Mr. Colm Desmond:

The Department cannot make a call regarding the overall predictability of the fiscal position which governs how all Government expenditure is decided in the budget each year. The Department can simply put forward proposals to the Minister for Public Expenditure and Reform. Those proposals are guided by an ongoing programme which is desirable of efficiencies to be achieved within the health sector. This is a desirable thing to do and will be necessary in any event and is stated as an underlying issue which will influence the delivery of the Sláintecare programme. The budget this year has set out a certain number of provisions in this regard and I think that was raised by Deputy Donnelly.

It is in that context that all Departments frame and are aware of the possibility and scope there may be but essentially, it is not the Departments' call in terms of its predictability or otherwise. The Department of Health's job is to seek to obtain as much as possible for the services that have been justified to it by the Health Service Executive, which are needed year on year, and to take account, as much as it can, of those unpredictable areas I mentioned in my opening statement. Mr. Mulvany alluded to a certain number of the areas which can arise during the year, the magnitude of which can be unforeseen.

Mr. Mulvany may wish to comment on staffing costs but the Department could revert with more detail in that matter.