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Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: What is the figure for the west?

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: Out of all the regions for which Mr. Woods has given me the information, the south's deficit has decreased while those of all the other regions have increased.

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: The south region has had quite a significant decrease in its deficit from €53 million to €44.7 million.

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: This is the other big figure that is here.

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: I wanted to get those figures so I could understand the most up-to-date components of it. Digging behind each of those figures, page 20 of the report includes information on primary care reimbursements, which we touched upon. One of the points made in respect of the increased demand for services, and I believe Mr. O'Brien touched on this point as well, is that a big chunk of the increase in...

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: It does say that the number of items reimbursed increased by 2.4 million items across the year.

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: That comes to the nub of my questioning. When the HSE is getting its figures ready for the year, I suppose it knows that if it issues a certain number of new medical cards, that will generate a certain amount of expenditure. Why has there been such an increase in the number of items on existing medical cards that has consequently driven the cost the HSE is managing at the moment?

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: That is not an unexpected variable though. At the start of the year, the HSE knows that people will be getting older and looking for more, that some people will, unfortunately, pass away, and that new people will be coming in. It is a stable enough universe.

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: I have a question relating to page 17 of the report from July 2012. It looks at the finance by different segments of expenditure and where the different deficits stand at present. Table 1 has a figure of €351 million, which has increased to the €404 million figure given earlier. The hospital services figure is in table 2. Can the witness give us an update on where that...

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: Is that part of the €404 million figure?

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: Would Mr. Woods be able to fill in that chart in terms of the components and that variance?

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: I mean the left side panel in table 2 on hospital services.

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: What does DML stand for?

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: In all cases, therefore, the deficit has increased as it went into the extra month.

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: That gives the deficit as it stood then.

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: The deficit figure of €500 million, which is a huge figure we are all very concerned about and which Deputy McDonald referred to earlier, has been in the public domain for some time now. Even in the report I have here, there is reference to the fact that the HSE expected, if things went unchecked, there would be a deficit of roughly that level later in the year. Am I correct in that?

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: When did that figure come into the public domain?

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: There has been clarity that if other things did not change and if measures were not put in place, a deficit of that level would be reached.

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: Mr. O'Brien made an interesting point in his submission earlier. He said that even if everything had gone according to plan-----

Public Accounts Committee: Vote Management and Budgetary Situation in 2012: Discussion with Department of Health and HSE (9 Oct 2012)

Paschal Donohoe: -----there still would have been a deficit level to which the service would have had to respond. This is a point we touched on in our June hearings, the issue of the lack of integration still in respect of cost accounting within the HSE. Why is it that even when there was a huge amount of money in the economy there were still deficit crises occurring in our health service? What is the...

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