Liz McManus (Wicklow, Labour)
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Question 65: To ask the Minister for Health and Children her views on the disclosure that the Health Service Executive handed back almost €100 million in unspent money to the Exchequer in 2006; the amount returned in 2005; the amount spent to date in 2007; the projects submitted to the HSE in 2005, 2006, 2007 related to new hospital beds, step-down beds and new hospital equipment and their cost; and if she will make a statement on the matter. [17866/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The final outturn on Vote expenditure for the Health Service Executive in 2006 shows a capital saving of €114 million, of which €42 million was used to offset a revenue overspend, while a further €47 million was used to offset a shortfall in appropriations-in-aid. This left a balance of €25 million to be surrendered to the Exchequer. The Health Service Executive's appropriation account for 2006 will show an overall surrender of €365 million — €25 million capital and €340 million in respect of the long stay repayment scheme.

In 2005 there was an overall surrender of €79 million. The capital programme had a saving of €50 million, non-capital programmes saved €4 million and appropriations-in-aid showed a surplus of €25 million. With regard to expenditure to date in 2007, the latest figures available from the Health Service Executive report total expenditure to the end of May as being approximately €4.8 billion against projected expenditure of €4.77 billion. Within these figures the trend in expenditure is much the same as in 2006. The capital spend is behind that planned, while the non-capital is running ahead of budgeted spend. I have discussed corrective action with the CEO as a matter of urgency.

The capital programmes submitted by the HSE in each of the three years, and approved by me, included sufficient projects to absorb its capital allocation for each year. However, actual capital expenditure in 2005 and 2006 turned out to be less than had been planned.

The HSE has taken steps to strengthen its capital management capacity, including the establishment of a single national estates function and the appointment of a new director. The level of capital funding provided to the HSE for 2007 will support a continuing high level of investment in our public health services and will enable the completion and commissioning of many new acute and community health care facilities.

Liz McManus (Wicklow, Labour)
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I congratulate the Ceann Comhairle and promise to obey him as best I can.

John O'Donoghue (Kerry South, Ceann Comhairle)
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Complimentary remarks will never eat into the Deputy's allotted time.

Mary Harney (Dublin Mid West, Progressive Democrats)
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Even if it takes an hour.

Liz McManus (Wicklow, Labour)
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Does the Minister not feel she should hang her head in shame? The news is worse than what was published in the papers. In 2006, €114 million of the capital fund was unspent and that is truly shocking. We have just heard about dialysis patients in Limerick who are unable to access dialysis at a reasonable time of day and there are similar needs across the country. Does the Minister accept responsibility for this? Against the best advice of her Secretary General and officials she decided that the HSE would be the Accounting Officer when it was established.

Year after year there has been underspending and a failure to deliver, even though the capital fund is anything but generous. Will the Minister for Health and Children accept responsibility for this? Rather than suggest the HSE will set up yet another Department with yet another highly paid director, which seems to be regarded as the solution to everything, will the Minister indicate to us how the funding will be spent for purposes we in this House determined it should be spent? There should be close evaluation because even the Comptroller and Auditor General was unable to assess accurately how money was diverted towards information technology projects within the HSE, with an overspend in that regard.

Mary Harney (Dublin Mid West, Progressive Democrats)
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One thing is certain, the Deputy has changed neither her tune nor her language.

Liz McManus (Wicklow, Labour)
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Unfortunately, the story is still the same.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I strongly stand by the decision to make the CEO of the HSE the Accounting Officer. I know of no good management system where a person is responsible for the delivery of services but is not accountable for the money involved. I do not believe that could lead to good management practice. I believe it is appropriate that the HSE should use expertise from outside the health service to run its estates function, as it recently did. The person appointed, Mr. Brian Gilroy, comes with a great deal of experience of projects in other sectors and I believe there will be a huge transformation in the manner in which this new national organisation sets about putting in place its capital programme.

Under the old health board regime the approach was to spend money no matter what. Money is allocated for particular projects and it is the duty of the HSE to ensure it is spent on those projects rather than spent merely for the sake of spending it. I strongly support this policy and I believe, though there will always be capital requirements, Ireland, together with Norway, at 5% has the highest percentage of capital spending on health of any country in the Organisation for Economic Co-operation and Development. I believe this is an appropriate level of investment.

Liz McManus (Wicklow, Labour)
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The health budget in Ireland is different to other countries because there is a large element of social funding. It seems the Minister has not changed her tune either. She is relying again on private consultants to the tune of €100 million in terms of what will be done in the health service.

While we all understand that not all projects proceed on time, does the Minister accept that checks and balances are in place in Government Departments to ensure that money not spent on one project in a given year would be diverted to other vital projects to prevent it from being returned to the Department of Finance at the end of the year? That is the way in which Departments work. However, the Minister's wilful decision has left us in a mess and the HSE's solution, yet again, has been to establish another department and increase bureaucracy. Meanwhile, patients are desperate for care, hospitals are desperate for extra beds and primary care centres are not being delivered. All these physical facilities and services are being denied to patients due to the Minister's incompetence.

Mary Harney (Dublin Mid West, Progressive Democrats)
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It would be arrogant for me to comment on my competence or otherwise. That is a matter for others to decide. It is important that money allocated by the Exchequer, through the Oireachtas, is spent on the projects for which it is identified. Allocated funds are switched to other projects. For example, money was reallocated to minor capital works last year.

Liz McManus (Wicklow, Labour)
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Yes, it went back to the Department of Finance.

Mary Harney (Dublin Mid West, Progressive Democrats)
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These moneys belong to taxpayers. It is right that if taxpayers, through their elected representatives in this House, identify projects on which money is to be spent, this money should be protected for those projects in future years in the event that it cannot be spent in the year in which it is allocated. Funding was switched to other projects, for example, to certain capital works, particularly in the care of the elderly, which were completed last year. I am confident the new expertise acquired by the HSE will make a major impact on ensuring capital projects are completed on time and within budget. Mr. Gilroy has been appointed full-time on a five-year contract and will not act as a consultant.