Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank the select committee for the opportunity to bring this Supplementary Estimate for Vote 38 before it today. I apologise to colleagues for not being available earlier today, as the committee had requested. I was attending a meeting of EU health Ministers, an annual meeting. It was quite long, but it included matters such as a briefing on Covie-19 vaccines so, regrettably, I could not make it to a meeting this morning. I thank the committee for accommodating this time today.

The additional funding I am seeking for 2020 is €514.5 million. In June, the Oireachtas approved an additional €2 billion to meet the costs of the health service’s response to Covid-19, bringing the new adjusted total for the health Vote to €19.9 billion. The Supplementary Estimates request for Vote 38 relates primarily to the costs associated with Government decisions on Covid made subsequent to the Revised Estimates in June. This includes additional funding for measures, including personal protective equipment, PPE, testing and tracing, €200 million for this part of the winter plan, escalation of no-deal Brexit measures, one-off funding to support disability services, one-off funding to support palliative care providers and the costs associated with the Covid-19 vaccination programme.

In June, I said that the additional approved funding of €2 billion would not represent the totality of the cost of Covid-19 for this year and that further funding would be required. This is that request. The health Vote has required Supplementary Estimates each year for the past number of years, and the HSE worked very hard last year to bring down the additional funding requirements. I am committed to working with the HSE and the Department to continue to strengthen the financial management.

On a side note, I draw members’ attention to the recently published Economic and Social Research Institute, ESRI, report, “How does Irish Healthcare Expenditure compare internationally?”. I am sure colleagues have seen it. It compares healthcare expenditure in Ireland to that of other OECD countries. It is the first report of its type that does this accurately. It is something I have sought previously, as have health committees in the past. There has been an ongoing perception that Ireland spends more than other countries on healthcare. The ESRI report shows that when measured per capitaand on a like-for-like basis Ireland’s total expenditure on healthcare ranks ninth among the EU 15 and it drops to tenth when one considers just the public aspects of healthcare expenditure. It is a topic I would like to engage on with the committee on another day, if the committee is interested. Between us, we could re-frame the conversation about healthcare expenditure in Ireland with a view from me and many of my colleagues that if we are not as high up the tables, there is room for us to continue pushing.

The health service has responded in an unprecedented fashion to Covid-19 and has incurred substantial additional costs in doing so. The single most significant medium-term cost is PPE. Included in June’s Revised Estimates for the Covid-19 allocation of €1.997 billion was €253 million for PPE. The HSE has forecast PPE expenditure of €920 million to the end of this year, which includes planned stock levels at year end of approximately 12-years supply in line with clinical management guidelines. This leaves a supplementary request of €667 million compared to the original allocation.

The June Revised Estimates approved €208 million for testing and contact tracing. This initial allocation was to fund testing and contact tracing until 31 August. Included in the Supplementary Estimates today is a request for €68 million, which is required to fund testing and contact tracing to the end of the year. Up to the end of November, almost 2 million tests had been carried out.

A significant element of the request relates to the HSE winter plan. The Government committed €600 million in total to deal with winter pressures and the additional pressures presented by the pandemic. This includes €600 million for 2020, which is in today’s Supplementary Estimates, and €400 million for 2021, which essentially is January, February, March and April. The winter plan is increasing the capacity of the health service and ensuring continuity of service by providing additional commute and community resources, staff and beds, as well as funding initiatives including the flu vaccination programme and many other items. Budget 2021 funds the permanent retention of many of these measures, which is very exciting.

Taken with the June Revised Estimates, the Supplementary Estimates today bring the total net cost of Covid-19 supports provided to the health service to over €2.5 billion and total health expenditure in 2020 to just over €20.4 billion. While the financial impact is very significant, the value of this investment in protecting our citizens in the face of the global pandemic is unquantifiable and, I would argue, priceless. I seek the select committee’s approval of the Supplementary Estimates of €514.5 million for Vote 38.