Since his appointment as leader of his party and his election to his new office, the Taoiseach has made several notable contributions with which I agree in respect of the delivery of outcomes and value for taxpayers' money. Nobody could disagree with those sentiments. However, what concerns me is the translation of that into effect. Before the Government arrives at a position where money is allocated, situations are assessed, reports are commissioned, objectives are set out and money is then allocated to achieve those targets and objectives. That is the normal procedure, going through the Department of Finance via the line Minister.

However, I will point to two examples where this process has slipped seriously. In 2006 and 2007, when the Taoiseach was Minister for Finance, the Government allocated €18 million and approved 130 posts in the area of palliative care services. Everybody in this House understands what palliative care means for elderly people who have a range of complex illnesses and may not have a good quality of life. Under the palliative care service proposals, the intention was that home care packages would be provided so that comfort, social contact, physiotherapy, chiropractory and other services would be available to older people in their own homes. Elderly people want to remain in their own homes for as long as possible. This point of contact with their home place is important for their comfort and mental well-being.

However, by May of this year, less than half the approved posts had been filled and only one in three in the three least developed regions. I see the Tánaiste is offering the Taoiseach some advice. I hope she is better informed of the figures in this instance than she was when she made her comments yesterday on the European Commission.

That man got his answer.

Millions of euro which were allocated by the Government for legitimate objectives and targets in the palliative care area have disappeared. In other words, the money is not being spent for the purpose for which it was allocated.

That is not the only area in which this has happened. The provision of mental health services is an issue that has been raised by Deputy Neville on many occasions. Between 2006 and 2007, €50 million was allocated by the Government for the implementation of its mental health policy, A Vision for Change, but that money has not been spent accordingly. The losers in this case are persons suffering from mental illness throughout the State who are desperately trying to access psychiatric services. We are all aware of tragic cases which occurred in the last 12 to 15 months where people were unable to access psychiatric services, with tragic consequences either for themselves or others.

In the case of both palliative care and mental health services, money allocated for legitimate objectives by the Government was not spent for that purpose. The Taoiseach allocated that money and somebody took it away. The Minister for Health and Children has said on more than one occasion that it is wrong to spend money if we do not know where it is going. Why is it that in these two cases, money allocated was not spent for the purpose for which it was intended? Why was it diverted and on whose authority was that done?

One of the main issues we face in trying to reform the health service is ensuring that resources are not continually put into acute services but that we provide more for community services and improve the frontline services in communities. In regard to mental health care, change has been ongoing for more than two decades in terms of providing community based facilities and trying to end inappropriate placements for people in mental hospitals who, under modern psychiatric circumstances, could be far better treated in the community. This initially met with some community resistance because of people's lack of knowledge that such care settings could be established within residential areas. They have since proved to be a great success because of the support of community organisations which have helped people understand that persons in that situation are capable of having a more fulfilling life in the community than in institutional settings. That has been going on for some time.

A problem with our health system has been the level of resources taken up in the provision of acute services. Some 70% of the total budget is expended for this purpose. It is true that the full allocation was not expended in the areas of mental health and palliative care last year. In regard to palliative care, direction has been given to the management of the health service this year to ensure the allocation is expended in this financial year. This has meant an increased provision of service and a much increased allocation to the voluntary hospice movement which does——

The Taoiseach is referring only to the €3 million allocation for this year. What about the allocation for the last three years?

——a tremendous amount of work in supplementing the statutory services that are provided in this area.

What about the allocations for 2006 and 2007?

Show me the money.

There are budgetary pressures every year in regard to the health budget and managers have to manage the situation as they see it. In some cases, this has meant that some new development areas have not seen the level of expenditure in a given financial year as was originally envisaged. Working within budget allocations is a particularly difficult task, especially in the health service, but it is one that must be respected if we are to have sustainable improvements in the future. In the case of both mental health and palliative care, I expect the allocated moneys will be expended this year.

The health service management was given the money and spent it elsewhere.

In managing the health budget, managers must at times utilise particular allocations in order to maintain the existing level of service, which costs more money every year even before considering any new developments that are envisaged.

There has been no extra money for mental health services.

The answer to the Deputy's question is that it is hoped the full amount will be expended on developments in the palliative care service this year. We want to see those developments take place.

Were the bonuses for HSE management paid? That is the question.

That does not answer the question. The Taoiseach was the Minister for Finance who made these allocations, and rightly so. Since his election as leader of his party and Taoiseach, he has pointed out that his priorities are health, delivery and outcomes. How can we have a situation whereby Ministers are allocated money by the Minister for Finance for specific targets and objectives which is not spent in those areas? That is the problem. As Deputy McCormack pointed out, the bonuses were not cut for managers and front line staff are not being recruited, with the result that on 13 May 2008 the Joint Committee on Health and Children heard evidence in respect of palliative care, which as Deputy Reilly regularly points out deals with people suffering terminal illnesses, the average waiting time for a hospice is eight days. The longest wait is 20 days but many of the people concerned do not have 20 days. The bonuses for managers are not cut, yet all the money allocated by the Taoiseach is unaccounted for and has disappeared. The Minister for Health and Children has said there is no point in spending money if one does not know where it is going.

I have had some difficulties with the Minister of State at the Department of Health and Children, Deputy Moloney, who is not in the House this morning, but I give him credit for saying on "Prime Time" that he was shocked at what was happening and the volume of money which was not being spent where it was allocated. He called a special meeting of the Joint Committee on Health and Children at which presentations were made by those involved in caring for the elderly and the hospice movement. He stated: "We do not have the authority to raise funds within this committee but we can ensure that funding allocated within the budget is spent within guidelines and headings." He went on to give this commitment:

...that funding allocated in 2006, 2007 and 2008 will be spent specifically in the appropriate areas. Even though the two previous years have now passed, the funding that was not used then can be front-loaded for 2008 and 2009. That is what we are about. If we as a committee cannot deliver upon that we should not come back to this room for further meetings. We are putting it as starkly as that.

The Minister of State is the Taoiseach's constituency colleague. Can I take it that he has the Taoiseach's imprimatur, that the moneys which were not spent despite being allocated by the Taoiseach as Minister for Finance in 2006, 2007 and to date in 2008 will now be front loaded and that the Minister of State's comments as chairman of the joint committee will stand up so that front line staff in palliative care and mental health can receive the moneys allocated for a legitimate purpose which is of importance and great sensitivity to many families? Nothing is as frustrating as seeing Ministers announce money for a certain purpose only to find it has disappeared into a black hole somewhere within the HSE. Can I get a commitment from the Taoiseach that the words of the former chairman of the joint committee will be implemented to ensure these front line staff provide the service to which they legitimately aspire?

Every morning, the problem with the Leader of the Opposition is that his party has not yet supported one initiative in regard to health service reform.

Play the man, not the ball.

Answer the question.

The Taoiseach keeps accusing people of playing the man and not the ball. He should play the ball himself.

For Deputy Reilly's attention, I can organise it so that every time his man completes a sentence, I can have people roaring and shouting on this side if he wants.

His Ministers keep coming out to say people are playing the man, not the ball.

Deputy Reilly ——

He will not answer the question.

Every time I open my mouth, I hear something from the Deputy.

Answer the question.

I want to answer the question.

You are in Government.

Stop playing the man and start playing the ball.

The Deputy's problem is that he is not the Leader of the Opposition.

The Taoiseach's problems are myriad.

Deputy Reilly, this is Leaders' Questions.

Answer the question.

Listen to me, I want to answer the question but I will make one point. If you keep that tactic up, I will make sure he will not be heard in this House.

It can be organised.

The new statesman.

The Taoiseach will not silence the people on this side of the House.

The Taoiseach without interruption.

I am not going to take that from any Member of this House. The Taoiseach will not silence the Fine Gael Party or any of its members.

I will not be shouted down by the orchestrated tactic engaged in by the Opposition for months. That will not work with me.

What is the answer?

He is filibustering.

I want to answer the questions but if Leaders' Questions——

You will not silence the people in this House.

——is about you organising a shouting match, then you will not get answers.

The Taoiseach might treat Fianna Fáil backbenchers like that but he will not do the same to the House.

Will the Taoiseach just answer the question?

I will answer the question but I will not listen to that sort of nonsense.

Let us have it.

He will not control us.

The Taoiseach without interruption.

If Deputy Kenny cannot control his own party, that is his problem. Leaders' Questions involve the Leader of the Opposition asking questions and me answering them.

What is the answer?

If I may reply without interruption, I will do so.

He has no answer and that is why he is filibustering.

The problem with Fine Gael is it wants it every way.

Blame everyone else.

Can the Taoiseach answer the question?

Let me answer the question.

He cannot answer the question.

I am able to answer the question.

He is dodging.

I have Deputy Bruton coming in——

I have to interrupt. We must understand each other. This is Leaders' Questions.

He is making a joke of it.

Deputy Kenny asked his question legitimately and the Taoiseach is entitled to reply.

Let us have it.

Allow him to speak.

Without interruption.

He is unable to reply.

The Leader of the Opposition is complaining that insufficient money is being spent in the community on mental health and palliative care services. He made the point that we are making cutbacks to front line services. That is not correct.

It is correct.

Those are the facts.

If Deputies want to hear the facts, an additional 3,500 front line staff are working in the health service this year compared to last year.

The home help service has been cut everywhere.

The suggestion that there is a reduction in front line staff is incorrect.

What about the money?

The whole purpose of health service reform is to take resources from the acute hospital sector and spend more resources in the community sector. Deputy Bruton comes here every day of the week to suggest that the rate of growth in public expenditure is too high, yet the Fine Gael Party has not supported one initiative to bring more support into the community sector at the expense of the acute sector.

You are wrong.

What about the jobs lost in home care services?

The Opposition is claiming there are infinite resources and that continuing to spend money all over the place will solve the problem.

Answer the question.

The Taoiseach has to be allowed to finish his answer.

I am simply pointing out that Fine Gael cannot have it every way. We are either going to have reforms that bring better value for money and bring about a better service or we will have Deputy Kenny saying every morning that more resources are the answer and his finance spokesperson saying that we are spending too much. You cannot have it both ways.

Fianna Fáil cannot have it both ways.

The Minister of State, Deputy Moloney, says one thing but the Taoiseach says another.

In regard to palliative care, I have made it clear that the supports for palliative care in the home have increased——

They have not.

——compared to what they were before.

In the real world, they have not.

That is a fact, and assertions to the contrary by a number of Deputies opposite do not change that fact.

Where is the money? The Taoiseach allocated it.

There are increased resources for that area and a direction has been given for this year which will ensure the extra moneys being allocated are spent in that area.

The money is not being spent.

I am making a point that needs to be made. If we are going to have, as happens in health budgeting, demands on the service beyond what was contemplated in the service plan, arrangements have to be made at the discretion of managers at local level who can decide how best to handle the situation. Opposition Members cannot say it should be done that way today but if there is a shortage in the acute sector tomorrow say it should be done the other way. They cannot have it both ways.

That is what the Government has done.

That is what they are trying to achieve every morning. At some stage they are going to have to decide which side of the fence they are on when it comes to reform in the health service.

Hear, hear.

The Taoiseach does not like health issues because they concern people who are dying.

Trite sound bites.