Jan O'Sullivan (Limerick East, Labour)

I welcome the opportunity to participate in this debate. I reassure Deputy Mulcahy I do not intend to be entirely negative in my contribution. I want to be positive about the Irish economy and the way in which we spend our money. As Deputy Mulcahy stated, we expect to continue to have a growth rate, albeit not as large as in recent years. I believe the figure for the next year is 3.25%.

As Deputy Mulcahy also stated, we have become dependent on growth based on property as opposed to growth based on production and export. This problem developed under those in Government at present. Ten years ago it was not the case to the extent it is now and it is a cause for concern. A couple of other issues also give cause for concern. Before the 2002 election, a splurge was followed by serious cutbacks in several critical areas, including foreign aid as referred to by Deputy Mulcahy. We do not want the same pattern to emerge following some bright promises before the election and warnings by the Minister for Finance, Deputy Cowen, that we can expect some hard medicine this year and into the future. Certainly the issues raised by my party leader this morning in regard to the social insurance fund and concerns about payment for pensions are genuine concerns. While there is money in the fund at present there is a real concern that into the future a much higher proportion of our people will be dependent on the economy as opposed to being productive within the economy. This matter was raised also by some of the Fianna Fáil Members earlier. That is a reality we have to face.

In regard to the proposal for a cut in PRSI before the election, the questions raised by my party leader this morning were genuine questions about affordability and information that would have been available to the Government before the election when those promises were made. There is a need for serious debate on where the money will come from, and what exactly will be delivered. We do not need the type of stop-start dealing with the economy that took place before the last election. I hope the economy will continue to grow and that we will look after the money prudently. The sum of money spent is not inconsiderable.

In the remainder of the time available to me I will address the health area where very sizeable sums of money are spent. We want to ensure it is well spent. The health budget is increasing but not at the same level as in recent years. I am concerned that it may not keep pace with wage costs and medical inflation which are the two big factors in health spending. I seriously question the operation of the HSE, and agree with Deputy O'Donnell in that regard, as to how it operates in terms of its accountancy systems and how money is spent. I note from one of the free newspapers that it was decided and approved at Cabinet yesterday that a consultant will be hired by the Government to study two diverse accounting systems operating within the health service. The appointment of former Secretary General of the Department of Finance, Tom Considine, was approved yesterday by the Cabinet. It appears the Government also has concerns about how the HSE does its sums, as does the Comptroller and Auditor General and the Committee of Public Accounts.

During questions to the Minister last week we raised the issue of the increased number of higher level managerial staff within the HSE. The Minister said she had put a system in place from December 2006 that would control that issue and that approval had to be given by her Department wherever people were being upgraded or appointed at senior management level. Yet she said the level had exceeded the expected number. Clearly there is not that level of control and yet there are regular meetings on behalf of the Taoiseach's Department and on behalf of the Minister for Health and Children with the HSE. There is a real problem with the HSE and how the money is spent.

The blunt instrument used in recent months in regard to the embargo is not the way to deal with it. I urge the Government to come to grips with the way in which the health money is being spent. The HSE will be three years in place in January. From my perspective and I have not been the spokesperson on health for very long and from the perspective of the various people I have had the opportunity to speak with in recent weeks, it appears the money is not properly controlled. There are a series of organisations within the health service, including HIQA, the National Hospitals Office, the primary and community care section and there is no proper governance system in regard to interaction between these bodies. That affects how money is spent. It appears the HSE was not properly planned from the beginning. The Minister referred to the possibility of voluntary redundancies. Three years later there is an attempt to put some kind of governance and order on the HSE but this should have been done before it was set up. We are trying to solve problems in systems already set up. That is one of the big issues the Government needs to address in terms of the health service, the sick, how money is spent, quality assurance, financial control and value for money.

The result of the embargo is that people in the National Rehabilitation Hospital were not able to go back into their communities due to a lack of care programmes. It makes no sense that people are occupying special beds, which are needed for other special patients, when they could be in the community. The Minister told the House last week that issue was being addressed. However, I received an e-mail today from the son of a patient concerned who was supposed to be discharged but was not discharged until today. The e-mail indicated that only three patients have been discharged with the extra care packages. Since we raised the issue last week the impression was given that the problem had been addressed, but I believe it has not been fully addressed. That is an example of the craziness of such an embargo across the health service. In other situations expensive equipment will lie idle because staff could not be allowed work overtime. This is not logical and patients are hurting.

Maybe this is not the place to argue for the ending of the embargo but it is the place to argue about the spending of the money and control of the budgets throughout the year rather than coming in with a sledge hammer at the end of the year and cutting services. There are a number of other aspects to the health budget. For example, the HSE gave back money last year, while this year it has considerably exceeded its budget, which does not smack of controlled accounting.

There is also the money which has been set aside for nursing home repayments. I presume the Minister will respond to this debate later. A sum of €360 million was allocated last year and only €150 million for next year. I want to know if the money that was not spent this year will go back into the budget to be spent next year. There are many other areas I could touch on. I agree the NDP money should be spent on rail, road and various projects, including the schools that need to be built.

One of the points included in the amendment tabled by Deputy Joan Burton on behalf of my party is that we preserve the NDP and spending on health and education. There is a need to get value for money and to protect essential services and the most vulnerable in society.

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