Brian Cowen (Laois-Offaly, Fianna Fail)

As I said, we are spending €15.2 billion on the health service, which represents almost half of the total tax take this year. There is a large spend on health - quite rightly - but we must make sure it is provided in the best possible way. There have been real improvements, including in the provision of cancer services, the number of people undergoing day-case surgery and the number of people coming through the health service generally. There are many people whose experiences of the health service have been favourable. There are also areas in which there are acute service pressures. Deputies will know from their own work where that may be the case. However, there are many people whose interactions with the health service are good, and that should also be acknowledged.

To return to the point being made by Deputy Kenny, €1 billion less was spent on the health service last year, €650 million through reductions in labour costs and €350 million through efficiencies identified by the HSE in the course of this year. Next year further savings will be required because the budgets must be tailored to the amount of money that is coming into the Exchequer. We had that discussion yesterday. The Croke Park agreement can minimise any impact on front line services by ensuring that all changes in work practices are agreed. Action plans for health and other areas of the public sector are being worked on at the moment. As soon as estimates are completed, an intensive effort will be made by all partners in health who are prepared to sit down and find a way forward that minimises the impact on front line services, recognising that there are limited resources available.

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