Mary Lou McDonald (Dublin Central, Sinn Fein)
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53. To ask the Minister for Public Expenditure and Reform his discussions with the Department of Health regarding expenditure on health. [2082/16]

Mary Lou McDonald (Dublin Central, Sinn Fein)
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My question relates to health. Nowhere is the chaos of the Government more evident than in accident and emergency and the burgeoning waiting lists. I would like the Minister to place on the record of the Dáil the discussions he has had with the Minister for Health, Deputy Leo Varadkar, in respect of health expenditure.

Brendan Howlin (Wexford, Labour)
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Apparently, the biggest hallmark of failure now is health. Last week it was housing.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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No, that is pretty spectacular too.

Brendan Howlin (Wexford, Labour)
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With Sinn Féin it is the crisis du jour. Discussions between my Department and all Departments on the issue of expenditure take place very regularly. The Department of Health is no different. At ministerial level there is the Cabinet committee on health and at official level there is a senior officials group on health where discussions on all health and health funding issues take place regularly. In addition, there are regular informal communications between officials of both Departments, heightened in the run-up to the budget. Such engagement is an important component in the process of providing a well-resourced health system.

This has led to health sector funding been prioritised and protected during the lifetime of the Government. Budget 2016 increased the gross health expenditure to €13.61 billion, a €970 million, or 7.7%, increase over the final 2011 spend. Such ongoing communication also resulted in the Government providing additional resources in 2015 for the fair deal scheme, for example, emergency department overcrowding and winter initiatives.

Something the House might note is that since the start of 2014 up to the end of November 2015 - the last time I had the figures - the HSE has recruited an additional 6,321 staff, an increase of 6.5%. This includes an additional 965 doctors and more than 1,000 additional nurses, again emphasising the Government's commitment to a well-resourced health care system.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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I do not take any comfort, nor I am sure does anyone, from the fact there is a Cabinet sub-committee on health, that the Government has an official group on health, that the Minister is discussing budgetary matters daily with the Minister, Deputy Leo Varadkar, and yet we have the mess and the misery that reigns in our hospitals. The Minister commended himself on his increase in funding to the system, but the current service plan imposed on the HSE is €150 million short of what it needs. We heard from Tony O'Brien, the man the Minister, Deputy Howlin, put in charge of the HSE, that funding for hospitals is €100 million less than required. That is simply to stand still. We know there is €1.5 billion less in the health budget than there was in 2008. That is where it sits. I would like the Minister to tell us in more substantive terms what discussions he has had directly with the Minister, Deputy Leo Varadkar, in respect of the underfunding of the health system.

Brendan Howlin (Wexford, Labour)
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The Deputy is now falling into the same viewer trap Fianna Fáil did over the weekend, that is, to assume 2011 was year zero and we did not have a complete and absolute economic collapse. Trying to restore the public finances has been the most demanding focus of Government for the past five years. One cannot pretend we had resources available to deploy as we wished. We had to reduce expenditure over that time. We protected health and health numbers as best we could throughout that process and that is self-evident. I do not believe either that every issue in the health service is to be met by more cash. For example, under the Haddington Road agreement, we deployed an additional 5 million hours from all levels of staff - from porters to consultant hospital doctors - to deliver better services.

While everybody, understandably, focuses on health failures, there is an enormous success story also from the majority of those who interact with the health service regarding the fine work done by doctors, nurses, porters and health workers.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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There is no pretence about the fact - it is not a good record for the Government - that there are 68,000 people waiting for inpatient treatments, 400,000 people waiting for outpatient appointments and under-staffing right across the system. My local hospital, the Mater hospital, is at least 100 nursing staff short of what is required. If the Minister is trying to put a gloss on this that he has done fantastically well and has protected the health service, all of the evidence speaks against that. The experiences of people on waiting lists and particularly those going into accident and emergency testifies to the contrary.

To boil it down, I want to know if the Minister for Health, Deputy Varadkar, has challenged the Minister to get his act together or the Government to collectively get its act together and commit the level of funding that is required just to have a stable, decent level of service within the health system?

Brendan Howlin (Wexford, Labour)
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It is very easy for the Deputy - perhaps she does not have any ambition to be on this side of the House - to say we need to spend more on health, housing-----

Mary Lou McDonald (Dublin Central, Sinn Fein)
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We need to spend more on health.

Brendan Howlin (Wexford, Labour)
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-----and disability and to spend more-----

Mary Lou McDonald (Dublin Central, Sinn Fein)
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No.

Brendan Howlin (Wexford, Labour)
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We have just had a discussion about value for money and-----

Mary Lou McDonald (Dublin Central, Sinn Fein)
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Hospital trolleys are not value for money.

Brendan Howlin (Wexford, Labour)
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-----one of the approaches we have had is to rebalance staff within the HSE. For example, we now have a higher percentage of front line staff than we had when we came into office because we reduced, as far as we could, administrative staff-----

Mary Lou McDonald (Dublin Central, Sinn Fein)
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The Government hammered the front line.

Brendan Howlin (Wexford, Labour)
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-----as we allocated resources to the front line. As I say, it is bizarre because the Deputy represents a party that wanted to destroy this country in 2011, pull down the troika agreement and send it packing. We would not have had a single hospital bed or nurse because we would have had nothing to pay them with by the end of 2011 had the Sinn Féin policies been implemented. That is a simple, inescapable fact.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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That is lying.

Brendan Howlin (Wexford, Labour)
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Like Fianna Fáil, Sinn Féin wants to believe that the economic collapse and-----

Mary Lou McDonald (Dublin Central, Sinn Fein)
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The Minister wants to leave elderly people on trolleys and people on waiting lists.

Brendan Howlin (Wexford, Labour)
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-----the loss of 330,000 jobs never happened and that we did not have to go through the difficult adjustment period the Irish people have endured for the past five years to put us in a position to start again-----

Mary Lou McDonald (Dublin Central, Sinn Fein)
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Did the Minister for Health, Deputy Varadkar, ask the Minister for more money?

Brendan Howlin (Wexford, Labour)
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-----investing in quality public services.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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Perhaps he did not.