Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

Yes. I am sorry I was not here for the start. I could say I was caught in traffic but I was getting coffee so I might as well be honest. Honesty is the best policy.

The Minister of State is welcome. I thank him for appearing before the committee. We have previously commented on the fact the Minister is not available but in the circumstances, and given the lateness of the time we adjourned last night, I will not go down that road. We thank the Minister of State for being here and for outlining the Supplementary Estimates to us. I have a number of questions which I will run through and ask him to reply to them together.

In the briefing note, we have been given a rough breakdown of the €529 million and how it is spent. I am looking for a more definitive breakdown, specifically of the €220 million that is spent in acute hospitals. How much of that was spent on agency staff? The focus is on the €346 million in savings to be achieved. I have questioned people from the HSE about this previously. Where did the figure of €346 million come from? A formula must been used. How was it calculated? What research went into it? How was that conclusion arrived at? It was unrealistic and it was not reached. It was missed by quite a long shot. Whatever planning went into it was not sufficient. I am also curious to know - the HSE could not give me a definitive answer - where the figure came from. We all heard the tapes of the fellas telling us where they got the figures for banking. I sincerely hope these figures did not come from the same place. Can the Minister of State indicate how the figure was arrived at?

The Irish Fiscal Advisory Council, IFAC, informed us that overruns in health have averaged €500 million per year in current spending terms and that, in 2018, the overrun would be €600 million. Is it not then the case that the health service has been underfunded to the tune of approximately €500 million per year since 2014? We cannot keep having overruns and Supplementary Estimates and get to the end of the year and say we are not being underfunded. One does not need to be a mathematical genius to figure out that if we keep overrunning, we are being underfunded. The IFAC stated that health budgets should be well-founded and credible. It further stated that weak planning and spending controls account for the genesis of many of the problems. I am interested to know how spending €234 million so far this year - or €866,792 per day - on agency staff fits into a well-founded or credible budget. Similarly the council stated health overruns are being masked by unexpected corporation tax and interest.

The council also states that as the top ten companies account for roughly 40% of all corporation tax receipts, unexpected revenue from this source should be deemed to be transient. We cannot rely on this revenue but it seems that we are relying on it. With that in mind, I ask the Minister of State to outline the Department's view on its duty to fund health in a responsible manner. If one ran one's house in this manner, one would find oneself in MABS. This is no way to run a household budget, never mind a massive budget for a very high spending Department.

Immediately after the budget last year I said, as did others, that not enough money was being given to the health service to allow it to even stand still. The budget was inadequate in terms of current service levels. We could talk all day about the inadequacy of current service levels but there was not enough money to even maintain them. Weeks later, the then head of the HSE, Mr. Tony O'Brien, wrote to the Minister and said that the HSE was being under-funded for 2018 to the tune of hundreds of millions of euro and that has turned out to be the case. I am no fortune teller because if I were, I would pick the lotto numbers and leave this House. That said, I could see that the budget was inadequate and I pointed that out at the time. A few months later, it was also pointed out by the director general of the HSE. At what stage in the year did the Department become aware that the health service was under-funded? The Department was not going to take my word for it but Mr. Tony O'Brien wrote to the Department about this. It strikes me as odd that he would have to write such a letter and that the powers that be would not be fully apprised of the position and aware that there was going to be a shortfall. I was not the only person who pointed it out but when I did so, I was dismissed. I was right, however. I will not say it gives me no pleasure to say that because we all love to be right but if I could see it and Mr. Tony O'Brien was flagging it, when did the Department become aware of it? That is material to how we keep finding ourselves in the same position at the end of the year, every year.