Mick Barry (Cork North Central, Anti-Austerity Alliance) | Oireachtas source

I would like to revisit the issue of unrealistic stretch income targets. The programme for Government states: "Service providers who fail to meet their targets and who do not engage fully with the new unit will be obliged to use their own budgets to ensure targets are met with the assistance of private sector providers." Hospitals basing themselves on an income stream from the State and an income stream from private practice is not new, unlike the issue of new targets. I am interested in the exploring the targets in the context of the comments of Mr. Carter that the stretch income targets are unrealistic. For example, the RSCI Hospitals Group submission states that the population in its catchment area has increased from 640,000 in 2002 to 817,522 in 2011 and it is projected to reach 875,000 by 2021. That is an increase of more than 27%. Has there been a commensurate increase in budgets? If not, how big is the shortfall? If the group is forced to fill the gap between State income and unrealistic stretch targets, what menu is available to Mr. Carter to generate private income? Is it solely down to income from private operations? To what extent might it involve borrowings and building up debts, which has been the experience with trusts in the UK? To what extent could that become a factor here?

The programme for Government states with regard to the issue of trusts:

We will advance progress made on Hospital Groups before strengthening their capacity to be stand-alone statutory Trusts. Hospital Trusts will gain greater autonomy (own their own assets, manage recruitment)...

Can the witnesses give us more information about how the trust system will operate? Is it the intention to get trusts to compete for funding and-or to move them off balance sheet? Where is this process at currently?