James Reilly (Dublin North, Fine Gael) | Oireachtas source

We did not interrupt Deputy Kelleher, so perhaps he would be good enough to leave us to make our contribution uninterrupted.

Deputy Caoimhghín Ó Caoláin asked from where the €113 million figure for medical card probity had come. The figure provided was €133 million. A sum of €20 million was provided for in the original Health Service Executive plan and a study conducted some time ago by PwC identified the possibility of making savings of between €65 million and €210 million. We pointed out at the time that these estimates were highly speculative and indicative only. The figure of €113 million is somewhere close to the mid-point of the PwC estimate. That is the answer to the Deputy's question.

I was asked when we could expect general practitioner care to be available for children aged under six years. It will be available somewhere in the middle of this year. Legislation is required, as is a new contract to reflect the new arrangements.

Deputy Caoimhghín Ó Caoláin has stated virtually nothing has been done on the issue of reference pricing. A substantial amount of work has been done on the issue and a considerable amount of money has been saved. There are many considerations involved, including the role played by the Irish Medicines Board, Professor Michael Barry and others in achieving savings in the drugs bill. Mr. O'Brien and Mr. Hennessy will be able to address the matter in a much more detailed manner.

The Deputy referred to extraordinary waiting times under the fair deal scheme. The average waiting time is in the region of three weeks. The reductions in funding for the scheme are being used to provide more places for additional home care initiatives. This could result in upwards of 1,000 people being able to stay at home, rather than ending up in long-term care. We are, therefore, exchanging 700 long-term care places for approximately 1,100 additional packages that will enable people to stay at home. This approach makes financial sense and is much more sensible from the perspective of the client and system. People do not want to go into long-term care before they need do so. If we can introduce new and innovative methods to help and support them to stay at home, we should take that route.

The Deputy referred to the Department making available funding for cochlear implants. This was a priority of mine and several members of the joint committee. I will ask Ms McGuinness to discuss the issue in detail.

I was asked also what was meant by the figure of €108 million in unspecified savings. I explained this matter, but Mr. O'Brien will discuss it in greater detail.

I am not sure what Deputy Séamus Healy meant when he described the budget as unsustainable for a third year in a row. In the past three years the number of people enduring long trolley waits has reduced by 34%. While there is always a blip at this time of year, members should bear in mind that three years ago this month 569 patients were lying on trolleys on a given day. Under the Government, the number of patients on trolleys has not come anywhere near that figure. The current figure is in the mid-300 range and in the first ten days of this month has reduced by approximately 10%. Ward Watch is a separate method of addressing additional spaces being taken up in hospitals. As the Ward Watch figure was not available to us last year, it is not possible to compare figures using that measure. One can, however, compare the number of patients on trolleys. We count the number of patients on trolleys in a hospital, rather than in the emergency department only.

Deputy Séamus Healy asked about the figure of €56 million for cost containment measures in hospitals. The officials from the HSE will deal with that issue in more detail. The Deputy also referred to savings of €7.5 million that are to be achieved through hospital reconfiguration. Obviously, savings can be made by having groups of hospitals working together in terms of how they organise their staff, etc.

The appointment of the boards of the hospital groups is imminent. I will leave the matter of agency costs to officials from the HSE. Deputy Séamus Healy correctly pointed out that he had raised this issue before Christmas.

It is true that the income limits applying to medical cards have remained unchanged since 2006. While one would have expected them to increase in 2007, 2008 and 2009, one would not have expected them to increase since, given the fall in inflation that has occurred. I should point out again that the number of medical cards is at its highest ever level.

I addressed the issue of mental health when I noted the additional funding and staff provided for this area which has been the Cinderella of the health service for many years. The Government has sought to address this matter and destigmatise mental health problems. For the first time, the new primary care centres have mental health facilities. We aim to have patients removed from the old institutions and treated in the community and to have mental health issues dealt with in the same way as any other health issue is dealt with. For this reason, a new psychiatric unit is being built in Beaumont Hospital to accommodate patients' needs and ensure they do not have to go to old institutions located at the end of peninsulas. These institutions would have been located out of sight and out of mind on islands if the authorities had afforded such an approach in those days. That it is the old way of addressing mental health issues. All members will agree with A Vision for Change, the strategy the Government is supporting and funding.