Patricia Ryan (Kildare South, Sinn Fein) | Oireachtas source

This is a very important Bill. It allows for the four-fifths rule, thereby allowing Departments to spend money next year. This rule means that Departments can spend up to four fifths of the previous year's voted expenditure before a vote must take place on the spending of extra money. If this Bill was not passed, there would have to be votes in January to allow Departments to spend. Since the Finance Act 2004, these Bills have also allowed for the capital carryover. Departments can carry 10% of their allocations over to the following year. The purpose of the Appropriation Bill is to give statutory authority for expenditure by the various Departments of the amounts voted for by the Dáil during the year.

Under Schedule 1 of the Bill, there are 45 headings under which spending will be approved. I would like to focus on Vote 38, which relates to spending by the Department of Health. Almost €22 billion is being spent on a health service that is still not fit for purpose. Ireland spends one fifth more per capitaon our health service than the EU average and we are not getting value for money. Sláintecare is in limbo. The boat is going to crash and everyone is jumping overboard instead of trying to steady it. It needs urgent intervention to get it back on course. The Minister knows this. So do I and so does everyone else.

We need root-and-branch reform of our health service. We need to use the expertise we have to develop a world-class system that is based on medical need rather than on ability to pay and that is free at the point of delivery so that we can end the scandals of elderly patients waiting on trolleys and long waiting lists for those who cannot afford health insurance. Many people cannot. They are then caught. If they do not have a medical card or insurance, they fall into limbo. Sinn Féin in government will build an all-Ireland health service we can be proud of. I ask the Minister to look at this matter.

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