Mr. Tony O'Brien:

I shall start by addressing the issue of the language used in the introduction to the service plan because much is being made of the issue. It is important, therefore, that I put the matter into context.

Until the Cabinet meeting in the relevant week in December, the level of deficit risk associated with the numbers in the service plan was unacceptably high. It derived from the €113 million figure for probity measures, which I made clear was not deliverable, and the figure of €108 million, in respect of which we do not yet know the method by which it will be deliverable. There is, therefore, a figure of well over €200 million in respect of risk. If it had been necessary to publish the service plan with that level of risk, it would have brought with it almost an inevitability and certainly a strong danger of a precipitative mid-year financial crisis this year. If there were to be such a crisis, the health service would be forced to take immediate corrective action, much as it has done in years past. Recent history demonstrates that this would leave the health service with very little room for manoeuvre and would likely create the conditions in which the only measures that could be taken would be those that would have a direct adverse impact on the level, quality and quantum of care provided for the most vulnerable in society. In that context, the version of the introduction prior to the relevant Cabinet decisions stated it would not be possible to meet "critical service priorities". It did not refer to the possibility of meeting all of the demographic pressures. The words that have changed are not, therefore, the words the Deputy believes were changed. I deleted a reference to it not being possible to meet critical service priorities because I no longer believesd there was that level of risk in the light of the changes made. Instead, the language members see in the service plan is consistent with what I have said previously and today at the committee. This section of the service plan carries my signature and consequently reflects my opinion on the overall position of the service plan. The words used previously in the plan were mine in the context of the risk there would have been without the key decisions made. The words used in the current plan are mine in the context of the actual service plan. I know there has been much reportage in one newspaper, but I share the Minister's view. As we will see when we discuss the issue of reference pricing, there are distinct dangers in taking newspaper reports at face value.

I ask Ms McGuinness to comment on the issue of cochlear implants, after which I will address the other issues raised.