Eamon Ryan (Dublin Bay South, Green Party)
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I very much appreciate the presentation. To set it in a slightly longer context - I made this point earlier in our discussion on another issue - if we take a 15 to 20-year perspective, the health budget in 2000, including both private and public health spend, was about €6.4 billion. It is hard to believe the scale of the jump but it had increased in 2007 to €15.7 billion. In 2013, which is when Mr. Desmond's analysis started, even though, as he said, there had been a significant curtailment of the budget arising from pay and other restrictions, health expenditure stood at €18.4 billion. The Estimate for this year indicates the health budget will be the guts of €21 billion if we include the Revised Estimate at the end of the year. In terms of the correlation between spending and outcome, we were not starting from a low base when Mr. Desmond started his analysis in 2013, but from a base which had dramatically increased in the previous ten or 15 years. There had been a very large increase in spending. It was not as if spending had reverted to the 2000 level or anything close to that. It is important to point that out because this committee is concerned about the effective spending of public funds.

One could say that all the problems arose because there was a contraction in the 2013 budget, for pay rates and services. However that contraction was in the context of significant increases in the budgets of the previous ten to 15 years. Does Mr. Desmond understand the point I am trying to make? Does he think that timeline has any relevance? How did we survive in the year 2000 on a budget of €6.5 billion?