Jan O'Sullivan (Limerick East, Labour)
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Question 114: To ask the Minister for Health and Children the information she has been given on plans by the Health Service Executive to reach its budget targets for 2008; if her attention has been drawn to the proposals to cut back on services; if her attention has further been drawn to plans by the HSE to introduce or increase charges to the public; if she has an arrangement in place whereby she would be made aware of such proposals; and if she will make a statement on the matter. [32183/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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In the first half of the year the Health Service Executive identified a projected deficit for this year in the region of €300 million if no remedial action were taken. The executive brought forward proposals to address the deficit and bring expenditure back in line with its Vote. The proposals were agreed by the board of the HSE. I was advised of the measures by the chairman of the HSE and that the goal for the remainder of the year would be to ensure an overall balanced Vote outcome on expenditure while optimising patient services and continuing the reform agenda.

These proposals, which were designed to ensure the delivery of the service plan, contained initiatives to further maximise value for money and reduce spending in areas where excess expenditure was occurring. The measures taken included bringing levels of service back in line with the targets set out in the service plan, as well as a range of cost savings in operational overheads. The latter included a reduction in travel and subsistence, a reduction in consultancy and advertising costs and the cancellation of all non-essential training. Other initiatives included increasing the collection of hospital charges and addressing absenteeism.

Implementation of these measures is being monitored by the executive and reported in line with the accountability procedures in place for monitoring the executive's expenditure and implementation of its service plan. These procedures include monthly meetings between my Department, the Department of Finance and the executive, quarterly high level meetings between my Department's Secretary General, the executive's CEO and their respective management teams. There is also ongoing liaison between my Department and the various directorates of the executive.

In respect of statutory charges, there were increases in accident and emergency and in bed charges at the beginning of the year.

Jan O'Sullivan (Limerick East, Labour)
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On a day when the Government can find an estimated €400 billion to €500 billion to guarantee the banks their money will be safe, I must question whether the Minister for Health and Children can guarantee in any way that vulnerable patients will be protected from health cuts, service cuts and increased charges. I find it extraordinary that the Minister is standing by — she said she has been advised of measures and that she is having ongoing information meetings.

Has the Minister been told increases in charges may be introduced before the end of the year? It has certainly been suggested to me that increases may be proposed to hospital charges and other charges, as well as new charges for people using the health services. Has the Minister been told that, as part of the proposals to reach the figure of €300 million, there are suggestions of cutbacks to home care packages and home help, as well as an increase in waiting lists because of reductions in services in the hospitals, and a variety of other proposals that will directly affect patients?

Can the Minister do something specific about this? If she feels the proposals with regard to both charges and cuts are unacceptable, can she take action to protect the public good and protect vulnerable patients from the effect of these reductions? In these circumstances, why did the Minister and her Department accept the biggest cut of all in the cutbacks announced earlier in the summer for various Departments?

Mary Harney (Dublin Mid West, Progressive Democrats)
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To deal with the last issue first, some of the matters covered by that saving were not proceeding this year, for example, the fair deal. It is also——

Jan O'Sullivan (Limerick East, Labour)
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The Minister could use the money for families who need it.

Mary Harney (Dublin Mid West, Progressive Democrats)
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It is also the case that a number of issues must be addressed for the remainder of this year, one being the repayments, which will be funded separately.

By way of general comment, the Government has not found €400 billion to bail out banks. What the Government has done is given a guarantee against a very strong asset base, a matter we will be debating in the House later today.

With regard to the health services Vote, like any other country where health services are funded by social insurance or private insurance, people must live within budgets. Public spending on health here has increased by 4.5 times in the past ten or 11 years, which is a considerable investment. There will be a 6% increase this year over last year in the number of home help hours.

The HSE produced a service plan, which I approved at the beginning of this year, and has given me an assurance it will meet all the targets provided for in that plan. However, we do not and cannot have the capacity for the provision of unlimited resources. The HSE, or for that matter any other State organisation, must live within the budgets that are voted through by the Oireachtas on an annual basis. To be frank, it is clear, given the financial challenges that face the country, that the position will be even more challenging next year.

I am not aware of any charges to be imposed on patients later this year or of any charges that could be imposed without my approval, and I have no intention of approving any additional charges for 2008. If the Deputy is being specific about an issue of which I am not aware, she should bring it to my attention. However, with regard to charges for beds, accident and emergency services or services of that kind, hospital charges require ministerial approval and cannot be imposed by the executive without ministerial approval.

John O'Donoghue (Kerry South, Ceann Comhairle)
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The time for that priority question has expired. The next priority question is No. 115 on the Order Paper and is in the name of Deputy James Reilly.