Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

Subhead 1 relates to net pensions costs of €83 million. Pensions is an area that is difficult to predict with accuracy as it is demand-led and once people retire they are entitled to claim superannuation benefits. As well as the demand element, the additional €83 million is driven by the public sector pay deal and a reduction in retained superannuation contributions because of the single public service pension scheme.

Subhead J1, HSE €1.347 billion, covers all main HSE core operations service areas, including acute hospitals, primary care, social inclusion, palliative care, mental health, older persons, community services and national support services. The subhead requires a Supplementary Estimate of €1.347 billion for 2024. This comprises €1.615 billion of additional expenditure, partly offset by a €268 million movement in HSE cash and working capital. While there are deficits across a range of core services, most of the supplementary ask, €1.544 billion, relates to acute hospitals. These deficits in core services are offset somewhat by other operations expenditure, which is forecast to be in surplus by €281 million. This primarily comprises an underspend in the office of the chief clinical officer of €121 million and an underspend in national support services of €135 million. The support services surplus partially reflects the fact that funding is held centrally by the HSE for certain measures, such as new development, and some of it is yet to be allocated to relevant service areas. When the budget is distributed, the surplus in support services will be lower and the deficits in those service areas will be reduced.

Subhead K4 concerns payments to the State Claims Agency regarding clinical negligence. The State Claims Agency supplementary requirement for this year is €50 million with a final allocation of €485 million. This is attributed to an increase in the number of claims and the value of settlements awarded, particularly claims arising from catastrophic birth injury. A sum of €50 million is required to fund the total cost of claims which will be settled this year.

Subhead L1 is the primary care reimbursement service, PCRS, and local demand-led schemes, €269 million. The PCRS administers a number of demand-led schemes, including general medical services schemes, community demand-led schemes and the national drug management scheme. A projected shortfall in PCRS funding of €186 million is related to overspends in these areas. A portion of the shortfall is driven by expanded eligibility to medical and GP card visits and cost-of-living measures, the drug payment scheme, for example. The local demand-led scheme deficit of €83 million is largely attributable to a combination of the increase in demographics, and therefore increased activity under the eligibility schemes, and price inflation, predominantly across high-tech medicines, long-term illness scheme and hardship medicines.

Subhead M2 is capital, which is €5 million. Supplementary capital funding of €5 million is being provided in respect of the Brexit capital apportioned for the OPW phase 1 and phase 2 projects, which relate to storage facilities in Dublin and Rosslare ports and Dublin Airport. The supplementary funding is based on figures presented to my Department by the OPW.

This year has seen a continued increase in demand for health services. This is driven by demographic factors, greater longevity and increased provision of services. As a result, the amount sought will bring the total Department of Health expenditure this year to €24.577 billion. The value of this investment in delivering crucial services to our people is immeasurable. I seek the committee's approval of the Supplementary Estimate of €1.754 billion for Vote 38.