Mary Harney (Dublin Mid West, Progressive Democrats)

In deference to Deputy Reilly, who tabled a question on cystic fibrosis, I will reserve my comments on it until we take that question.

The sum of €160 million arises because of the emerging economic circumstances in March, according to the Department of Finance. I said at the committee last week that the shortfall was €160 million rather than €100 million. Furthermore, I stated in my reply to Deputy O'Sullivan's question that, in the context of the budget next week, the Government is considering the shortfall. It has a considerable impact on the HSE because it affects appropriations-in-aid and the consequent increase given the level of unemployment and the number of medical cards.

Even accepting all that, the HSE clearly has a budgetary challenge. The HSE spends approximately €1.2 billion each year on what I would call some archaic work practices. I refer to junior doctors getting paid for their lunch and to live out of the hospital. These are practices that would never be negotiated in current circumstances. The priority for dealing with the financial constraints must be in the context of that envelope of very rigid work practices whereby we cannot deploy people from where they may not be needed to where they are needed.

When the HSE submits its service plan to me, I will want to ensure it is dealing with issues such as travel and subsistence, work practice issues and legal issues. The HSE spends an enormous sum each year on legal issues. Since we are reducing professional fees to doctors, dentists and pharmacists by approximately 8%, I hope the HSE will be in a position to do the same in regard to legal fees. My priority will be to ensure we minimise, if possible, the impact of the financial constraints on services to patients, either within the hospital or the community, and that we maximise the potential to live within budget on the basis of some of the sources to which I referred.

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