Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I appreciate that we are trying new procedures in the Dáil, but this has been a four-hour debate, in which any number of speakers have made contributions totalling 225 minutes. To be brutally honest, it is not possible for me to do justice to those 225 minutes of speeches, all of which I was present for and all of which I listened to. In the spirit of the procedures we may develop in this House, allowing a Minister only ten minutes to lay out the state of play and only five minutes to reply to four hours of speeches is not going to work. I can only address one issue, therefore, which was raised by several Members. That related to funding for mental health, which I know has been a matter of public commentary in recent days due to the suggestions of a recent transfer of funding from the mental health budget.

First, I would like to point out that the mental health budget is €791.6 million for this year. It is ring-fenced and it is an increase of 4.4% this year. I have heard people using the figure €35 million. That is the increase in the development funding for mental health. The total budget is €791.6 million. That is €160 million higher than it was when this Government came into office, so it is one of the areas where there has been a substantial increase in funding, whereas in other areas funding has been frozen or has decreased. The €35 million will be fully provided for in the base budget for next year, and the key task is to ensure we get the best value from this assessment and that it benefits the greatest possible number of people.

Some time related savings are being made. Recruitment takes time and while new posts are being filled, it was not possible to fill them all from 1 January. Developments take time - one needs to hire people and to tender - so it was not possible to fill all posts and start all new developments from 1 January. As was outlined on page 8 of the HSE service plan, it was decided that savings from the timing of the implementation of this and other initiatives would be utilised elsewhere in the community. These are known as time related savings. They occur in other areas of service development and not just in mental health. This is clearly spelt out in the service plan which states that the HSE will use €20 million in time related savings from these planned initiatives on a one-off basis to continue to provide the 2015 outturn levels of home care and transition care beds, which is above the 2015 planned service level, and to put in place up to an additional €1.5 million as a purchase agreement for vaccines.

The national service plan was approved by the Government last December. It was launched and endorsed by the Minister of State, Deputy Lynch, by me and by Tony O'Brien thereafter. It was approved by a motion of the Dáil following a debate. Therefore, claims of some sort of raid are entirely inaccurate. I do not believe the acting Government should make any material changes to the service plan for 2016. Of course the new Government can do so if it wishes to when it takes up office. I do not believe there is anything to be gained from setting one part of the health service against the other part, and in this case it is people attempting to set mental health against social care for the elderly, and I do not agree with that approach at all.

In the time left to me, I will make one or two other points. One relates to the issue of Waterford, which a number of Members mentioned several times. If something is a matter of money or allocating resources, money can always be found. It cannot be found out of thin air, however. It is found at an opportunity cost of doing something else or it comes from another service, but money can be found. That is the prerogative of politicians: to find money and to allocate it. From time to time, political deals are done in that space, but I do not think it should ever be a political decision or that there should be a political deal when it comes to where we locate specialist national and regional services. That ended a long time ago. The former Minister, Mary Harney, in fairness to her, put a stop to that. She set up the national clinical programmes, which are a partnership of the HSE, the royal colleges and the specialists on a national level.

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That meant that decisions were not made by politicians looking for votes or making promises or by local clinicians who, of course, will always advocate for their local region or hospital no matter where it is, whether it is in Dublin, Waterford, or Cork. Out of that came the national cancer plan. Specialist centres were designated in which services were centralised. It was difficult and there were marches on the streets. It was very unpopular but I think we almost all accept that it was the right decision. I am not prepared to go back to a situation in which the decision on where we locate specialist regional and national centres is made based on political deals. That would be wrong and I would not like to see us go back to that under any circumstances. When it comes to cardiology services, I am not an expert. No politician is an expert. We have a national clinical programme that looks at the numbers and decides where specialist services should be located. That is how it should be done. It should not be based on lobbying, political speeches and certainly not on political deals.

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