Dr. Eddie Casey:

The Deputy alluded to the fact that we would consider that in the totality of the health budget. As a share of the overall health budget, that is not really that large. That is how we think about it. We can tolerate some overruns and underruns to an extent when they are small as a proportion of what it is we are spending overall. I would look at VAT in that context. Our points about overruns do not really come from the demographic side. We have looked at demographic pressures in detail and we published a separate report every year called the Stand-Still Scenario. Basically, we take current policy and ask what would happen if we were to continue growing this set of policies in line with demographic pressures and cost pressures, basically prices, wages and things like that, and what budgetary policy might look like in a few years time given those and how they are expected to evolve. We find there are not major differences between us and the Department of Finance or the Department of Public Expenditure and Reform in terms of demographic pressures. Most of the differences are down to that other element, the prices, wages and cost pressures which they do not account for systematically over the medium term. Their argument would be that is something for the Government of the day to legislate for in terms of provision.