Mr. Liam Woods:

In response to Senator Burke's question about the 42 audit reports, we publish our audit reports six-monthly in arrears. They are a matter of public record. In terms of the Senator’s points about the nature of the issues arising through those reports, the audit committee in the HSE tracks and reports them. We could probably synthesise those to give the committee a view of the type of issue we are considering and the compliance with the resolution of those issues. There is no problem about that per se. If it is of help to the committee, we are happy to do that.

I will ask some of my audit colleagues to comment on costs and loss. They are not always about costs and loss, but to the extent that we can make such an observation we will of course do so.

In respect of the end-of-year budgets in hospitals and the use-it-or-lose-it mentality regarding resources, there has been a deliberate desire to move away from an environment in which that is a practice. We have done that very deliberately because we have a strong view that we want to incentivise and encourage hospitals to live within their resources and not to penalise them for running a small surplus. We do not want to live in a land where we always have deficits in hospitals and the incentive is to spend money, and spend more than they have. The most strategic move taking place that will affect that is the move to an activity-based funding approach whereby we will increasingly fund hospitals for what they do, not what they spend. We will use comparative analysis of the costs of similar services across the country to inform that, and work is under way on that. The Minister may have mentioned it to the committee. Our activity-based funding strategy will influence how we resource hospitals and will move us further from the use-it-or-lose-it mentality, which we have no desire for within the system.

I would need to get further detail to answer the Senator’s question about prescriptions. I have not come across it and I do not know if the audit section has come across it, but I would be interested in getting more information from the Senator on it.