Results 1,981-2,000 of 26,350 for speaker:David Cullinane
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: The answer then is that the health service is not adequately funded for 2024.
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: Let us unpack that a little. We have to go back to last year to understand better what might happen next year and the funding implications for the health service under budget 2024. When Mr. Gloster was most recently before this committee, he said that the cash deficit for 2023 was likely to be approximately €1.1 billion but what he called the income and expenditure line deficit would...
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: -----that there would be a deficit in the region of €1.5 billion. Is the estimated deficit for 2023 still approximately €1.5 billion?
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: Okay, but it will be in the territory of €1.4 billion to €1.5 billion.
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: Mr. Gloster and the Secretary General have been consistent in saying that the two main drivers are the fact that health inflation is running high at the moment and increased demand. There was a third element in relation to cost controls and so on but over two thirds of the deficit is the result of inflation and demand. Is that correct?
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: For 2023, we could end up with a deficit of between €1.4 billion and €1.5 billion, as Mr. Gloster has said. If we were to achieve all of the savings and efficiencies about which the Secretary General spoke and which may be put in place for next year, and also taking into account what has been put in place for this year, even if we were to achieve the top end of that, it would...
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: The vast majority of it is outside the control of the HSE. Is that correct?
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: I understand that. When a budget is framed for 2024, we have to be conscious of what went before in 2023. I will finish my point so we are clear. We are facing a deficit of €1.5 billion, the majority of which is coming from costs outside the control of Mr. Gloster and Mr. Watt, including those resulting from inflation and increased demand. Even if Mr. Gloster achieves all of the...
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: Exactly, but Mr. Gloster needs a revised Estimate to carry into 2024 and we do not know how much of that he will get. The hope would be that he will get all of that but that will only be for 2023. Then what is important is what goes into the base for the following year.
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: What I asked both Mr. Watt and Mr. Gloster the last time they were here was how much of the €1.5 billion deficit for this year would be recurring. How much of that-----
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: The majority of it, and yet the health service was not funded any of that. It got around €400 million of one-off funding as part of the €1 billion figure to which the Secretary General referred, which also includes Covid expenditure, Ukrainian funding, money for waiting lists and so on. I think a figure of €480 million was earmarked in the budget under the resilience...
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: That is for the ELS, which is separate again.
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: Exactly. That is my point. Unless that was put into the base for next year, we will have the same problem again next year, with a deficit running again in 2024. That is the difficulty. If I then come to ELS, I want to be clear about what that means. Existing levels of service means to simply stand still, to provide for demographic pressures, inflation, pay and all of those issues. What...
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: I know that but for the purposes of clarity, the HSE got €708 million. Mr. Watt said €808 million but €100 million was for new measures.
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: The health service got €708 million but how much did the Department seek for 2024, just to stand still?
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: The Department got €700 million.
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: Yes, but once-off does not cut it. I am talking about permanent funding. The Department sought €2 billion and it got €700 million. Is that correct?
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: Okay, so there is a shortfall of €1.3 billion.
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: Yes, but with respect, Mr. Watt, I do not have a lot of time and I just want to be accurate and clear. The Department sought a minimum of €2 billion, it got €700 million so there is a shortfall of €1.3 billion. That is in the base, in core expenditure.
- Joint Oireachtas Committee on Health: Consideration and Implications of 2024 Health Services Funding: Discussion (24 Oct 2023)
David Cullinane: There is a shortfall of €1.3 billion. That means that Mr. Gloster has to write a service plan for next year that guarantees a deficit for 2024. Would that be fair to say?