Mr. Seamus McCarthy:

The appropriation account for Vote 38 - Health records gross expenditure of €20.8 billion in 2020. This represented a 19% increase on the gross expenditure of €17.5 billion incurred in 2019. The majority of the gross expenditure in 2020, amounting to just under €20.5 billion, was paid to the HSE. This was spread across 14 subheads in the account. Other subheads of the Vote provide for payments of grants and other support to bodies under the aegis of the Department and funding for the National Treatment Purchase Fund and Sláintecare initiatives.

Receipts into the Vote in 2020 totalled €488 million. These comprise mainly €270 million recovered in respect of the cost of providing health services to EU nationals under EU regulations, and receipts of €168 million from the proceeds of excise duties on tobacco products.

At year end, net expenditure under the Vote was €120 million less than provided for. With the agreement of the Minister for Public Expenditure and Reform, €68 million in unspent capital allocations was carried over for spending in 2021. The remainder of the surplus for the year, €52 million, was liable for surrender to the Exchequer. I issued a clear audit opinion for the appropriation account.