Michael McGrath (Cork South Central, Fianna Fail) | Oireachtas source

I thank Deputy Farrell. I acknowledge she has been here since the beginning of the meeting, which we appreciate. Health expenditure is a challenging and complex area, as she knows. There is a close working relationship between the officials in my Department, the Department of Health and the HSE. There is a dedicated group, the health budget oversight group, which meets regularly to tease out these issues and make sure there is ongoing communication and good co-operation relating to the management of health expenditure. It is such a large area of our overall expenditure. The allocation in 2022 is €22.2 billion, with a further €200 million held in reserve. A particular challenge we face in respect of health expenditure relates to Covid-19. The Deputy will recall the wave of the Omicron variant we had at the beginning of the year, which would not have been envisaged on budget day last year. That led to significant budget-related expenditure that went above and beyond what was allocated to health on budget day in respect of Covid. That is the first issue. There is an overrun relating to Covid-related expenditure. We are working through that issue with our colleagues in the Department of Health as part of the Estimates process.

On the non-Covid side, we are analysing overall core expenditure. We have made much progress with beds and adding capacity to the system. Thousands of staff have been recruited. The Department of Health has received sanction for the recruitment of a number of staff beyond that. We are working through the budgetary implications of that at the moment. To add complexity to that, there are other measures that would not have been funded on budget day which we will have to fund, such as measures relating to the recognition payment. There are health-related costs associated with looking after the displaced people who came here from Ukraine. We decided on an expanded flu vaccination programme. As part of the Building Momentum agreement, we honoured our commitment regarding the Haddington Road hours. Given the scale of the workforce for which the Department of Health has responsibility, it had to make provision for significant expenditure relating to that agreement. There are many different moving parts, but the Covid cost will be more than was provided for originally, with a need for additional expenditure. We are working through core spending at the moment and assessing the need for a Supplementary Estimate in the coming weeks.