Colm Burke (Fine Gael)

I welcome the Minister. I thank him for his detailed summary of the service plan for 2012. It is a difficult area. Last year we spent €13.416 billion on health care and the total income tax collected in the country was €13.317 billion. In other words, we spent more on health care than we collected in income tax. It is a frightening figure when one puts it in that context but it points to the fact that we are giving priority to health. This year I note that we will spend €13.317 billion on health care, which is the same amount we collected in income tax last year. It demonstrates the cost of health care.

Health care covers a broad area ranging from elderly care, mental health and hospital services to the front-line services being provided in the community. It is a huge budget and a comprehensive service is being provided. I agree there are difficulties in this area, but the Minister has faced up to dealing with them and is very proactive in creating efficiencies, which is what we must achieve. The Minister said that in real terms there is a cut of €750 million in the budget. It is a huge cut for any Department to face. The Minister is facing that challenge and dealing with it.

There will be staff cuts. Approximately 2,044 staff retired between September and January and another 1,770 will leave by the end of February. A substantial number are leaving the service and this must be catered for. We must consider the issue of staff who are retiring but who are prepared to continue to provide services until new staff can be put in place. I raised one of these issues with the Minister last week. Where a replacement is not immediately available, a person who is retiring should be allowed to carry on doing the work. A service should continue on that basis rather than have it close down. Not everything can be done by the rule book. Sometimes we must bend the rules a little in order to maintain services at all cost.

I welcome the serious effort being made to reduce the number of agency staff being employed. It is unfortunate that this practice has used up a huge proportion of the budget of many hospitals in the past 12 months or two years. I am pleased, therefore, that a serious effort is being made to cut out this practice and get value for money, which is what taxpayers and the Minister want.

Despite all the difficulties the Minister faces, he is dealing with the reform of the service to make it more efficient and reconfiguring services. I give him one warning in this regard. Reconfiguration cannot be set in black and white. There may be an ambitious programme, but reconfiguration cannot be done overnight. In this regard, I will bring a case to the Minister's attention privately later. There is a need to set up an implementation team to oversee the reconfiguration process. Rather than proceeding in a straight line and closing a particular unit on a particular day, we need to ensure the proper transfer of services is provided for. There needs to be give and take in this process. In bringing forward reform and reconfiguration not all decisions should be taken by one person. There should be a joint approach by nursing and medical staff and administrators.

There is a need for more competition in private health care in certain areas of the country, which could fill a niche. I have referred one matter to the Competition Authority on which I am waiting for a decision. I hope the net result will be the creation of more competition in the private health care sector which will, in turn, bring down the cost of health care for the ordinary person, which is what we all want to see. It should be our priority to bring down the cost for everyone in the country while providing a very good service.

I thank the Minister for coming to the House and presenting the health service plan for 2012. With my colleagues, I wish him well in the implementation of the programme. I hope we will continue to maintain and reform the services in place.