Jim Daly (Cork South West, Fine Gael) | Oireachtas source

Yes, but it is a demand led service. Deputy O'Reilly said that she does not have the power to tell fortunes or see the future and nobody on the other side of the House has that power either. We cannot accurately predict how many people will present at accident and emergency departments or primary care facilities, how many people will require surgery and so on. We cannot predict what new drugs will become available in any given year, how many people will require those drugs, whether they represent good value for money, what they will cost and so on. There are lots of unknowns and variables from year to year in any health budget. Ireland is not unique in that regard.

The demand led aspect of this makes it very difficult to quantify the budget required. Something that may not be told as well as some of the other stories in the health service is the fact that there has been a significant increase in the amount of activity within the health service in recent years. A very significant number of procedures have taken place and there have been enormous increases in day case activity and hospital admissions. I know from my area that there has been a significant increase in the activity of child and adolescent mental health services, CAMHS. Approximately 26,000 people are being seen by CAMHS every year, which is a very significant increase. The numbers waiting to be seen are continuing to increase but the full story must be told by pointing to the increased numbers of people who are being seen and treated. That is where we get the real picture. This is relevant to the issue of trolleys too. I feel very strongly that the focus on trolleys is misguided. It is so easy for politicians and those in the media to obsess about trolleys and trolley figures. The real issues are how long people are waiting and delayed discharges. We need to work on the numbers coming out of hospital and what is preventing them from being discharged. For too long, we have been looking at how many people are blocked on the way in to hospital when the real focus should be on those whose discharge is delayed because of a lack of transitional care in the system.

The Deputy's point about reliance on corporation tax belongs to a broader debate involving the Department of Public Expenditure and Reform. The issue is in the news again because there has been another unexpected increase in corporation tax receipts. It is accepted by all Departments and the Government as a whole that corporation tax receipts can go up and down significantly. We have seen that happen and will not be building in a reliance on such receipts. I do not think there is a direct correlation between the funding of the HSE and the amount of corporation tax collected. It just so happens that both are in the news at the moment.