Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

Okay but it is also reported that senior officials in the Minister's own Department do not have confidence in the HSE financial reporting because of the service's weak financial systems. That in turn leads to a lack of confidence on the part of the Department of Public Expenditure and Reform in the whole health Vote, which in turn undermines the confidence of the Taoiseach. When it comes to the health service and particularly the Sláintecare reform programme, we need to have the Taoiseach fully committed. However, if the systems are not in place to provide the credibility and the confidence in the financial arrangements within the HSE, then we are not going to get the ongoing support of the Taoiseach on this. That is something that must be borne in mind.

Nobody is taking from the HSE's handling of Covid, nor that of the Minister or the Department. We need to make that clear from the start. Covid was very well handled, especially the vaccination programme in its entirety. That was well done and the testing services were well done and all of that. However, the financial issues within the HSE existed for many years prior to Covid. Unless they are addressed now as a matter of urgency, we are going to continue to be in this twilight zone about where money is going in the health service. There will be a continuing view it is a black hole and we are not going to have credibility about the spending of moneys in health.

There are fundamental things that need to happen and happen very quickly and I would like the Minister to report on those. These include, as he has already referenced, a fully-integrated financial management system within the HSE. It is just extraordinary that an organisation with a staff of 130,000 and a budget of €21 billion does not have an integrated financial management system, so we do not know where money is going. We do not know if we are getting value for money. We do not know if money is going where it was intended to go.

The second aspect is the individual health identifier, which is an essential tool. A business plan was produced in 2016. There has been very slow progress.

I raise this business of money being allocated on an annual basis for staff in different areas and then when it comes to the end of the year, people put their hands in the air and say they could not recruit consultants or GPs or nurses or allied health professionals. They say it is too bad there is a serious recruitment. What is being done about that? Why has no ongoing workforce plan been produced?

The other point relates to devolution of power from the centre, which is what is proposed in the regional structures, the need for accountability legislation and a population-based approach to service planning. The Minister spoke earlier about progress in the Sláintecare plan. In his own progress report produced last week, his contention there would not be borne out. The scorecard is not good with Sláintecare. I can go through them all but he knows the progress report, on pages 14 and 15, lists all the areas where the situation has disimproved. It is not a very good scorecard. Will he tell us what he is going to do to ensure the four areas I listed will be progressed consistently and rapidly in the coming year?