Marc MacSharry (Fianna Fail) | Oireachtas source

I again welcome the Minister to the House and thank him for making himself available. We are opposing the Bill. Ordinarily, on a personal level, I would not be comfortable with €12 billion or €13 billion of the people's money being under third-party control. I regularly spoke in that vein when I was on the other side of the House and former Deputy Mary Harney was Minister. However, I am not confident that the Department of Health under the Minister's stewardship is the right place for the budget. Over recent years the budgeting and financing of the HSE and the health services has been an unmitigated disaster. Never before have we had post-budgetary verification processes whereby the Minister's handiwork is overseen by the Minister for Public Expenditure and Reform and the Taoiseach. It does not give one confidence.

The main reason I oppose the Bill is that when the text of the service plan was presented, it was changed at the last minute after Ministers warned that the original version was political dynamite and would lead to uproar due to the widespread cuts.

Despite my criticism of Tony O'Brien in his role, he seems to have more of a handle on the facts than the Government does. He wrote: "It will not be possible in 2014 to fully meet all of the growing demands placed on the health services." However, when the service plan was published the next day it had been altered and the letter stated: "It will be very challenging in 2014 to fully meet all of the growing demands..." There were other changes also. A blunt statement in the introduction signed by Tony O'Brien declared: "The level of investment required to meet many of the critical service priorities ... cannot be met". It could not have been clearer. That was changed, and the published version stated: "some service priorities ... may not be met". The version presented to the Minister stated that the actual budgetary challenge facing the health service for the year was in excess of €1 billion, but that sentence was omitted from the version presented to the public.

I am concerned about the budget going into the Department if the practice is one that alters the true financial position and paints a complexion other than the truth for public consumption. That would not give one any confidence. For all the difficulty I have with the current position, I believe it is better when one considers how the Cabinet tampered with the facts before they were prepared to present them to the public. Mr. O'Brien's predictions have been correct when one considers the continuing cuts that have been necessary and the shortfall in the budget announced on 25 June of €158 million in terms of the deficit in the Vote to date.

That, in essence, is the reason we will not be supporting the Bill. While it is an unmitigated disaster, taking the budget in at this time under a Cabinet which is prepared to doctor the truth for public consumption in the way it did this year does not give one confidence. We would prefer, however blunt and undesirable, the Tony O'Brien approach of telling people the truth. There is no doubt the past few years have been challenging for the Minister in terms of cuts, but we are better dealing with the truth, the whole truth and nothing but the truth in trying to portray a budget to the people and following a particular plan. Looking back on recent years, it was anticipated that many millions of euro would be saved in various areas, but those savings have not materialised. In terms of the expenditure report for 2013, which was published at the end of 2012, we were told that the reduction in the cost of drugs and other prescribed items would result in savings of €160 million in 2013 and €330 million in a full year. Did those savings ever materialise? In 2014 the expenditure report anticipated savings in the cost of drugs of only €78 million. That was significantly less than the €330 million that was originally predicted.

Clearly, Tony O'Brien was right in predicting that he needed up to €1 billion extra to do the basics. Basic adding and subtraction seems to be a problem on an ongoing basis in running the service. I do not think people are more sick, on average, this year than they were last year or the year before. In taking €1 billion out of the allocation between 2008 and 2010, notwithstanding additional initiatives that were introduced to fill the hole created by the UK's paying less in respect of a fund to which it used to contribute, as well as the shortfall in the health levy, the HSE operated within budget. We are very far from that position now. We have had the headless chicken approach to health, with bits and pieces being dealt with. We had the medical card debacle, which we all agree was a disaster; we had the suggestion of universal provision for children under six, with yesterday's Second Stage debate on the legislation, which was generally welcomed; and we have talk of universal health insurance, but there was never less running out the door in that respect. That in turn is putting more pressure on the public system. The Minister will forgive me for stating that we do not have confidence in the system. There have been debates on all aspects of it over the years and we will have more, but we will be opposing this Bill.

I note in today's newspapers, following a parliamentary question that was answered yesterday, reports that the review of maternity services has not started yet and that the Minister has not selected the people to conduct the review despite the fact that the now resigned chairman of the West/North West Hospitals Group had prepared a report with his own company. One wonders under what authority they were acting. I know he has resigned, but the Minister might indicate whether the former CEO, Bill Maher, or the board as a whole had any input into it.