Brian Stanley (Laois-Offaly, Sinn Fein)
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I want to move on to the HSE. As referred to earlier, the budget for this year is over €21 billion. I have no argument with that but there is a sense that even if we filled a tipper lorry with money and tipped it up outside the HSE's headquarters, the services at the other end would not materialise. I do not want to rhyme it all off here because I have taken this up with the Department of Health and the HSE previously and will be doing so again when they appear before this committee again. Basically, we have increased and increased the amount of money we are putting in to health, which is good, but the services are not there. Not alone are the services depleted, they are actually disappearing. Public dental services have disappeared in the part of the world that I inhabit. They do not exist any more in the county in which I live. I could go on and on.

Recently we got a profile of the schemes available for children with autism and there are gaps all over the place, lengthening waiting lists and so on. I know we have come through Covid and we must take that into consideration. That said, we are a high spender on health. In fact, I think we are now the second highest for health spending, which is good but countries that are spending less, which are not low-wage economies but comparable northern European countries, have amazing outcomes. I know we cannot have a utopia with a perfect health system because that does not exist but other countries are 90% of the way there while we are only 30% to 40% of the way. There are gaps all over the place. Any public representative, whether a county councillor or a Deputy, or anyone familiar with dealing with the public on these issues knows of the gaps in the system. Day after day, we come across gaps where services do not exist.

My point is that from the point when we tip in the money - €21 billion plus, which is fine - to the point when we get the services, is anyone talking to senior and middle management in the HSE and asking them what is happening here and why are there no services at this end? I am sure the Department of Public Expenditure and Reform monitors what goes on in the Dáil and in the media in relation to the absence of health services, despite all of the money being invested. What is happening there?