Mr. Robert Watt:

The overruns in 2023 were recurring spend unless two things happened – prices fell or demand fell – and neither of those is likely to happen this year. We are seeing inflation slowing down, but that is not the same as prices falling. The demands on the system are astronomical. To provide one figure, the number of outpatient consultation referrals went from 600,000 in 2013 to 1.3 million last year. The number increased by more than 330,000, or almost a quarter, between 2019 and 2023. That is partly due to a post-Covid effect, with people who would normally have sought consultations deferring those during Covid but whose conditions or problems have since worsened, leading them to seeking assistance. We just do not know. We hope that growth will return to a steady 3% or 4%.

In the absence of action, last year’s overruns are recurring and are embedded in the system. The challenge for all of us around this table and our colleagues in the HSE and the Department of Health is to determine what actions we can take to try to make those savings and keep the deficit as low as possible.