Mr. Eddie Casey:

The Deputy asked how difficult it would be. There is no doubt that it will be difficult. A good way to think of this is that the first step one needs to take in getting a handle on health expenditure is understanding what is happening. A good way to do that, which we have learned on the fiscal council from endorsing macroforecasts, is trying to forecast what expenditure will be. Through doing that, one puts in place a framework and system for understanding exactly what expenditure will be today and, eventually, tomorrow, looking into the medium term. Forecasting monthly will allow them to understand what is reasonable to expect and what is happening right now. Another way to understand what is happening right now is to move to a better accounting system in the sector. Right now in health, it is hard to get a clear sense of how much is being spent on all healthcare. We do not have a monthly, consolidated, general government and audited set of accounts for health spending. With regard to realistic forecasts, as Mr. Barnes said earlier, two basics need to be considered, which is what the demographic pressures are and what price pressures one will face. Those are important in health where price pressures tend to push drug prices and wage prices higher. If one gets those things on a realistic footing, since it is not that hard as a starting point to get them reasonably right, then one might have two arms improved.