Colm Brophy (Dublin South West, Fine Gael) | Oireachtas source

It certainly is a key issue. I appreciate it may sometimes be unfair to take one line from an opening statement, but I have a real problem with it. Mr Desmond said: “Furthermore, the nature of the health services is such that the normal budget management levers available to other sectors, such as reduction of services, are simply not available to us and consequently, overruns can and do occur.” People from other Departments would probably like to be able to use such a line. It seems the health services can manage within a budget if they choose to. With such a consistent overrun across so many areas, it strikes me that the operating practice was just to manage the fact that there would be an overrun. The normal type of operational management structures were not in place.

In the context of the Department of Health versus other Departments, it had differences of 1%, 2%, 4% or whatever. Let us consider the heavy hitters. The health area had an overrun of €655 million. The next biggest heavy hitting Department is the Department of Employment Affairs and Social Protection with an overrun of €139 million. That Department’s budget is €10.62 billion; the budget for the Department of Health is €14.871 billion. There is a major difference there. The overrun for the Department of Education and Skills is €181 million. While one can juggle around on 1%, 4% or whatever, it is a very substantial overrun.

It seems to occur due to a complete lack of ability to control or predict expenditure accurately. In the early part of the year the expenditure overrun seems to be relatively modest. It then seems to go out of control in the latter part of the year. If that only happened once, one might believe that something just went wrong there, but it happens almost every year. In some of the tables I saw almost the exact same pattern of lack of control in four consecutive years. Surely somebody is capable of making the decision to redo how that expenditure is dealt with.