Marie Sherlock (Dublin Central, Labour)

I thank the Cathaoirleach, the Minister, the Ministers of State and officials for attending here today. There is a lot focus on the hospital system in the Minister's opening statement today but I want to first focus on primary care. To me, this is where the greatest value for money can happen, yet we see there is a €15 million underspend with regard to pay in primary care this year. This is, of course, helping the Minister's figures as regards cost overruns elsewhere.

We know we have a disgraceful situation in dental care where we have a third fewer dentists in the public service relative to 2009 and we know we have a massive shortage of psychologists. There are psychologists whose applications are still in the Minister's Department who have come from the UK and are waiting to be recognised to work here. Those applications are waiting several months in her Department. Certainly, when we look at the level of waiting lists across other primary care services, I am perplexed as to how there could be an underspend with regard to pay in primary care. The Minister might explain why that is so because, to me, this is the very antithesis of what Sláintecare should be, which is greater care in the community.

Related to that, I want to ask about the PCRS. I will group the two questions together. This is the single largest cost overrun item or part of the supplementary budget and I have to ask about forecasting and budgeting. First, as regards budgeting, it is noted there is a cost overrun because of HRT. That was announced in the budget last year and was late in being introduced. Why was that not properly budgeted for? The second key question relates to the forecasting of the PCRS. There is a reference here that there were more claims relative to what was predicted. There is an issue here regarding people living longer with chronic conditions requiring medication. Is the Minister satisfied with the forecasting within her Department as regards PCRS, older people and nursing homes? They are some of the very significant drivers of poor forecasting, as I see it here, in estimating what the appropriate amount should be and getting it badly wrong which then requires extra amounts in the supplementary budget.