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

The revelations by Martin Wall on Monday in The Irish Times, following the release of correspondence between the Government and the HSE through a freedom of information request, confirms what I have said for some time, that, in essence, there was a fundamental lack of transparency at the heart of the process for providing money for health in 2018. There is a clear attempt by the Government to cover up the truth on the challenges facing the health services in 2018. The Government published a spending plan for health in the full knowledge that it will not be sufficient. I am not talking about the usual toing and froing or the arguments and counter arguments between the Government and the HSE but clearly there has been an attempt to paper over the gaps and to hide the truth from the public. The attempt to paper over the disagreement was made by putting in a figure of €346 million in value for money savings. We now know, however, that in the days after the publication of the plan, the HSE director general said that the targets will not be realised. This was subsequently revealed by The Irish Timesalso.

The correspondence shows that there was an understanding, or that assumptions were made, to keep off the books potentially hundreds of millions of euro in other risks. For example, there was no provision for pay pressures, €68 million of which was in the earlier draft. Was this a reference to the employees of hospices and disability organisations who had balloted for strike action and who have been denied their fair pay by the Government? The Government also instructed the HSE not to include any sum in the plan to deal with a carryover of its financial deficit from 2017. The director general of the HSE has estimated other significant challenges facing the HSE, but the Government clearly wanted the financial difficulties played down in the published service plan. Departmental correspondence states:

The financial challenges need to be addressed only once (in the financial section?). Details on the assumptions and arrangements to address financial challenge should be contained in the letter accompanying the NSP [national service plan] rather than included in the main document.

Decoded, the HSE is being told to bury the negative stuff as effectively as it can, and not to put it upfront because the public might see it too clearly.

There are also revelations about Sláintecare. The Taoiseach has repeatedly said that the Government is committed to Sláintecare but the HSE director general has said the plan is challenging because he would have to develop the service plan "in the absence of an agreed implementation plan and transition funding for Sláintecare". A sum of €3 billion was supposed to have been provided. The HSE director general was told by the Department that he was "overly focused" on a transition fund as it has not been approved yet. Clearly, this reveals a fundamental lack of commitment to the implementation of Sláintecare.

There is much more in this correspondence. The HSE pointed out that the plan would be challenging in terms of "performance and protecting patient safety". The Department's response was to warn the HSE that it was using "unacceptable language". Why has the Government gone to such lengths to prevent the truth from coming out and to prevent the HSE from telling it as it is with regard to the challenges facing the health services in 2018?

See this speech in context