Dan Neville (Limerick, Fine Gael) | Oireachtas source

I welcome the Health Service Executive (Financial Matters) Bill 2013 which rolls back on delegation to the HSE of issues which should come within the remit of the Minister for Health and the Department of Health, disestablishes the Health Service Executive Vote and provides that HSE funding will from 1 January 2015 come from the Vote of the Department of Health and establishes a statutory financial governance framework for the HSE.

The HSE Vote will be abolished and a new and robust financial governance structure will be introduced. This follows on from the enactment of the Health Service Executive (Governance) Act 2013 under which the HSE board was abolished and replaced by the directorate. Under the existing system, which developed following establishment of the HSE, the Minister can abdicate almost all responsibility for the operation of the health service provision. This is being changed. I welcome that.

Before speaking further on the Bill I want to raise an issue of concern in relation to funding of mental health services. I will try to be as brief as possible. In 2012, the Government allocated an additional €35 million for development of the mental health services, including recruitment of 414 whole-time equivalent professionals to develop the community mental health service. Recruitment did not commence until October of that year. By the end of the year, no staff had been recruited. However, €2 million was allocated to the National Office for Suicide Prevention, which brought its budget to approximately €4 million. This means €33 million of the €35 million, or 94%, was not spent on that for which it had been allocated. I am informed it was spent in the mental health area. On what was it spent? When I asked that question during a meeting of the Joint Oireachtas Committee on Health and Children one of the officials accompanying Mr. O'Brien, told me that it went towards the budget deficit.

In 2013, 447 staff were to be recruited but only 137 were recruited. Had the 414 staff from the previous year been recruited they would have had to be paid in 2013. This means the €35 million had to be allocated on a continuous basis otherwise staff would have had to be let go. In all, 513 staff were recruited. Assuming that 50% were recruited in the first half of that year and the other 50% were recruited in the second half of the year, this means only 30% of the €70 million was allocated that year, plus an additional €4 million to the National Office for Suicide Prevention, again almost doubling its allocation. This means €45 million of the €70 was spent elsewhere. Where did it go? In two years, €78 million was not spent on that for which it was allocated. Where was it spent? I am informed it was spent in the mental health services area but was it used to meet a deficit of moneys moved out of the mental health services? Perhaps the Minister of State would throw some light on that issue when replying to the Second Stage debate.

The Health Service Executive (Financial Matters) Bill 2013 provides for the disestablishment of the Vote of the HSE and the funding of the HSE from 1 January 2015 from the Vote of the Office of the Minister for Health. It establishes a new financial governance structure for the HSE, which is necessary as the existing statutory system of control, which exists by virtue of the HSE having its own Vote, will no longer apply. The Bill gives the Minister the power to set a net budget for the HSE and to approve, as part of the service plan, that if the HSE exceeds its budget in one year, it must discharge its liabilities arising as a first charge the following year. The Bill also imposes certain legal obligations on the Director-General of the HSE to ensure that the executive operates within the financial limits imposed by the Minister and provides for a new procedure for the approval of capital plans.

The purpose of the 2004 Bill was to give the HSE greater operational autonomy from what was seen as a politicised decision-making system but it crucially weakened the accountability of the HSE to the Minister for Health and his Department.

Experience has shown how flawed it was to remove the accountability of this House and the Minister for what was happening with the finances allocated to the Department of Health. The Bill seeks to rectify this situation by restoring the Vote of the HSE to the Office of the Minister for Health and thus re-establish appropriate and proper accountability for the HSE to the Government.

This is another step on the reform journey along with the dissolution of the HSE, the establishment of a health commissioning agency, new community care structures and the establishment of hospital trusts. It is appropriate that the Minister has been progressing reform since the publication of the Future Health document a little over one year ago. The Minister published reports on establishing hospital groups and on the future of smaller hospitals. Since that publication the Minister and the Government have appointed chairpersons for each of the seven groups and they are currently in the process of appointing senior executive officers.

In March 2013 the Minister published Healthy Ireland, the Government strategy document for empowering people to get healthier. The Government also published Tobacco Free Ireland, the strategy for making Ireland tobacco-free by 2025. Furthermore, the Government has published a package of measures to tackle alcohol misuse in the form of the Public Health (Alcohol) Bill. The Joint Committee on Health and Children is finalising the report on obesity in children, which will be a relevant contribution and I hope the Joint Committee on Health and Children will publish that document in the near future. I pay tribute to Deputy Fitzpatrick, who did a good deal of work and research for the committee. He put in considerable effort to produce a worthwhile report on child obesity, which is a growing problem in Ireland, as has been highlighted in recent years. I am pleased to support the Bill.

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