Mr. Tony O'Brien:

A number of questions touched on the issue of the Estimates and the service plan, such as the question in respect of bilateral cochlear implants or what we can do about addressing the issue of delayed discharges for persons whose acute episode of care has been completed but who need to remain in a bed. As Deputy Ó Caoláin noted, at any given time there are many hundreds of such people, roughly equivalent to a medium-sized hospital. All these issues will form part of the service planning process. Our room for manoeuvre in respect of the service planning process is highly constrained and a €666 million challenge has been set out in the Estimates day announcements.

In addition to that, our own assessment of the impact of the demographic challenge on our service and the need to address very significant deficits in the critical range of services that we are currently able to provide, in our view, mean that the challenge we have to address in the service planning process is broadly equivalent to €1 billion, in other words, the swing that is required is broadly equivalent to €1 billion. It is important to stress that in seeking to address all of these key issues we do have that very significant challenge.

A question has been asked about the €113 million probity. There was a probity measure included in the 2013 service plan. It had a €10 million element attached to it. That has carried forward. Therefore, that needs to be added to the €113 million in that context.

As the Minister outlined, the health side in the discussions was very clear that, in relation to that measure and in relation to pay-related savings which is substantially the Haddington Road agreement, we saw the need for an objective verification process to establish where the risk lies in relation to those issues. For our part, in the Health Service Executive, I have already commissioned both our internal HR and finance functions, supported by PA Consulting, to carry out a thorough risk assessment against those two challenges. As I stated previously, a probity figure of €113 million does not in any sense affect the individual rights of persons who would already have been eligible for medical cards. It will not affect the way we approach the assessment. Therefore, if that €113 million cannot reasonably be expected to be produced from a probity measure, then an alternative way of meeting that shortfall will have to be found. That also applies in the pay-related area. We are carrying out a thorough assessment which will be fed into the process that the Minister has already described. I emphasis that the next few weeks, in terms of service planning, are very challenging and absolutely critical.