David Cullinane (Waterford, Sinn Fein)
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I welcome the Minister, the Ministers of State and the officials who are here. I wish to make one point or observation, which is important for me to make. The Minister might recall that when we had discussions about Supplementary Estimates last year, which was also after budget 2024, this committee clearly set out our concern that the health service was not properly funded for existing levels of service, ELS, not just for one year, but for a number of years, and that this was leading to a growing deficit which would require money being put into the base. We cited three reasons that were given at the time by the Department and the HSE and which the Minister actually restated in his opening statement today, namely, the growing demand, pay costs and all of those issues, and health inflation. This committee estimated and put on record that €1.5 billion was needed to be put into the base. We received very strong pushback. We had meetings of this committee in which we received very strong pushback from officials. In fact, we received even stronger pushback from the Secretary General of the Department of public expenditure and reform who certainly was not of the view that any deficit existed or any Supplementary Estimate was required. In fact, I went before the finance committee and had a very robust exchange with the then Minister for public expenditure where I was told I was raising alarm and that the figure would be nowhere near €1 billion, never mind €1.5 billion. I am making the point that here we are 12 months later and the figure is €1.7 billion. Everything said to us by officials in the Department of the Minister present and by the head of the HSE has turned out to be correct: the deficit was real and has now been put into the base. It is important to set the record straight because we had lengthy discussions on this matter. I am not attributing blame to the Minister on this one; the fault lies elsewhere. It was very unhelpful and a chaotic way to fund healthcare. I hope, going forward, we will not see that anymore. Whatever the estimate is for existing levels of service, it must be scientific and real and it has to be funded to end the madness of what we have seen in recent years. I am just making that observation.

My first question relates to the productivity and savings task force the Minister established. Deputy Durkan talked about State claims. I agree that patient safety is the main reason we should try to limit claims in that space. The legal cost is one thing, but there are also the volume of claims and the amount being paid out. That is only one area, however. Agency spend, management consultancy, overtime, outsourcing and all of that are areas where we can save money. Will the Minister outline how much money has been saved to date and in what areas? It is important for us to understand that. Given we are seeing changes in work practices, and we need to see more, is there any scientific financial evaluation or data that demonstrates how savings and efficiencies can be achieved through changes in work practices and as we roll out more advanced technologies, such as virtual beds and all of those kinds of areas? That is something we are being told can happen. I am interested and curious to hear from the Minister’s response whether this has been quantified. Separate from that, what savings that have actually been achieved have been quantified to date?