John Crown (Independent) | Oireachtas source

It is a given that the country found itself in a very difficult situation financially and found itself making what have been called difficult choices, clearly choices that were more difficult for some than for others, over the last few years. The two parties in the Government signed up to a programme which was largely based on trying to get the public finances into order through a process of curtailed public spending known as austerity. One of the most painful parts of that, of course, was the decline in spending on the health service to save money and, as a result, a decline in services. That there has been a decline in services is apparent in that waiting lists are longer and staffing levels are lower. I have seen figures of up to 10% for a global decrease in the number of those employed in the health service and 13% in the number of nurses employed in the health service over the last five years. While the pain and decreased numbers have occurred, what savings have occurred?

I recently saw figures, and we are depending on the very frail accountancy processes of the HSE and the Department of Health, which suggest that €14 billion was being spent in 2010 and that the projected figure for this year, when one factors in the various supplements that are made, is €13.8 billion. In return for a decline in service and a drastic reduction in the number of staff there has effectively been no saving of money. How have these resources been spent?

I have a suspicion that if one decides not to replace three nursing posts but when one is desperately stuck to replace them with two agency nurses who cost as much as three nurses, and the same applies to physiotherapists and junior doctors, one has a system where there is still a decline in the service and fewer people in post, but one spends just as much money. Is it possible to get answers to these core questions? What has been the year-by-year spend on the public health service in this country since 2008, what are the staffing numbers during that time and what number of people have been employed on an agency basis? Something does not add up. We have taken the pain in double terms. Patients and staff have taken the pain, but the savings have not been made. Something is badly wrong. This would be a good topic for debate in the House with the Minister for Health. It would be an opportunity to dissect the data, see what has been achieved and give the report card on austerity in the health service over these years.