Micheál Martin (Cork South Central, Fianna Fail) | Oireachtas source

Last week I asked the Taoiseach some basic questions about the HSE's or the health service budget, but he did not answer the questions I asked. He went on a general tour of spending generally and within the context of health services. My fundamental point last week and this week is that we are essentially being misled by the Government and the HSE on the budget for the health service in 2018. The service plan was published, but the very fact that it was published in December after the budget was a problem in terms of transparency and honesty about the figures. I asked a very basic question as to why it had taken a freedom of information request to reveal that the bulk of approximately €346 million in savings identified in the service plan would not be realisable and that the CEO of the HSE was saying this was extremely challenging. That is not to mention the deficit of €172 million. There is no real understanding of how it will be provided for. I refer to what the HSE is stating about existing levels of service and the funding required.

The budget represents an increase of €413 million on the final figure, the outturn, for 2017, which is the crucial figure. It represents an increase of approximately 2.9%. Pay accounts for approximately €278 million of this sum and is part of public service pay agreements. Demographic costs constitute the big issue facing us all in terms of spending. In the light of these costs, the amount allocated is hardly adequate, but it is a significant factor. Basic health inflation, the incremental cost of developments in 2017 and so on must also be borne in mind. There is a figure of approximately €196 million for new service developments. One then has to factor in savings of €346 million. When one goes through the figures - it can be confusing to the public at large - one notes that, in essence, the HSE will find it extremely difficult to deliver services at the level they were provided last year, never mind expand services. That explains why those working in the health service cannot work out all of the general talk about global figures and increases when hospitals such as St. Finbarr's are being asked to accept a cut of up to 21 whole-time equivalent positions, when ten beds lie unoccupied in Bandon, despite the fact that there are now considerable issues about elderly people finding placements in long-term care settings and when revenue funding was refused in Letterkenny, despite record levels of overcrowding. It explains the disconnect. There is a massive fudge in the presentation of the health figures.

Will the Taoiseach release all of the correspondence between the HSE and Minister leading up to the Estimates and the budgetary process? It is absolutely unacceptable that we must rely on freedom of information requests to find out the real story about the concerns of the chief executive officer of the HSE about this year's Estimate. Will the Taoiseach facilitate meetings between HSE directors and leaders and spokespersons of the various political parties in order that there can be a fully transparent assessment of the implications in 2018 and for the health budget in general? Does he accept that there is a fundamental credibility problem with the figures, as presented, for the health service Estimate for 2018?

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