Mr. Colm Desmond:

The evolution of acute spending, which is essentially what the Deputy is referring to, is monitored throughout the year. It is certainly one of those areas, among others of which the Deputy will be aware, that have tended to overrun. It is, therefore, considered both in its detailed components, as the Deputy has described, and in its overall composite form. It is interrogated by the HSE centrally as part of the performance framework that I have described, and by the Department in its engagement with the HSE on whether a Supplementary Estimate should be sought. It is on that basis that the performance indicators do indicate, when the service plan is established at the beginning of the year, what the likely evolution of spending will be. However, it is not always the case that the various components of the acute sector, for example, can remain within that area, due to particular circumstances. The winter issues and Storm Emma, for example, had a significant impact on the acute sector this year.