constitution to pursue cases and once they do so, we are in an adversarial system. My Department must act prudently and properly in line with the advice of the Attorney General. Before engaging in such litigation, we brief our Ministers fully and both the Minister for Health, Deputy Reilly, and the Minister of State at the Department of Health, Deputy Kathleen Lynch, are fully aware of these matters from a legal perspective.

We are dealing with different cases and expectations differ on the part of the various litigants. We have to consider each case on its merits to decide on the best defence. In the current economic climate, if we were to open the floodgates the consequences for the basic operation of our health service could be serious. The Department is funded by the Exchequer and the Oireachtas funds the health system. Whenever we are faced with legal challenges that have financial consequences, we are required to exercise a duty of care in respect of the State. We do that through the Attorney General's office. It is a matter for the committee and the Oireachtas to decide how much to spend on the health service and I am accountable as Secretary General for ensuring these matters are dealt with in accordance with the best evidence-based governance practices.

We have, however, provided a considerable amount of information in response to parliamentary questions. Since the litigation commenced in 2005, for example, we have already reported on a total of 33 cases involving fees paid to private nursing homes which were settled at a cost of €1.2 million. I face serious constraints when it comes to discussing legal fees. I cannot provide details on legal costs, but we are represented in the usual way by the Office of the Chief State Solicitor and the Attorney General. The Department fully complies with all financial and accounting procedures, including those required by the Comptroller and Auditor General. There is a proper accounting and reporting structure.