Health budget overruns and cuts
Deputy McDonald challenges the Government’s €666 million health-budget cuts, citing rising demand, a likely €500 million supplementary estimate and pressure on services. Minister Quinn says overruns are a longstanding consequence of demand-driven healthcare and will be considered by the Government; McDonald remains dissatisfied.
It seems that reality has bitten in respect of the health budget. Finally the Taoiseach and the Minister for Health, Deputy Reilly, have come to their senses and are now accepting what we all have known for many months, that the Government will not meet its targets for proposed cuts to the health budget. Last year, the Minister and his colleagues, particularly those in the Economic Management Council, EMC, imposed €666 million of cuts on the health budget for 2014. This was despite the fact that there had been a €200 million overspend in 2013 and that everyone knew that demand for services was on the increase. In fact, in total the Government agreed to a cut of over €1 billion in health spending for 2014. Health professionals warned that this could not be done without hurting patients. They told the Government that fewer staff could not treat more patients, that people would suffer and potentially lose their lives as a result of this decision but the Government refused to listen. It pressed on, regardless of the human cost and week after week, in hospitals and communities across this State, we have seen that cost. The cuts imposed included €133 million from the medical card budget which was why parents with chronically ill children had their cards so cruelly snatched from them. Now, the cat is out of the bag.
Comment on this
The HSE will need a supplementary budget again this year which will be even bigger than that of last year.
If reports are to be believed, it appears that a further €500 million is going to be needed. Does the Minister accept that he, the Government and the members of the Economic Management Council got it wrong when they imposed an additional €666 million in cuts to the health budget? Will he, on behalf of the Government, commit to protecting the health budget from further cuts, either this year or in the budget for 2015?
Comment on this
The Economic Management Council consists of four people, two of whom previously held the position of Minister for Health and have some knowledge of how the Department operates. They were not in the Department when the HSE was established. That has been the cause of a great many difficulties as a result of the less than satisfactory way in which it was set up. Budgetary arrangements for this year and overruns in the health budget are matters for concern and will be considered by the Economic Management Council, the Minister for Health and the Cabinet.
Comment on this
I thank the Minister for that less than illuminating response.
Comment on this
I answered the Deputy's question; I did not reply to her speech.
Comment on this
Does the Minister accept that while the members of the Economic Management Council to whom he refers and who he says possess a level of expertise may have had some exposure to the Department of Health, it is clear that they got it very badly wrong? Does he also accept that, against the backdrop of overruns within the Department, incredible pressure on the system and rising demand, it was ill-conceived to suggest - much less impose - cuts of the order of €666 million? The facts reflect that we are facing into another Supplementary health Estimate of the magnitude of €500 million. Will the Minister confirm that is the case? I asked him a straight question, namely, whether he would admit or accept that the decisions relating to the delivery of health services made in the context of the most recent budget were wrong. I then asked him to give a commitment that there would be no further cuts to the health budget this year or in the budget for 2015. Will he provide a slightly more comprehensive answer? Does he accept that the Government got it wrong and will he give a commitment that there will be no further cuts?
Comment on this
I cannot recall a time in the past 25 years when it was not necessary to introduce a Supplementary Estimate for the Department of Health. The Deputy sitting beside Deputy Mary Lou McDonald has been a Member of the House for some time and possesses wide-ranging knowledge of the health area. I am sure he will concur with what I am saying in this regard. As a result of the fact that the health service is demand-driven and because, unlike the position on the number of pupils who are going to attend school in any one year, that demand cannot be predicted in advance, it is simply impossible to achieve a balanced budget. What is at issue is the scale of the demand and what is required to meet it. In the first instance, that will be a matter for discussion by the Ministers for Health and Public Expenditure and Reform. I am sure that if the Deputy tables parliamentary questions to these Ministers when they have concluded their discussions, they will be able to inform her of the detail involved.
Comment on this
Therefore, the Minister does not know the position.