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Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: Are the figures for new measures I just mentioned, comparing year on year, even though things have changed in the budget? There are new advances in medicines all the time. Is the figure €100 million this year as opposed to €254 million last year? If anything, given advances in new technologies and so on, we would expect it to increase.

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: That is why the figure stands out as being an anomaly. In 2017, the budget was not nearly the size it will be 2024, yet we only have €100 million for new measures. Are red flags built in for the Department of Public Expenditure, National Development Plan Delivery and Reform to indicate this does not look right because it is so small compared with other years? Who does the checks and...

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: The Department obviously based that €400 million figure on something. It looked at innovation and new medicines that were available. This has nothing to do with savings that could be made. The Department projected that it would need €400 million to be able to keep up with innovation, the supply new medicines and so on but it got a quarter of what it asked for and thought was...

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: How can we have an innovative, forward-thinking health service if just a quarter of what is requested is given? The Department would obviously be asked for a justification. I am just trying to get at how this all adds up or works. It does not add up to me. We are constantly talking about how we have Sláintecare and new innovations in health and then funding for new measures in the...

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: I have concerns about innovating as otherwise the Minister is not a very good negotiator. That is what this is pointing to. Mr. Moloney, in his opening statement, noted, and the Minister often says this too, that "Ireland ranked first in the EU for expenditure on healthcare as a proportion of our national income and as a proportion of total government spending despite our relatively young...

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: We can see the problem with the figures that are given out. Does the figure for Ireland include private healthcare?

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: It is fairly significant. Does the figure on expenditure on healthcare given to the committee include private healthcare?

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: It does, and I know that.

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: Yes, it is in the ESRI report that it does. It does not seem relevant to me, in a discussion about funding for public healthcare, to put out figures for private healthcare. Does Mr. Moloney see what I am trying to say? We really need to get away from this approach of "What are you complaining about when we spend more as a Government?" We need to look at a number of things in terms of the...

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: The issue is that we do not know. If we do not have all these variables and everything else to be able to do the measurements properly, do we really know where we are in respect of health spending? We bandy about a line - I am trying to be helpful – that the overall spend is whatever in proportion to whatever. However, the devil is in the detail regarding how the money is spent and...

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: Apparently, the problem is that international evidence tells us that such a system with private, for-profit healthcare provides actually drives up the healthcare costs. We are driving up the costs of healthcare and then we are measuring but we are leaving out whatever does not fit a narrative. Are we trying to make things fit into a narrative here? Mr. Moloney does not create the policy...

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: Where does Ireland rank compared with other OECD countries on public expenditure on healthcare?

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: We do not know what our actual expenditure is on public healthcare delivery here and the outcomes we get for it. We talk about life expectancy, and that is fair enough and I agree. However, I would like to see the what the life expectancy is for those at the bottom decile compared with life expectancy as a whole. We are moving further and further away from a delivery of healthcare –...

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: Which areas have been identified? The Department has identified use of agency staff in terms of consultancy; I do not mean medical consultants but other consultancy. What is calculated there with respect to the deficit?

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: I wish to move to capital expenditure before I finish. The Department of Health has been allocated €24 million less in this year’s budget than what was outlined in the NDP for 2024. This is even including the non-core capital expenditure. We have talked about the high levels of inflation since the NDP review was presented. This means that it does not go anywhere near as far...

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: There is one across the board in the different Departments. Is the Department of Health capable of delivering those projects with far less in real terms and even slightly less in nominal terms? Many projects are promised.

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: I will tell Mr. Moloney what I am trying to get at. We need honesty in respect of what will and will not be delivered. Projects were announced before the budget over the past number of months and there are expectations. When we decide these figures in the budget, I cannot see how the money is there to be able to deliver many of these projects in terms of capital expenditure.

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach: Budget 2024 Expenditure Ceiling and Resource Allocation for the Department of Health and HSE: Discussion (14 Nov 2023)

Rose Conway-Walsh: I know what Mr. Moloney is saying. The key question when he says “overspend” is whether we are overspending or underfunding. That is why the OECD figures and all those other figures, how we are driving things and the private and public healthcare divisions are so important to answer the question. Are we underfunding or overspending?

Written Answers — Department of Foreign Affairs and Trade: Departmental Expenditure (14 Nov 2023)

Rose Conway-Walsh: 52. To ask the Minister for Foreign Affairs and Trade to provide, in tabular form, a breakdown of the €776 million allocated to international cooperation in Budget 2024, and the €1.2 billion, comprising allocations from other Government Departments and Ireland's share of the EU budget (development cooperation) which constitutes the Official Development Assistance; if he would...

Written Answers — Department of Health: Nursing Education (14 Nov 2023)

Rose Conway-Walsh: 487. To ask the Minister for Health if he will provide an update on the payment of clinical placement allowances to undergraduate supernumerary nursing and midwifery students, as set out in Circular 4/2023; and if he will make a statement on the matter. [49321/23]

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