Brian Cowen (Laois-Offaly, Fianna Fail)

I remind the Deputy he was a member of a Government which unanimously agreed that, based on bitter experience in the past, the best way of trying to develop the health services was to introduce service planning. On the basis of allocations provided to hospitals, service plans would be drawn up and adhered to in the interests of maintaining a level of service that had been provided on an ongoing basis and building incrementally, year on year thereafter, in the event of further investment being made in the health service. This was unanimously agreed at the time and I was the first Minister for Health to introduce and live by those disciplines.

On the particular issue which has arisen in Crumlin hospital, the problem in relation to service planning is that there was an overspend of €10 million last year and the projected overspend, on an increase in the allocation from €128 million in 2007 to €137 million this year and an increase in the hospital's budget of almost 40% over the past four years, is of a further €14 million beyond the €137 million figure. What is being said and must be accepted by all of us is that if we are to have planned and sustainable improvements in the health service, quite apart from the reforms being put forward by the HSE to build greater community care services in order that services are not all taken up at the acute hospital end, we also have to maintain the reforms introduced by previous Governments, including the one of which the Deputy was a member. Service plans have to be adhered to in the interests of developing services in the short and longer term.

The Opposition now appears to suggest that we can develop a health service based on the demand led system of budgets regardless of what budgets are allocated to which hospitals. The idea that this approach rather than trying to adhere to the budgetary disciplines required would not create even greater dislocation or more problems escapes me. That is the position in relation to Crumlin hospital.

What is being required is that we try to live within existing allocations. Owing to the good work Crumlin hospital has been doing and its important work nationally, an agreement was made to deal on a once off basis with last year's overrun of €10 million and provide a further €7 million in respect of a projected overrun of €14 million this year, while requiring the hospital to work within its budget which will be amended from €137 million to €144 million this year based on an allocation of €128 million last year. That is what is being required of the hospital and consultation is ongoing between management and representatives to determine how to meet this requirement.

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