Mr. Bernard Gloster:

There is a distinction between the plan and the funding cycle. The plan I am talking about is our approach to managing unscheduled care, because of the lightning rod situation that occurs in the emergency departments and the requirement to focus on other parts of the healthcare system. There is no problem in the emergency department if every other part of the healthcare system is actually doing what we need it to be doing.

Senator Hoey is talking about the annualised funding model, which is a service agreement. We have an overarching agreement with most funded agencies, which is called part 1 of the agreement and can be for a number of years. That states the intention and basic requirements. We are not in a position to change the annual funding cycle because that is exactly the cycle we are in ourselves. The health service is part of the Vote of the Oireachtas after the budget. Every year, that is what the allocation is. The Minister sets out the priorities for the health service based on that allocation. The only thing I would say is that, leaving aside the minutiae of the exact detail of the money, we and our local managers try hard to agree with organisations what the pathway of their growth, development or sustainability is over three to five years, depending on the service. I am very familiar with the one the Senator talked about from my previous life in Tusla. There is pretty strong certainty that no current refuge will be without its annual budget. The issue is the adequacy of the budget to pay the staff the service wants to pay. That is currently the subject of a fairly significant dispute.

I would love to see multi-annual funding but it is a matter for the Oireachtas. I do not wish to shove it back but it is a matter for the Oireachtas in the budget.