David Cullinane (Waterford, Sinn Fein) | Oireachtas source

The head of the Department of Health, Mr. Robert Watt, appeared before the Joint Committee on Health and said that the existing level of spending, ELS, for 2023 and 2024 was underfunded. We know that for 2023, the health service ran a deficit of approximately €1.5 billion. The cash deficit was approximately €1.1 billion but taking accruals into account, the head of the HSE said the deficit was €1.5 billion. The HSE has put that down to a number of factors, including additional demand and higher inflation. The HSE also says that the ELS was underfunded at the start of 2023. It was much stronger in its criticism of the funding for the ELS for 2024 and what was in budget 2024.

I received a number of documents in response to a freedom of information, FOI, request. They are briefing documents that were prepared for the Minister for bilateral meetings that took place with the Minister for Health and officials from the Department. One is dated 6 October, which I think was the second meeting. There was a meeting on 3 October and another on 6 October. The briefing note states that the Department's assessment was that 3.5% was appropriate for the health Vote. The Minister's briefing note reflects his Department's assessment that 3.5% was appropriate for the health Vote and any increase beyond that limit would impact the limited funding available to address a small number of new developments. The problem is that the ELS is not meant to be contingent on what funding is available for new developments. It is meant to be scientific. It is meant to consider inflation, carryover measures and demographics. The figure is the figure. How did we arrive at a situation where the head of the HSE, the head of the Department of Health and the Minister for Health are clear in their analysis that what was needed for the ELS was in the region of at least €2 billion and yet what was provided was €707 million? How could there be such a variance between the two positions?