Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I am not saying Deputy O'Reilly or any other member suggested that. There has been an issue in our health service regarding the non-collection of fees owed to the State. That is not my view or a political view, it was the view of the Comptroller and Auditor General in his 2015 report. It is appropriate, therefore, that, in its service planning every year, the HSE sets out its expectation as to what the revenue level is likely to be and an expectation that managers would bring in that funding. If we, as an Oireachtas, want to change this, that is fair enough.

On capital spending, Deputy Kelleher is correct in the sense that there is clearly huge pent-up demand for capital investment. I welcome that the Sláintecare report examines not only the revenue side of the health service but also the capacity side in terms of capital. We can address this issue through the ten-year capital plan. I say that for a number of reasons. If we decided to build a number of major new hospitals, ambulatory care centres and so on, there is a significant lead-in time in that regard in the context of planning, tendering, etc. In this regard, a ten-year plan provides more flexibility and scope to the health service. I would not like to interfere in any other ministerial area in terms of the conversations which the Deputy suggests should happen with the European Union regarding fiscal rules and how they are applied to capital. I am satisfied that the ten-year capital plan will provide us with a vehicle for advancement of the bed capacity report, when concluded. As correctly highlighted by Deputy Kelleher, trying to develop a major project with a two, three or four-year envelope is very difficult and not practical. These are projects that require a multi-annual approach. The assurance of funding on an annual basis allows for better planning.

Seven staff in my Department are working on Sláintecare under the direction of a deputy secretary general. The lead executive, when he or she arrives, will head that process. Deputy Kelleher asked about my involvement in this area versus that of the Taoiseach, an issue on which I have previously engaged with the committee. In terms of my understanding of the committee report, it provides that the programme reform office should be accountable to the Minister for Health of the day but also that the office should be under the auspices of the Department of the Taoiseach. Without getting into a definition of the word "auspices", if this office is to be accountable to me, as Minister, and to whoever comes after me, there is a way that needs to work. I want to assure the committee that the Department of the Taoiseach is involved in the steering groups and in the Cabinet sub-committee, which is chaired by the Taoiseach. When the lead executive arrives, we will do all that is required to ensure that the process is robust. We need a whole-of-Government approach to this. I do not dispute that.

In regard to the cancer reform programme, which, as a country, we can and do hold up as a really good example of cancer reform, the lead on this programme worked for the HSE and was not based in the Department of the Taoiseach. We managed to make incredible changes. We should not get too tied up in the physical location of the office, although I accept that people want to know that Sláintecare is supported at a higher level than that of line Minister.

Deputy O'Reilly made the point that we designed the consultants' contract.

On the issue of who designed it, I want to be clear that neither I nor the Government designed the consultants' contracts position or the public-private mix. I am determined to help us get to a better place in that regard in accordance with Sláintecare. I would not have designed it like this and I am not happy with the public-private mix.