Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I agree with much of what Deputy Durkan stated. One of the things we are lacking in the health service is data. I think that is the reason the Sláintecare committee put such a focus on ehealth. I am pleased that we are going to be able to deliver the ehealth agenda in full because of the ability it provides in tracking that to which Deputy Durkan referred in terms of where the blockage lies. If one has a clinical director in a hospital who realises there is congestion in the emergency department, he or she should be able to check on the needs of the patients and say, whether, for example, there are 20 people in beds who need MRI or CAT scans and that if they get those scans, 20 beds will be freed up. The inability to have all the data collated is a blockage in the system and the ehealth agenda is very important in that regard.

I very much welcome the agreement that has been reached at the Workplace Relations Commission in respect of section 39 organisations. I hope it will bring stability and certainty to the staff working in the sector and to those for whom they care and provide services. That is something we welcome. I thank SIPTU, led by Paul Bell and others, for their further engagement.

On the overrun or overspend, I will provide some figures. The Estimates for 2018 provided for gross expenditure of €15.332 billion for health services. Of that, €14.839 billion is for current expenditure and €493 million is for capital expenditure. The last available position at the end of June shows that the HSE's income and expenditure position is €341.7 million above profile. While there are offsetting surpluses and deficits, to respond to Deputy Durkan's question, a large proportion of the overall deficit is in the acute hospitals division. As regards the exact figures in Tony O’Brien’s letter or anybody else’s commentary, we do know yet because the year is not yet over. I have said on a number of occasions that there will be an overspend or an overrun, whichever way one wishes to classify it, and that will need to be addressed. The Minister for Public Expenditure and Reform and I are seeking to address it and I hope the matter can be resolved in the coming days.

When the HSE publishes a service plan, there is a legal requirement under the legislation for it to say that it is going to deliver said plan within budget. It knows the funding available at that stage. While I accept the point made, it is easily conflated with a failure to deliver everything within a service plan. In fairness, Deputy Durkan is not doing that. People have legally signed up to deliver the service plan with the knowledge of the funding they have available.

I will ask Ms Magahy to comment on Sláintecare, staffing and how she intends to proceed. She replied to Deputy Donnelly on the issue. I respect the processes being undertaken by the INMO and the PNA and I do not want to say anything to interfere with their consultation with their members. It is important that the process runs its course before I make further comment, other than to make one point. In terms of recruitment and retention, there is a retention challenge in particular for nurses and that is what the Public Service Pay Commission found. We are putting forward proposals in line with what the Public Service Pay Commission said to try to address the challenges. The new entrant pay agreement will ensure the pay of new, often younger nurses restored to an equivalent level to that of their colleagues. That should be welcomed by nurses, teachers and other sectors. I am pleased agreement has been reached in that regard. We also want to see somebody be able to become a senior nurse quicker than is currently the case. There is a financial benefit to that, and also to the specialist qualification allowance. I will not interfere in the process but nurses will have to make an adjudication on those proposals. The executive made comments on that in the aftermath of the EGM but that needs to go through a process and then we need to engage.

Mr. Duffy, of the Public Service Pay Commission, does also say in his document that there may also be at some point in time, which he does not specify, where there should be further engagement. He specifically references Sláintecare because, as the Deputy correctly indicated, the delivery of Sláintecare will require healthcare professionals, including nurses, and may also require people to take on different roles and tasks and to work in different structures. I am conscious that the line is there in the report of the Public Service Pay Commission and I am eager to explore it further but I am respectful of the process.