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

The HSE service plan is credible, provided it is adhered to. It is always a struggle for the Health Service Executive, most public bodies and Government agencies to remain within budget every year. The funding they would like to have to do what they want to do will always be lower than what can be provided by the Government through the taxpayer.

As is always the case every year the HSE will have to work very hard to stay within budget but the HSE service plan, which the Government approved and which was signed off on before we approved it, is credible if what is in it is adhered to. What is in it is that we will have - at the very least – the existing level of services we had last year plus a number of specific improvements that are funded. The funding is being held in the Department of Health to make sure those improvements actually happen and will be given to the HSE as they happen. That is what we expect to be done, but it will be a struggle. There will be plenty of engagement and over and back involving the HSE, the Department of Health and the Department of Public Expenditure and Reform as the year goes on, as we sort this out, but the overriding objective is one that results in, at the very least, the existing level of service and on top of that the additional €200 million or so that is being provided for new services being spent on those new services and not being sucked into other costs.

As Deputy Martin said, it is an increase of €413 million on the outturn last year. That is a real increase and that is on top of a very high base. Let us not forget that our health budget is now the highest ever since the foundation of the State. On a per capitabasis we now spend more on health than almost any other country. We are in the top five. Even during the recession our health spending was above average per capita. The fundamental problem in the health service - there are problems - is not solely one of resources. It is about how resources are deployed, and they are not deployed as they should be. When one looks at something that has got a budget of €15,000 million and we are talking about €450 million, €500 million or €800 million, we are talking about a variance of 6% or 7%. We are talking about the effect of 6% or 7% of the health budget. Why not look at how the 100% is spent? Let us imagine if the €15,000 million was spent well and efficiently what kind of health service we could have. Instead, we only ever talk about the increment - the 1%, 2%, 4% or 5%. That is what is wrong. Fundamentally, what we have is a health service where all problems get monetised and then they get passed on. That is not working. It will not work as a system and it must change.

To answer Deputy Micheál Martin's specific questions, the service plan for the health service must be done after the budget. It cannot be done until the HSE knows what its budget is and that is in the health Act. I think Deputy Martin might have been the person who brought the health Act through the Oireachtas so that is where it comes from but it might have been the Minister who took over from him, Mary Harney.

In terms of the correspondence, the Minister for Health has advised me that it has all been FOI'd so it has all been released already. The HSE goes before the Oireachtas committee on a quarterly basis to account fully for its actions. Any Oireachtas Member, including those who are not members of the committee, is free to attend such meetings.

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