Wednesday, 21 May 2008
Since his appointment as leader of his party and his election to his new office, the Taoiseach has made several notable contributions with which I agree in respect of the delivery of outcomes and value for taxpayers' money. Nobody could disagree with those sentiments. However, what concerns me is the translation of that into effect. Before the Government arrives at a position where money is allocated, situations are assessed, reports are commissioned, objectives are set out and money is then allocated to achieve those targets and objectives. That is the normal procedure, going through the Department of Finance via the line Minister.
However, I will point to two examples where this process has slipped seriously. In 2006 and 2007, when the Taoiseach was Minister for Finance, the Government allocated €18 million and approved 130 posts in the area of palliative care services. Everybody in this House understands what palliative care means for elderly people who have a range of complex illnesses and may not have a good quality of life. Under the palliative care service proposals, the intention was that home care packages would be provided so that comfort, social contact, physiotherapy, chiropractory and other services would be available to older people in their own homes. Elderly people want to remain in their own homes for as long as possible. This point of contact with their home place is important for their comfort and mental well-being.
However, by May of this year, less than half the approved posts had been filled and only one in three in the three least developed regions. I see the Tánaiste is offering the Taoiseach some advice. I hope she is better informed of the figures in this instance than she was when she made her comments yesterday on the European Commission.
Millions of euro which were allocated by the Government for legitimate objectives and targets in the palliative care area have disappeared. In other words, the money is not being spent for the purpose for which it was allocated.
That is not the only area in which this has happened. The provision of mental health services is an issue that has been raised by Deputy Neville on many occasions. Between 2006 and 2007, €50 million was allocated by the Government for the implementation of its mental health policy, A Vision for Change, but that money has not been spent accordingly. The losers in this case are persons suffering from mental illness throughout the State who are desperately trying to access psychiatric services. We are all aware of tragic cases which occurred in the last 12 to 15 months where people were unable to access psychiatric services, with tragic consequences either for themselves or others.
In the case of both palliative care and mental health services, money allocated for legitimate objectives by the Government was not spent for that purpose. The Taoiseach allocated that money and somebody took it away. The Minister for Health and Children has said on more than one occasion that it is wrong to spend money if we do not know where it is going. Why is it that in these two cases, money allocated was not spent for the purpose for which it was intended? Why was it diverted and on whose authority was that done?
One of the main issues we face in trying to reform the health service is ensuring that resources are not continually put into acute services but that we provide more for community services and improve the frontline services in communities. In regard to mental health care, change has been ongoing for more than two decades in terms of providing community based facilities and trying to end inappropriate placements for people in mental hospitals who, under modern psychiatric circumstances, could be far better treated in the community. This initially met with some community resistance because of people's lack of knowledge that such care settings could be established within residential areas. They have since proved to be a great success because of the support of community organisations which have helped people understand that persons in that situation are capable of having a more fulfilling life in the community than in institutional settings. That has been going on for some time.
A problem with our health system has been the level of resources taken up in the provision of acute services. Some 70% of the total budget is expended for this purpose. It is true that the full allocation was not expended in the areas of mental health and palliative care last year. In regard to palliative care, direction has been given to the management of the health service this year to ensure the allocation is expended in this financial year. This has meant an increased provision of service and a much increased allocation to the voluntary hospice movement which does——
There are budgetary pressures every year in regard to the health budget and managers have to manage the situation as they see it. In some cases, this has meant that some new development areas have not seen the level of expenditure in a given financial year as was originally envisaged. Working within budget allocations is a particularly difficult task, especially in the health service, but it is one that must be respected if we are to have sustainable improvements in the future. In the case of both mental health and palliative care, I expect the allocated moneys will be expended this year.
In managing the health budget, managers must at times utilise particular allocations in order to maintain the existing level of service, which costs more money every year even before considering any new developments that are envisaged.
That does not answer the question. The Taoiseach was the Minister for Finance who made these allocations, and rightly so. Since his election as leader of his party and Taoiseach, he has pointed out that his priorities are health, delivery and outcomes. How can we have a situation whereby Ministers are allocated money by the Minister for Finance for specific targets and objectives which is not spent in those areas? That is the problem. As Deputy McCormack pointed out, the bonuses were not cut for managers and front line staff are not being recruited, with the result that on 13 May 2008 the Joint Committee on Health and Children heard evidence in respect of palliative care, which as Deputy Reilly regularly points out deals with people suffering terminal illnesses, the average waiting time for a hospice is eight days. The longest wait is 20 days but many of the people concerned do not have 20 days. The bonuses for managers are not cut, yet all the money allocated by the Taoiseach is unaccounted for and has disappeared. The Minister for Health and Children has said there is no point in spending money if one does not know where it is going.
I have had some difficulties with the Minister of State at the Department of Health and Children, Deputy Moloney, who is not in the House this morning, but I give him credit for saying on "Prime Time" that he was shocked at what was happening and the volume of money which was not being spent where it was allocated. He called a special meeting of the Joint Committee on Health and Children at which presentations were made by those involved in caring for the elderly and the hospice movement. He stated: "We do not have the authority to raise funds within this committee but we can ensure that funding allocated within the budget is spent within guidelines and headings." He went on to give this commitment:
...that funding allocated in 2006, 2007 and 2008 will be spent specifically in the appropriate areas. Even though the two previous years have now passed, the funding that was not used then can be front-loaded for 2008 and 2009. That is what we are about. If we as a committee cannot deliver upon that we should not come back to this room for further meetings. We are putting it as starkly as that.
The Minister of State is the Taoiseach's constituency colleague. Can I take it that he has the Taoiseach's imprimatur, that the moneys which were not spent despite being allocated by the Taoiseach as Minister for Finance in 2006, 2007 and to date in 2008 will now be front loaded and that the Minister of State's comments as chairman of the joint committee will stand up so that front line staff in palliative care and mental health can receive the moneys allocated for a legitimate purpose which is of importance and great sensitivity to many families? Nothing is as frustrating as seeing Ministers announce money for a certain purpose only to find it has disappeared into a black hole somewhere within the HSE. Can I get a commitment from the Taoiseach that the words of the former chairman of the joint committee will be implemented to ensure these front line staff provide the service to which they legitimately aspire?
The Leader of the Opposition is complaining that insufficient money is being spent in the community on mental health and palliative care services. He made the point that we are making cutbacks to front line services. That is not correct.
The whole purpose of health service reform is to take resources from the acute hospital sector and spend more resources in the community sector. Deputy Bruton comes here every day of the week to suggest that the rate of growth in public expenditure is too high, yet the Fine Gael Party has not supported one initiative to bring more support into the community sector at the expense of the acute sector.
I am simply pointing out that Fine Gael cannot have it every way. We are either going to have reforms that bring better value for money and bring about a better service or we will have Deputy Kenny saying every morning that more resources are the answer and his finance spokesperson saying that we are spending too much. You cannot have it both ways.
I am making a point that needs to be made. If we are going to have, as happens in health budgeting, demands on the service beyond what was contemplated in the service plan, arrangements have to be made at the discretion of managers at local level who can decide how best to handle the situation. Opposition Members cannot say it should be done that way today but if there is a shortage in the acute sector tomorrow say it should be done the other way. They cannot have it both ways.
Given the Taoiseach's increasingly busy schedule, he probably does not get much time for pushing shopping trolleys around the supermarkets in Tullamore, but I want to raise with him the problem of rising prices. I will focus on two aspects in particular, the first of which is the rip-off of Irish consumers by British retailers with shops located in Ireland.
Last weekend, The Sunday Business Post carried a survey — one of a series published in recent times — which shows that the prices charged in the Irish branches of British retail outlets are up to 50% higher than those charged in their UK shops. The survey provided details in respect of a number of British retailers — Tesco, Marks & Spencer, Argos, Laura Ashley etc. — that have branches in Ireland. These higher prices are being charged despite the fact that the euro has strengthened against sterling. The euro is now worth 80p sterling. At one stage, it was valued below 60p sterling. In such circumstances, one would have expected that the prices charged in the Irish branches of British retail outlets would have fallen. Instead, they are much higher than those charged in the UK. For example, a leading brand of detergent costs the equivalent of €12.50 in a British branch of Tesco while it costs €18.89 in an Irish branch. In the case of Marks & Spencer, a pair of shoes priced at the equivalent of €44 at a British branch costs €55 euro at its Irish branches. The prices charged by Argos at its Irish branches in respect of electrical items are 20% higher than those it charges in the UK. What is happening in respect of this aspect of pricing is inexplicable.
The second matter to which I wish to draw the Taoiseach's attention — the position in this regard is also inexplicable — is the price of diesel.
Diesel used to cost less than petrol. However, the price of diesel is increasing each day. On my way to the Dáil, I noticed one petrol station at which diesel is priced at €1.39 per litre. No one can explain why the price of diesel has shot ahead of that of petrol or why it is continuing to rise. The only explanation appears to be that the oil companies, anticipating a shift by motorists to diesel cars and other diesel-powered vehicles as a result of environmental concerns, etc., are taking the opportunity to hike up the price.
Difficulties relating to pricing affect people on a daily basis. The National Consumer Agency was established a couple of years ago but it does not appear to be doing anything about these difficulties. What action does the Government intend to take to address the rise in prices, which is inexplicable and for which there is no justification? What does the Taoiseach intend to do to encourage the National Consumer Agency, which was established by the Oireachtas, to act more effectively in the interests of consumers?
It is intended to discuss these matters with the chief executive of the National Consumer Agency. The question of profiteering in respect of imports as a result of the difference in the currency exchange rate is a matter for the National Consumer Agency, the Competition Authority and the Department.
I am glad the rate of inflation decreased in the past month. However, it still stands at 4.3%. The basket of food items is an important factor in the computation of the consumer price index. I acknowledge that there has been an increase in food prices as a result of a number of international factors which are indicative of a change in the food security situation worldwide. Deputy Sherlock stated last week that the latter is an issue for consideration for debate in the House.
I take the point that the National Consumer Agency highlighted these matters in the first instance. It is the responsibility of the agency to protect consumer interests. The Tánaiste will pursue with the agency's chief executive the further policy issues that can be articulated or implemented to assist in resolving this matter.
That will not provide much comfort to the people obliged to pay these prices. I refer, in particular, to those on fixed incomes, such as pensioners, who are being affected by rising food prices. The price of a loaf of bread is 20% higher than it was at this time last year and the price of a litre of milk increased by 30% in the same period. Action is required in respect of this matter. It is not good enough to state that a discussion will take place between the Tánaiste and the chief executive of the National Consumer Agency in which they will bemoan what is happening.
In the past couple of years, the Government stood down the groceries order and stated that increased competition would lead to a reduction in prices. However, one of the biggest beneficiaries of the abolition of the groceries order, Tesco — the chief executive of which pays himself £10 million sterling per annum — is charging up to 50% more for goods in Ireland than it does at its UK branches. The National Consumer Agency may, as the Taoiseach stated, have highlighted some of what is happening. However, it does not appear to have taken direct action to protect consumers from the rip-off prices being charged by some retail outlets.
If the rip offs being visited upon consumers are not curtailed by the retailers responsible for them, the Government will be obliged to take action to remedy the situation. In light of the fact that the euro is strengthening against sterling, prices here should be falling and people should be reaping the benefits. Irish businesses that export their products are feeling the squeeze as a result of the change in the relationship between the euro and sterling. However, consumers are not enjoying the benefits of that change.
In certain shops, one can find items which are priced in sterling — I understand this practice is not legal — but the retailer will not allow one to purchase them in that currency. I met a shopper this morning who informed me that she requested to pay the sterling exchange rate for a particular item. However, the retailer insisted on charging her the higher euro price. This type of behaviour cannot be allowed to stand and people cannot continue to be ripped off in this way.
In his earlier reply, the Taoiseach failed to address my point in respect of the price of diesel. Why are motorists and hauliers obliged to pay so much more for diesel than used to be the case? What is happening in this regard? It appears the oil companies are engaged in some kind of cartel activity in order to hike up the price of diesel and rip off motorists and hauliers. The latter will have consequences down the line for jobs and businesses.
The agency possesses the competence to follow up on an individual issue to which the Deputy refers, quite apart from the general question which is also a matter of some concern.
The price of oil and diesel is a matter that must be addressed by the Department of Enterprise, Trade and Employment with the relevant agencies. There is a need to ensure that there is transparency as regards pricing arrangements. Oil prices have doubled in the past 12 months, from $62 to $126 per barrel. That sort of variation depends on the availability of oil and the stocks that are already in place. Without prior notice, I do not have details of the latter to hand this morning.
We have established agencies to deal effectively with these matters.
The Tánaiste has indicated she has already made arrangements to discuss the situation and their analysis of it with representatives of these agencies. Those discussions will also focus on identifying the action which can be taken and which might prove effective in respect of this matter.