Vol. 496 No. 6
29 Mr. Noonan asked the Minister for Finance the reason the forecast outturn for expenditure by the Department of Health and Children, as shown in Table I of the Estimates for Public Services 1999, is more than £32 million less than the 1998 Estimates for that Department; if he will sanction the spending of this money to improve the health services; and if he will make a statement on the matter. [23877/98]
The forecast outturn figure for Vote 33 in Table 1 of the Abridged Estimates Volume for 1999 is a net amount and is a snapshot at a particular time of the evolution of both income and expenditure on the Health Vote as the year goes on.
The health services are financed by taxation. About 90 per cent of the Health Vote is paid for by general taxes, such as PAYE or VAT. The remainder is paid for mainly by the health levy of 1.25 per cent on incomes above the threshold — £207 per week at present — which is a form of taxation. This appears as an appropriation-in-aid on the Health Vote. Each year money is allocated for the health services which is spent irrespective of what the yield from taxes turns out to be. What is important is the gross spending authorised each year. What matters is the level of service provided and I would stress that the current year's allocation provides for an increase in spending of £258 million — more than 9 per cent — over the 1997 outturn.
As the House is aware, the Minister for Health expects to introduce a Supplementary Estimate for the current year on Thursday next. My Department has been informed by the Department of Health and Children that that Department has throughout the year consistently underlined to agencies and the public the determination to operate both the letter and spirit of the accountability legislation. The Supplementary Estimate being considered will not, therefore, propose additional funding for increases in cost or activity which it has been made clear must, in any current year, be managed by agencies within the context of their service plan and annual determination.
I emphasise that I and my colleagues in Government fully support the Minister for Health and Children in his management of the health services and in particular in his efforts to maintain financial discipline and accountability in line with the provisions of the Health (Amendment) (No. 3) Act 1996.
Does the Minister recall that when he presented the Book of Estimates last Wednesday he made a film presentation in the press centre? In the course of that presentation he pointed to figures on the screen and said that the increases in expenditure were offset by substantial reductions. The Minister went on to say that the overruns of £131 million in the Garda, prison officer and Agriculture Votes were being offset by savings. He identified savings in social welfare and health the service.
Please ask a question, Deputy. The time is limited.
I know the time is limited. I have discovered that already. The Minister said he was applying £42 million of savings on the Department of Health and Children Vote to cover over-expenditure in pay. There was, I presume, a run of £10 million on the health pay Vote. Therefore, there is a net saving of £32 million on the Health Vote which the Minister said he would use to cover overruns on Garda and prison officer overtime. Can the Minister confirm that even though the Minister for Health and Children is spending his full Estimate and overrunning by approximately £30 million on demandled schemes and other aspects, there is still a saving on the Health Vote arising from the 1.25 per cent health levy which the Government has no intention of spending on the health service this year and which is being treating as normal taxation buoyancy which will accrue to the Exchequer. There are savings on the Health Vote which remain unspent and it is the intention of the Government to continue on that basis. Is that correct?
There are no savings on the Health Vote.
What about page 3 of the Minister's speech last Wednesday?
The Deputy knows, or should know, the realities of the situation. After Deputy Bruton's performance last week which indicated his lack of knowledge of the Health Vote, net, gross and appropriations-in-aid, I am not surprised he failed to get two budgets through the House. His knowledge of the Department of Finance was poor. Whatever about anyone else in Opposition, Deputy Noonan knows the amount of money allocated to the Department of Health and Children is the gross amount. Money collected from taxpayers goes to the Exchequer. It is irrelevant whether the Exchequer regards that money as general taxation or youth or health levies. The Deputy knows the gross amount is the amount which will be disbursed.
The amount provided at the start of 1998 will be below that which the Minister will spend and there will have to be a Supplementary Estimate. These are the facts. The Opposition had a field day last week about the accounting arrangements. However, Deputy Cowen and I have explained that was all it was. There is no saving on the Health Vote. Last year I agreed a 9 per cent increase in the Health Vote but the outturn will be greater than 9 per cent. The Estimates for next year provide a gross allocation of £3,479 million. This represents a double figure increase on the 1998 outturn.
That concludes Priority Questions.
May I ask a short supplementary question, a Leas-Cheann Comhairle? I have only had one supplementary question.
I understand that, but it was a rather long question. I am sorry Deputy but the Chair is confined by Standing Orders. We are moving on to Question No. 30.
This is extremely unfair, a Leas-Cheann Comhairle.
The Deputy may feel it is unfair, but the Chair has no control over this matter and is bound to apply the rules.
The Minister said he had savings. Now he says he had no savings.
We are moving to question No. 30 in the name of Deputy Bell.
This is a very frustrating parliamentary exercise for Members trying to do their job from these benches.
The Deputy is doing an excellent job. He should not complain.
This matter will go further. I do not regard this as funny. There are serious questions to be asked. This Minister has misled the House. He will not make any point in reply.
It is unreasonable for the Deputy to allege the Minister misled the House.
The Minister used the word "savings" in his script last Wednesday and described savings in the Department of Health and Children. He now claims there are no savings.
The Deputy should withdraw the remark.
A Leas-Cheann Comhairle, I will withdraw the remark if you can supply me with a suitable word to describe the contradiction.
I ask the Deputy to withdraw the remark.
There is a contradiction between what the Minister said on Wednesday——
Will the Deputy withdraw the remark?
I substitute the word "misleading" with the phrase that there is an absolute and total contradiction between the Minister's claim last Wednesday that there was a saving and his claim today that there is no saving.
That is fine. I call the Minister to reply to Question No. 30.
Of all Opposition Members, at least Deputy Noonan knows a little about the Health Estimates we are discussing.
The Minister conned the people. He is deliberately misleading the House.
I ask Deputy Noonan to withdraw that allegation. It is not appropriate to accuse any Member of misleading the House.
The Minister is playing with semantics.
Deputy Shatter, the Chair is on his feet. We will have some order and respect for the Chair. I ask Deputy Noonan to withdraw the remark that the Minister deliberately misled the House.
If I withdraw that remark it sounds like——
It is a matter for the Deputy. Does he wish to withdraw the remark? If he does not do so, I will ask him to leave the House.
The Minister misled the House, whether it was deliberate——
I am asking the Deputy to withdraw the remark that the Minister deliberately misled the House.
I think the Minister deliberately misled the House and I am leaving the House.
