Mary Harney (Dublin Mid West, Independent)

We have been driving down costs. This year we will take €240 million out of the drugs cost, for example, by changing the manner in which pharmacists are paid and what we pay producers of medication which goes off patent. The nursing homes support scheme, A Fair Deal, is a good example of saving. The NTPF was asked to procure beds because it has a good track record in procuring services and getting value for money.

The HSE uses private providers of home-care packages. I support that although I am often criticised for it. If the money can go further and provide more services to people at home and if the quality of the service is assured, that is what we should be concerned about. I want to see more of that.

It is not appropriate for me, and it is against the law, to get involved in price negotiations with hospitals on behalf of insurers. I want to see insurers driving down their costs. The costs of some medical procedures are driven, to a large extent, by salary levels. On the public side, we must move to economic costing. The taxpayers cannot subsidise the cost of care for some while it is not accessible to others. The review currently being carried out is looking at whether public hospitals should move to procedure-based costing. In private hospitals the insurers negotiate a price for a procedure. In public hospitals it is based on the number of bed nights per patient. We need to bring greater clarity to this matter. The allocations group's report will greatly help us gain insights in this area.

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