James Reilly (Dublin North, Fine Gael) | Oireachtas source

I point out to Deputy Caoimhghín Ó Caoláin that if the amendment to section 10 was not being introduced, there would be no legal constraint on the HSE's spending. That constraint is imposed by virtue of the executive having its own Vote.

I must inform Deputy Billy Kelleher that there will be a clear line of accountability under the new arrangements. The HSE will be given a new expenditure figure by the Minister and obliged to submit its service plan in line with the net budget. There will be a legal obligation on the executive to ensure the plan will be implemented within the limits of the resources provided. As is the case, the national service plan will have to be approved by the Minister. It will also set out the budgets to be allocated to the different sectors within the health service.

Deputy Billy Kelleher is fond of referring to shambles, disasters, catastrophes, etc. I highlight for him the fact that in 14 of the past 17 years it has been necessary to introduce Supplementary Estimates in respect of the budgets for the Department and the HSE. That was during the wealthiest period in the country's history, namely, the so-called boom years. It is not surprising that it has been necessary to introduce Supplementary Estimates at a time when the population is growing, when, thankfully, more older people are surviving and when, as those opposite pointed out, we are seeking to reduce budgets. Nonetheless, thanks to the great work of the men and women employed in the health service, 95% of those waiting for outpatient appointments have been treated or seen in under 12 months, 99% of those awaiting inpatient procedures have been treated in under eight months, while there has been a 24% reduction in the number of patients obliged to endure long waits on trolleys. That figure is still too high and we need to do more. In that context, we will continue with our reforms.

The Bill before the House is another step on the road to further reform in creating a procurer-provider split. The HSE is buying services from itself. I am sure everyone agrees that there is no particular incentive to be competitive with oneself when one is providing a service. Clearly, it is in the interests of all those involved that we create the procurer-provider split. That will be achieved in the context of a health reform Bill to be introduced later this year. In the most recent general election the people gave us a very clear mandate to, as some would say, abolish the HSE. I prefer to say we are replacing it. In order to do so, however, we must transfer the Vote back to the Department as a first step.

There are great people working within the health service and this legislation will assist them in delivering the excellent services they have been trained to deliver and which they wish to deliver but which, as a result of the system the Government of which Deputy Billy Kelleher was a member put in place, they have been prevented from delivering. It is my belief we can look forward to a brighter future. The OECD figures for health spending show that Ireland is slightly above the average and that, in actual fact, we should be below the average as a result of the profile of the population, namely, that there are so many young people living here. In order to achieve efficiencies and savings further down the road, further reforms will be required. The Deputies opposite will have to acknowledge that if money could have solved the ills of the health service, this should have happened during the 12 years in which the spend on health quadrupled. However, that did not prove to be the case.

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