David Cullinane (Waterford, Sinn Fein)
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The Minister can put a spin on the situation but the reality of what is in the briefing notes prepared for him, which I presume he was asked to articulate to the head of the Department of Health and the Minister for Health, paints an entirely different picture. Perhaps the Minister will let me finish my point. It suggests this was not the normal cut and thrust of division that might take place in respect of the ELS. I am sure that does happen every year, but there was very serious pushback from the Department of Public Expenditure, National Development Plan Delivery and Reform on, for example, the levels of inflation. The briefing note presented to the Minister stated that the inflation figures presented by the Department of Health in its bid reflect a very poorly managed base. It goes on to say that the Department of Public Expenditure, National Development Plan Delivery and Reform does not accept the inflation figures. In fact, the Minister's own Secretary General said as much when he was before the Joint Committee on Finance. The head of the Department of Health said that inflation was running somewhere between 10% and 17%, depending on what one is looking at, and that applied to both pay and non-pay expenditure. He said inflation is, at a minimum, 10%. The Department of Public Expenditure, National Development Plan Delivery and Reform was pushing back strongly against that.

It also pushed back, and this makes no sense, against the deficit for this year. We were told the vast majority of the spending will recur next year but the Government has not provided for it. That means we are going into next year with a black hole and an absolute guarantee that there will be a substantial Supplementary Estimate next year. This was all published and is in the public domain. Another line in the briefing note further illustrates the point I am making. In respect of both the ELS and the overrun for 2023, the briefing note states, "To be very clear this would also amount to embedding mismanagement into the base after a period of record investment and failures in financial governance across the acute sector." The briefing note prepared for the Minister speaks to the failure of the HSE and the Department. It pushed back against the claims in respect of the inflation rate, which either is or is not 10%. It stated there is a fear of embedding mismanagement into the base. Another document states that the Department of Public Expenditure, National Development Plan Delivery and Reform's opening position for the Department of Health was €808 million. That was what the Department of Public Expenditure, National Development Plan Delivery, and Reform proposed for the Department of Health at the meeting on 3 October. It further states that the Department of Health should not be told that figure because it would understand it as a negotiation, which it was not.

I must put to the Minister that a picture is painted of a lack of trust between the Department of Public Expenditure, National Development Plan Delivery and Reform and the Department of Health. That is clear in every line of the two documents that were given to us. It also suggests that the decision to calculate the ELS was not based on any of the data the Minister was given by the Department of Health or the HSE.