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

The answer to the Deputy's question is that the Government makes these decisions. The Government acts collectively, signed off on the budget as a collective and accepts collective responsibility for the budget, including the health dimension of it, and ultimately, of course, it is a decision of the Dáil because it is the Dáil that votes on Estimates and it is the only body that allocates money to the health service, at least from a political point of view.

The health budget is always a challenge and that is not something that is unique to Ireland by any means. Health services all over the world struggle to come in on budget, and in Ireland that is no different. It has always been a challenge. Long before I was a TD, the health budget was a challenge for governments. No matter how much is allocated, there will always be calls for more. Whether the increase on an annual basis is a big one or a small one, there will almost always be a requirement for a supplementary. The years 2023 and 2024 are not going to be any different, but I do need to set out some of the facts because a lot of what the Deputy said was, characteristically, misleading.

First, the budget for 2024 is the biggest ever, at €22.5 billion. To put that in perspective, it is more than €4,000 for every man, woman and child in the State going to the HSE. It is a considerable amount of money. The waiting list initiative is fully funded, the emergency department programme is fully funded and, far from there being a recruitment embargo, the HSE will be allowed to hire 2,000 extra staff, in addition to replacements, throughout the course of 2024. When I was Minister for Health, not all that long ago, the budget for health was €14 billion or €15 billion, and an increase in any one year of €500 million would have been something I would have given my left hand for, quite frankly. Since then, we have seen the health budget increase by somewhere between 60% and 70%. Yes, our population has grown, it has got older and there is medical inflation, but not to that extent.

These are real increases and they have made a real difference, by the way. Our life expectancy is now one of the best in the entire world. Despite the Deputy's misleading comment, waiting lists peaked after Covid and have fallen by about 20% since then, which is not the case in most European countries, where waiting lists are still rising. That is not to say people are not waiting too long - they are, in their hundreds of thousands - but waiting lists have peaked and fallen 20% from the peak. Patient outcomes are better than ever before, particularly in areas like stroke, cancer and cardiovascular disease, and at the moment, while we experience overcrowding in too many of our hospitals too much of the time, generally speaking, if we take any day this week, roughly 100 or 120 fewer patients are waiting for a bed than would have been the case this time last year. Medicines are less expensive, free GP care has been extended to the majority of the population, we have abolished hospital charges, we are ending the public-private mix in our public hospitals with the new Sláintecare contract, contraception is free for women under 31 and State-funded IVF is now available. These are real changes for the better, done by this Government, done under the leadership of the Minister, Deputy Stephen Donnelly, and that extra money is making a difference.

In terms of recruitment, as I said, while we do have recruitment and retention challenges in some parts of the health service, what we have actually seen in the past three years is a recruitment surge. More than 22,000 extra staff are working in our health service, roughly the equivalent of the entire population of Longford. That is how many people have been hired and added to our health service in the past three years, and it includes 6,000 more nurses and midwives and 2,000 more doctors. There is capacity for the HSE to hire another 2,000 people next year, in addition to replacing everyone who retires or resigns, but it cannot just hire without approval and that has to change.

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