Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

The Deputy's question goes right to the heart of everything we are dealing with where he has pretty much identified the issues. First, I will deal with the last question with regard to the chief executive officer. The Department of Public Expenditure, NDP Delivery and Reform does not engage directly with State agencies and engages with line Departments, which do that. I would not criticise the Department of Public Expenditure, NDP Delivery and Reform for that. Perhaps it should, but that is not the policy. It goes through the line Departments and through Ministers.

The Deputy raised two important points which are probably ultimately linked. One is productivity and the other is volume and inflation. There is a difference between the advice I have and the advice the Minister, Deputy Donohoe, has with regard to volume and inflation which the Deputy laid out and which is there to see. Where I believe the Department of Public Expenditure, NDP Delivery and Reform is correct on the productivity piece. It is the case and the Department is correct in saying that the very significant increases in funding, beds, primary care centres, workforce, etc., has not been matched by the same level of increase in patient care. There are two parts to this.

Over the past few years we have been following the Sláintecare philosophy around increasing productivity at a structural level. All of the investment in enhanced community care and all of the investment in general practice, chronic disease management, caring for patients closer to the home, the public-only consultant contract, and many other issues are about creating a more efficient and productive healthcare service. In other words, more patient care for the given level of money. Over the past two years, I have been prioritising the roll-out of what is called the Health Performance Visualisation Platform, HPVP, system. Basically, this is a productivity platform being rolled out in every hospital which is giving us, for the first time ever, very granular information on the level of activity, on, for example, outpatient appointments, inpatient day cases, etc., for a given level of clinicians and money. We will be publishing this information and I know, that members of the committee will be very interested in it. What we are seeing from this, where it is still preliminary, is that the Department of Public Expenditure, NDP Delivery and Reform is correct on the productivity point. That is why I am setting up a productivity task force and significant team to drive this. We have been working through structural productivity but this is very much operational productivity. The Department of Public Expenditure, NDP Delivery and Reform is correct on that.

The Department of Public Expenditure, NDP Delivery and Reform is frustrated about the productivity, which is an absolutely legitimate frustration, and it is correct to insist that we get more patient care for the increase in money. It may be the case that that frustration has spilled over to a general view on health which perhaps is colouring some of the other issues but I do not know and that would be a matter, obviously, for the Department of Public Expenditure, NDP Delivery and Reform itself.