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Dáil Éireann debate -
Tuesday, 23 Apr 2002

Vol. 552 No. 3

Priority Questions. - National Health Strategy.

Derek McDowell

Question:

25 Mr. McDowell asked the Minister for Finance the discussions held with the Department of Health and Children regarding the funding necessary to implement the National Health Strategy; the way in which it is planned to provide the finance necessary; if he envisages that borrowing will be required; and if he will make a statement on the matter. [12502/02]

In the course of preparation of the health strategy, I had detailed discussions with my colleague, the Minister for Health and Children and subsequently provided additional funding totalling €249 million for implementing certain priority aspects of the strategy in the 2002 budget. Other resources within the overall health allocation of €8.2 billion in 2002 are devoted to services consistent with the strategy's objectives. The Government is committed to the implementation of the health strategy, which is an ambitious and comprehensive document designed to develop and reform the health services so as to better meet the health needs of society over the years ahead. The pace of implementation will depend on the availability of resources in the future. Thus, the ongoing funding of the health strategy will be determined annually in the context of the preparation of the Estimates and budget. I assure Deputies that I will seek to achieve value for money from whatever future resources are allocated to the health area, and that no borrowing will be incurred on account of health expenditure, even for capital purposes, unless it can be clearly demonstrated that the associated revenue implications are sustainable in the long-term.

I remind the Minister of his comments last November, on the day that the Estimates for the current year were announced by his Department, when he said the health strategy did not amount to much but was a roll-up of existing policies. Does that not summarise his view of the strategy, and does not what he said over the past six months bear out the contention that he has no intention of providing the additional resources that are central to the implementation of the ten year strategy?

The facts do not bear that out. In 2002, we are providing an additional €249 million to implement priority aspects of the strategy. Other facts are that since 1997, health spending has more than doubled; that there were 67,895 people employed in health in 1997 and there will be 93,850 people employed there at the end of this year, which is an increase of 38%; that as a percentage of total Government spending, spending on health has risen from 21% to 26%, and that 55% of income tax in 1997 was spent on health and that at the end of 2001, it was 76%, while at the end of this year, 80% of all income tax will go to fund health.

I can give chapter and verse on my commitment to health during my time in office. We have now reached over and above the EU level of spending. We have a younger population than the rest of the EU without the same dependency ratios. It is as well that we had such economic success in recent years which has provided the extra resources for health because without that the health situation would be dire. If we had the same strategy as when the Deputy's leader was Minister for Finance, that is, to give no money to health, the situation would be chronic now.

The Minister failed to get value for money.

The Minister's reply was interesting but had nothing to do with the question. The health strategy was published 12 weeks ago and is prospective, looking to the next ten years, which is what my question was about. An example is that the strategy promises 3,000 additional acute beds to replace the beds taken out of the system in the late 1980s, but Department of Finance sanction is required now in order to have those beds available in three years time. No such sanction was given and the Minister has no intention of giving it.

The Deputy asked a question about the health strategy over the next ten years. I doubt if in 1996 anyone was asking the then Minister for Finance what he would be spending on health in 2006.

The Government has just produced a ten year strategy.

It is a ten year strategy which, like the national development plan, will evolve. Everything, including spending on health, education and social welfare, is conditional on the availability of resources. If the Deputy's proposals for the election, are to minimise economic activity, no one will have the resources for any area because resources come from increased economic activity resulting in greater Exchequer revenues which can be spent on health and other policies. Without economic activity, we will not have that, and over the past five years this Government has been able to provide vast resources to the health area because of the economic activity. If we have the same economic policy over the next five years, much extra resources for health and other areas is guaranteed, which is the message we will send to the people soon.

There will still be no progress.

That is a separate matter which we can debate also.

The Minister has confirmed what we suspected, that the health strategy is just an aspirational document drawn up by someone in Hawkins House with no sanction from the Department of Finance. The central point is that, in order for the targets to be met, sanction must be given several years in advance so that we will avoid the sort of delays that meant it took 15 years for Tallaght and Beaumont hospitals to come on stream. Such sanction is clearly being withheld by the Minister and his Department.

I assure the Deputy in the last days of the Dáil, and if he aspires to high office, that neither he nor anyone else on the Opposition benches will be able to sanction moneys that he does not have in 2002 for 2006.

The Minister did just that for pensions in 2026.

The Deputy would be an astute operator to see that far ahead, and I wish him the best of luck, if I am still in politics at that time. I assure him that the health strategy took a long time to produce and is the most detailed one ever. Some €8.2 billion has been put forward for 2002, which will probably increase as every year we have Supplementary Estimates. It is a considerable amount and most of the plans are rolling forward. In the history of the State, no Government has committed as much to health. Deputy Mitchell may be correct and I myself have raised the issue of whether we are getting value for every euro that we spend, but that could be said for much of Government spending.

It is clearly wasted.

One cannot deny that the amount of money being put into health is colossal as are the plans being progressed. I can give chapter and verse on the cost of the plans. In 2001, it was €7.6 billion and about €4.8 billion in extra current spending over a seven year period, which is a serious amount of money.

That is why I asked the question.

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