Vol. 847 No. 2
1. Deputy Sean Fleming asked the Minister for Public Expenditure and Reform his plans to introduce measures to ensure traceability to specific projects in respect of funding for good causes from the national lottery that are allocated to departmental budgets; and if he will make a statement on the matter. [29925/14]
Will the Minister introduce measures to ensure traceability to specific projects in respect of funding provided from the proceeds of the national lottery good causes fund? Some Departments such as the Department of Transport, Tourism and Sport do it very well, but nobody in the other big Departments knows where the money goes.
Appendix 1 of the Revised Estimates for Public Services which is published each year gives a breakdown, by Department, of all expenditure areas supported by the proceeds of the national lottery. For approximately a decade, the total allocation for the relevant subheads has exceeded the amount available from the national lottery surplus. Therefore, these subheads are now described as being part-funded by the national lottery and the balance of the expenditure in the subheads comes from allocations from normal Exchequer sources. For example, this year overall expenditure under the subheads supported by the national lottery is estimated at €408 million, while the proceeds deliverable from the national lottery are estimated at just over €200 million. The balance comes from the Exchequer as a top-up. Individual Departments with responsibility for expenditure part-funded by the national lottery surplus publish details of their expenditure on their websites, including lists of recipient organisations and the amounts involved.
I appreciate what the Minister has said and it is accurate to a point, but it is not the full story. I fully accept that people can see the exact location of money allocated by the Department of Transport, Tourism and Sport which made an announcement last week. I draw the attention of the Minister to other areas. He mentioned Appendix 1. The biggest Department receiving funds from the national lottery appears to be the Department of the Environment, Community and Local Government and the biggest area is housing, probably comprising grants for elderly people and what used to be known as disabled person's grants, community facilities in housing projects and support for community and voluntary organisations. In the Department of Arts, Heritage and the Gaeltacht a lot of money goes to An Comhairle Ealaíon. Further amounts go through the HSE. Youth organisations receive approximately €50 million through the Department of Children and Youth Affairs. In these cases what we see are lump sums. The Department of the Environment, Community and Local Government cannot state to which housing projects the money was allocated. It can state 20 housing projects were part-funded but not how much went where.
I looked at the subheads on foot of the question asked. The Department of the Environment, Community and Local Government includes an allocation of €38.6 million under subhead A.7 - private housing grants. They include the housing adaption grants for people with a disability. This scheme provides grants of up to €30,000 to assist people with a disability in having necessary adaptation and improvement works carried out. Money is provided for the housing aid for older persons scheme, under which grants of up to €8,000 are provided for older people living in poor housing accommodation to have refurbishment or improvement works carried out. The mobility aid grants scheme is also supported from the subhead. It is available to fast-track grants of up to €6,000 to provide for basic works to address mobility problems, including the provision of grips, rails and ramps. I hear what the Deputy is saying about how much of it is lotto money and voted expenditure. I will speak to line Departments to seek greater clarity in the published accounts at the end of the year.
I am pleased that the Minister sees the point I am making. I have been following this matter for some time and raised it at the meeting of the Committee of Public Accounts last week. The Comptroller and Auditor General agreed with my point that there was a lack of traceability and stated he could not trace the money because there was no mechanism in place in some line Departments. Members of the public do not realise that grants for disabled people and the mobility aid grants scheme depend on their playing the lotto. It should not be the case that they are dependent on lottery sales. Now that the Minister has privatised the national lottery, it is important that people know where the proportion of money from the national lottery for good causes is spent. This link has been broken and must be re-established.
We have not privatised the national lottery. After the end of the year it will be run by a consortium which includes An Post, the organisation which has always run it and a prime mover in the consortium. The Deputy is right on the issue of transparency. We need to know where the lotto money is going and this is done. We need to have even more transparency and I am happy to address the issue. We know that all of the money is expended on the right things and we want to generate as big a surplus as we can. This year it will be approximately €200 million, in line with the figure in recent years. We top it up to support specific areas in which very important works are undertaken, particularly in recent years when they were under pressure. Nobody who buys a lotto ticket would begrudge elderly people mobility aid grants, ramps or other aids in being a beneficiary of their taking a punt.
2. Deputy Mary Lou McDonald asked the Minister for Public Expenditure and Reform his views on the quantum of adjustment in public expenditure required in budget 2015; and if he will make a statement on the matter. [29846/14]
My question relates to the forthcoming budget which is only three months away. We are coming to the end of this Dáil session and I would like the Minister to set out the extent of cuts he envisages in the forthcoming budget. Will he set out where the Department is at in budgetary planning?
The Government's fiscal target for 2015 has been well signalled. It is to bring the general Government deficit below 3% of GDP, in line with the commitments made by the country under the excessive deficit procedure. The budget to which the Government will agree in October will be designed to meet that target and will reflect the up-to-date economic and fiscal outlook.
The Deputy will be aware that the most recent official budgetary estimates are contained in the stability programme update published in April. At the time it was estimated that a consolidation package of €2 billion would be necessary next year to deliver a deficit of 2.9% of GDP. There have since been some positive developments which have been welcomed by all. The Exchequer returns for the first half of the year represent a solid performance in terms of tax and expenditure. Tax revenues are growing and, in overall terms, expenditure on public services is within the budget parameters set out last year. Last week the Central Statistics Office announced an upward revision of the level of GDP for last year. This will have a favourable impact on our deficit-to-GDP ratio for this year and next. The GDP growth reported for the first quarter of the year is also encouraging. We expect all of this to ease the level of fiscal adjustment needed to meet our 2015 deficit target. The precise impact is being assessed and will form a critical element of the Government's announcements on budget day.
I am sure the Minister is aware of the impact the recent series of austerity budgets has had on service levels and on people's capacity to spend, plan and budget for their own households and lives. It seems from the soundings from the new Tánaiste and leader of the Labour Party, whom I congratulate on her new positions, that she is also aware of this. While I appreciate that the Minister cannot provide exact figures, I find it hard to believe that a matter of weeks away from the budget, he cannot give us some sense of the magnitude of the cutbacks that are envisaged. I welcome his statement that a €2 billion cutback might not be necessary, but I would like him to go much further than that by providing some specific details and assuring the House that further cutbacks will not be made in areas such as health and education and that people who rely on social welfare payments and have fixed incomes will not lose out.
Every decision that was made in advance of the budgets of the last three years, as delivered by the Minister, Deputy Noonan, and me, was aimed at repairing an economy that was calamitously broken. Objectively, we have done a good job in building a sustainable platform for future expenditure and the future well-being of the Irish people. On each occasion, we made decisions that were the least worst options available and would have the least worst impact on the most vulnerable people. We have done that by protecting core social welfare rates, for example. I am glad that these determined and difficult decisions have led us to have a platform now. As I am not a fortune teller, I do not know what will happen in the next number of months. However, I am confident that we will not require budgetary adjustments of anything like the order specified in the most recent medium-term economic forecast to reach the target of a deficit-to-GDP ratio of less than 3% of GDP. We will spell out the details of that when all the data is available towards the budget day in October.
The Minister is certainly not a fortune teller, but he is the Minister for Public Expenditure and Reform. His Government colleagues, including the Minister for Finance, might believe him when he says "objectively, we have done a good job" of protecting the most vulnerable people in society, but that is not the experience on the ground. The budgets that have been delivered by this Government so far have impoverished sections of the community. Many people have been left with no option other than to leave by boarding the emigrant planes to Sydney, the United States and further afield. I welcome the Minister's assertion that the overall level of cuts will not be of the order of €2 billion. Reading between the lines, the Minister is insinuating that it will be much less. Does that mean the proposed adjustment will be halved? I would like the Minister to be more specific, because people deserve some level of certainty in their lives as they plan their budgets heading into the autumn. I remind the House that this should not just be a case of scaling back the cutback agenda. An effort has to be made to begin to repair the damage that the Minister and his colleagues have inflicted on families and low-income workers in the succession of budgets over which they have stood.
Rather than responding to the views of the Deputy, who has been far from objective from the beginning, I will leave it to a more objective person to make a determination on whether our budgetary strategy has been successful.
Is the Minister referring to someone like the Minister for Finance, Deputy Noonan?
If we had followed the path recommended by the Deputy's party leader, which involved defaulting on our debts, we would be in a worse position than Argentina is in 20 years after its default. Our people would be impoverished, we would have no inward investment and it would be impossible for this country to borrow money anywhere at anything like reasonable rates of interest. It is interesting to note that our ten-year bond yield yesterday was 2.3%, which is below the capacity of Britain to borrow money. I think that is a testament to how far we have brought the country in the last three years. The Deputy is right when she says that many people are desperately squeezed. We know that. We want to give as much support, help and money back to people as is possible, consistent with our determination to have a sustainable platform on which this country can thrive into the future.
3. Deputy Stephen S. Donnelly asked the Minister for Public Expenditure and Reform further to a recent submission to him on equality budgeting, if any of the proposals will be incorporated into this year's budget documents; if he will provide a distributional analysis of the proposed budget to be provided to Dáil Éireann on budget day; and if he will make a statement on the matter. [29847/14]
This question fits in very well with the conversation we have just had. Last October, I joined members of the equality budgeting campaign in making a submission to the Minister, Deputy Noonan, on whether equality budgeting could be incorporated into this country's budgetary process. He suggested that the Minister for Public Expenditure and Reform is responsible for this area. At its simplest, we are looking for an analysis that would answer the question, which has just been discussed by the Minister and Deputy McDonald, of who gets hit the hardest in any proposed budget. Does the Minister believe any of the components of equality budgeting can be incorporated into this year's budgetary process? If the Dáil were to be given a distributional analysis by income, gender and age on budget day, in addition to the budget proposed by the Cabinet, I think it would be a great success because it would allow us to see who is being asked to carry the burden.
As I indicated in response to the previous question, the primary objective of recent budgets has been to restore stability to the public finances. In this context, it has been of vital importance to every member of the Government to spread the burden of adjustment in as fair and as equitable a manner as possible to protect the most vulnerable people in society and stimulate economic growth and jobs-rich recovery. As the Deputy knows, expenditure on health, education and social protection accounts for over 80% of gross voted current expenditure. In implementing the budgetary adjustments required to achieve a successful exit from the troika programme, the Government has sought to protect front-line spending in these areas. We have allocated €19.6 billion to the Department of Social Protection in 2014. In allocating this amount, we have maintained the primary weekly rates of social welfare payments since this Government took office. Similarly, in the area of education, the Government has sought to protect funding in respect of DEIS resources. This funding is provided in addition to the normal funds allocated to tackle educational disadvantage by prioritising the educational needs of children and young people from disadvantaged communities from preschool right through second level education.
As the Deputy is aware, there have been a number of reforms to the budgetary process at national and EU levels. These reforms can assist the Oireachtas and the Deputy in timely consideration of the Government's expenditure plans. In line with the new budgetary timetable, a Revised Estimates Volume was published on 18 December last. This new timetable allows for earlier consideration of the Estimates by each relevant line committee of the Oireachtas. The Revised Estimates Volume has been expanded so that each Department and office now reports on key performance indicators that are relevant to its area of operation. The purpose of this is to show what services are being purchased with voted moneys and the impact of these services on Irish citizens and Irish society in general.
Additional information not given on the floor of the House
When making Government decisions on budget matters, the Government is aware of gender equality issues, people experiencing or at risk of poverty or social exclusion and people with disabilities. Expenditure measures and policy proposals are being submitted to my Department as part of the second comprehensive review of expenditure. The final proposals will be carefully considered by the Government in advance of finalising the 2015 Estimates. On budget day, in relation to distributional analysis, the Government will publish illustrative cases showing the effect of major changes in revenue and certain social welfare payments.
I have to say, with respect to whoever drafted the Minister's response, that it does not address the question I asked in any way. I asked whether a distributional analysis clarifying who is being asked to bear the highest burden will be provided by the Ministers, Deputies Howlin and Noonan, and their Cabinet colleagues when they come in here on budget day to propose a draft budget to the Dáil for its consideration. I am aware that the Labour Party espouses a budgetary approach that asks those who have the least to carry the least burden. The problem is that the latest analysis, which came months after we had to vote on the budget, suggests that the last few budgets have been regressive and those who have the least have been asked to bear the highest burden. The analysis I am calling for is becoming common practice around the world. It has been successfully implemented in Scotland. I propose that a distributional analysis, setting out how each of the income deciles, each of the two genders and each of the age groups would be affected by the budget if it were to be voted through, should be brought to the Dáil for its consideration. That would put the Dáil and the public in a better position to examine and query the budget proposal being made.
I approve, read and alter all answers I deliver here. They are not prepared in some way externally.
I am responsible for all answers I give here.
To answer this particular question, one cannot take one budget in isolation, particularly in times of crisis; nor can one compare the three budgets we have had, which have been crisis budgets designed to rescue us from disaster, to a normal budgetary cycle. That is why I explained to the Deputy that we have changed the whole mechanism for doing budgets by asking each committee, through the new line Department system, to do the work and to call in the Secretaries General well in advance of the budget. They should do so now, before the budget is announced in October, and look at the comprehensive review of expenditure and at all the options. I suggest that the committees drill down into the options and make recommendations. We will provide as much data to the committee system as Deputies require.
I acknowledge that the budgetary process has significantly improved, certainly in the three years since I have been in the Dáil. However, I ask that the Minister answer the specific question because it would be incredibly useful both for public consideration and for Dáil Éireann's consideration. Of course crisis budgets are different from steady-state budgets. None the less, it is probably more important in a crisis than at any other time, because very tough decisions are being made, to know if particular groups - whether males, females, different age groups or people along the income spectrum - are being asked to carry a disproportionate share of the pain of the correction. Some of the budgets since the crisis have been unbalanced in asking certain groups, particularly lower-income groups and especially sub-groups such as lone parents, to bear an unreasonable share of the correction. It would be an incredibly healthy thing for parliamentary democracy and for the socioeconomic effects of the budgets if we knew on the day the budget was released the proposed distribution of the pain of the correction.
I have answered the question a couple of times but I will do so again. One cannot look at each budget, particularly a series of crisis budgets, in isolation. One must look at the cumulative effect of budgets. For example, the analysis done by some looks at all taxation increases as being progressive, even if one has reached the very highest marginal rate of taxation in comparison with any other OECD country - in other words, if one increases taxation, that is progress, and if one reduces expenditure, it is regressive.
We need to have a realistic model to see what levels of taxation are appropriate and what types of taxation are appropriate. That is the sort of drilling down that is required, rather than a crude graph system about which the Deputy is talking. I would have thought that somebody of the calibre of the Deputy would be developing those systems and making the new committee system work, calling in the key officials in line Departments to test those theories and to ensure, for example, that our progressive taxation system, by comparison with any country in the OECD, is maintained.
I disagree with the notion that any category of social welfare recipient was subjected to a disproportionate impact, because we worked with all our might and main to protect social welfare spending, as the Deputy knows. That is a fact. If the Deputy reads any of the commentary from the external overseers in the troika, he will see that they comment on our very high levels of social welfare provision, which we were determined to maintain and which I am proud that we protected.
4. Deputy Sean Fleming asked the Minister for Public Expenditure and Reform the procedures in place to ensure that recipients of State contracts abide by all relevant laws and regulations including tax, social welfare and health and safety and that this also applies to subcontractors engaged by the main contractor; and if he will make a statement on the matter. [29926/14]
I wish to ask the Minister what procedures are currently in place to ensure recipients of State contracts abide by all relevant laws and regulations in regard to income tax, social welfare and health and safety rules and to ensure that this applies also to subcontractors on various projects.
Public procurement procedures require all applicants to meet specified standards when applying for public contracts. In this regard, applicants are required to make signed declarations in respect of their financial standing, their legal standing and their payment of taxes and social contributions. The criteria on which contracting authorities may exclude applicants from the award procedure of public contracts are set out in public procurement regulations and directives. Before an applicant is excluded, the applicant may make a case and provide supporting evidence as to why it should not be excluded. The contracting authority must consider this evidence.
It is a condition of the award of public contracts above €10,000 that the successful applicant either provide to a contracting authority a current tax clearance certificate or demonstrate a satisfactory level of subcontractor tax compliance in the case of the construction, forestry or meat processing sectors, which are subject to relevant contracts tax. The same tax clearance requirement applies to any non-resident contractor being awarded a public contract.
In regard to public works, there is a substantial body of legislation that directly or indirectly governs construction activities. However, two key pieces of industry-specific legislation - the Safety, Health and Welfare at Work (Construction) Regulations 2013 and the Building Control Regulations 1997 to 2014 - place considerable responsibility not only on contractors but on all those involved in construction projects. The ultimate sanction for a serious breach of health and safety regulations is a criminal conviction and imprisonment.
In regard to the contract documents, clause 2 of the standard form of public works contracts requires the contractor and his personnel to comply with all legal requirements. In addition, the works requirements, which are a key part of the contract documents, set out detailed specifications on how regulatory standards are to be met.
The management of the tendering process for a public contract is a matter for each contracting authority. It is the responsibility of each contracting authority to ensure that tenderers comply with all the requirements of the process.
I thank the Minister for his reply. What he said is fine, but it does not address the issue to which I refer. The Minister spoke about people applying for contracts, the conditions for contracts, producing tax clearance certificates and the responsibilities on contractors and the contracting authority to ensure people tender properly. We all take that as read, and everybody agrees with that, but what measures are in place to ensure they actually abide by the above? I listened to the Minister's reply but there was no mention of anybody at public level looking after the taxpayers' interests to ensure the contractors abide by the conditions they are meant to abide by.
I will give two examples. Approximately €3 billion is to be spent on capital projects this year. The biggest areas are roads and schools. I have said in the House previously that I know of schools, which I have reported, where subcontractors on-site bus people to sign on every Thursday morning and then bus them back to continue working. I said to the Secretary General of the Department of Transport, Tourism and Sport at the Committee of Public Accounts last Thursday that, as we speak, some of subcontractors on the largest road projects, contracted by the National Roads Authority under public private partnership, are telling people who want to work that they must be on the dole and that they will not employ them if they are not in receipt of a jobseeker's payment because they do not want to pay them the full rate. If they want a job, those people must sign on. However, they risk prosecution and they cannot make PRSI contributions so their records will be diminished as a result.
The Minister should put measures in place for on-site inspections by the Department of Social Protection, the Revenue Commissioners and the Health and Safety Authority to ensure people on these sites are officially there.
I must say I am taken aback by the charges the Deputy has made. It is a legal responsibility for each contracting authority to comply with the law and to ensure contracts are fully compliant with the law. In the case of roads, it is a matter for the Department of Transport, Tourism and Sport and the National Roads Authority, while in the case of schools it is a matter for the Department of Education and Skills. The Deputy said he raised these matters with the Accounting Officer in each of those Departments. If he sends me the details, I will ensure they are acted on.
I thank the Minister and I accept that. I have been told by workers that they do not want their names mentioned. One can understand that because they appreciate the work when they get it. There should be an inspection mechanism across the public service to ensure on-site inspections of capital projects by the Department of Social Protection. Workers have reported some of these sites and sometimes the contractors have been fined two years after the contract is completed, but a fat lot of good that is as workers have lost their jobs in the meantime for protesting at the gate that they could not get legitimate work. This is an ongoing issue. There should be inspections of the PRSI record of every worker on every major State contract.
It is a matter of legal compliance. Contractors have to sign statutory declarations. There is a legal consequence which would make them subject not only to action but to debarment from public contracts should the matters the Deputy set out be proved to be true. If they Deputy sends me the details, I will ensure the line Departments act on them. I do not think it is up to me to have another set of measures.
For example, in the area of health and safety, it is clear there are organisations to carry out site inspections and so on and the same applies in respect of social welfare, where there are social welfare inspectors. However, if the Deputy provides me with details, I will ensure any specific case or suspicion he may have will be investigated fully.
5. Deputy Stephen S. Donnelly asked the Minister for Public Expenditure and Reform if his Department has commissioned independent analysis on potential savings in the Irish health system since March 2011; if so, whether this analysis is available; if no independent analysis on potential savings has been undertaken whether he will consider commissioning such analysis; and if he will make a statement on the matter. [29667/14]
This question pertains to health care, in which the Department of Public Expenditure and Reform has become more involved. It really is an attempt to solve something that has puzzled me for many years. Members are aware there have been significant cuts in health care that have come at great pain to many people. While Ireland's health care expenditure per capita is approximately halfway up the OECD tables, we have one of the youngest populations and research by the National Competitiveness Council shows that when one adjusts for that young population, Ireland has the second-highest health care spend per capita in the OECD, next to the United States. However, as everyone is aware, Ireland's health care outcomes are not second highest. Consequently, in spite of all the pain that has been felt in trying to get on top of the health care budget, Ireland still is spending more per capita, when one adjusts for the young population, than anybody except the United States but is not getting the health care outcomes. There is plenty of external analysis from the OECD and others to suggest that a changed model of health care provision and expenditure could save billions, while improving the level of service delivery. My question is whether the Minister has commissioned an independent report that has gone into the wiring of the Health Service Executive, HSE, to ascertain whether things could be done fundamentally differently.
I have not commissioned any independent analysis on potential savings in the health sector since March 2011. That would be a matter for the Minister for Health, as the Government has line Departments with line Ministers responsible for their own areas. In terms of analysis, a comprehensive review of expenditure was carried out during 2011 and was published in December 2011 in conjunction with the 2012 budget. In my budget speech in October 2013, I announced a second comprehensive review of expenditure, the objective of which will be for each Minister and each Department to examine and propose measures that will contribute to the overall expenditure target set out by the Government for each of the next three years. This review also will expand on the existing analysis carried out by Departments and my Department since 2011. The Department of Public Expenditure and Reform will co-ordinate the review process and will produce the final comprehensive report alongside the budget documents for next year. In addition, a separate review of capital expenditure is under way that will set out the capital envelope for the next five years.
In January 2014, I published the Government's second Public Service Reform Plan 2014-2016. This sets out, at a high level, the key priorities and objectives in the main public services, including health. As set out in the reform plan, there are significant and administrative reforms such as usage of additional hours, as well as areas of reform of overtime pay, premium pay and all the rest.
On health expenditure, I note that at present there almost is a given that health expenditure is being reduced greatly. Consequently, I should tell the Deputy that in the budgets introduced by the Government since 2011, the money given to the HSE has not fallen. There is a general commentary about expenditure cuts but the facts are different. Net expenditure from 2011 to 2013 for the HSE has increased by €72 million, not reduced. Total non-pay funding given to the HSE has increased by €407 million, not reduced and I can provide the hospital details to the Deputy as well. Consequently, the Deputy is correct that the Government needs to drill down to make sure it gets value for the enormous effort it has made to maintain expenditure in the health area.
I thank the Minister for his reply. I would love to get those figures, as the numbers I received from the Government show a fall from approximately €16 billion to approximately €13 billion for this year but perhaps I can get the numbers at which the Minister was looking. I have looked at the comprehensive review of expenditure, which in the first instance is an internal document, that is, it is the HSE trying to fix itself from a health expenditure perspective, which-----
It has the knowledge.
Actually, I do not believe the HSE has the knowledge. I believe that what it has been asked to do and has tried to do is to make incremental savings, namely, to cut a bit here and there and to try to be a bit more efficient here and there. However, I do not believe the HSE has the knowledge to examine the current health care system and conclude that the manner in which health care in Ireland is delivered - which is a hospital-based system rather than a community-based system - is not the best for the patient and costs far more money than it needs to do. The Minister stated that his Department has not commissioned any report. He might know, because it is relevant to public expenditure, whether an external report has been commissioned that examines both health care delivery in Ireland and the HSE and concludes that in fact, a shed load of money can be saved by, for example, moving from acute to community-based care, while at the same time improving health care outcomes for the patient. I believe this would be a great opportunity and even if the Department of Public Expenditure and Reform has not done so, is the Minister aware of any report of this kind? If not, does the Minister think there might be a great opportunity to commission one?
Most of these questions would be more appropriately directed to the Minister for Health, because an enormous reform agenda is under way. This is because the structure that was put in place, which basically built the superstructure of the HSE on top of the old health boards, simply has not worked and has been extraordinarily top-heavy and to disentangle it involves a huge body of work. Were the Deputy to ask me for my personal view, there is an enormous amount of focus on structural change and the Deputy has suggested further structural change. However, I believe we must do what we were doing particularly well. There is a move from acute care to a greater focus on primary care and the Government is providing the resources for that. However, I will provide specific figures to the Deputy and might forward them to him in writing, rather than expecting him to take them down now. For clarity, total HSE expenditure fell by €19 million between 2011 and 2013. In 2011, it was €13.903 billion and at the end of 2013, it was €13.884 billion.
I thank the Minister. As I see it, having worked in health care abroad, there is an opportunity here. I have asked some of the most senior people in the HSE to show me the plan or document that sets out how health care delivery should be with regard to primary care centres, community-based teams, home care, respite care and all that good stuff, that sets out what it looks like today, which is an acute-based model, and which sets out how the transition will be made from the model that obtains today to the model we need. That document and thinking have not been done. While primary care centres are opening, which is welcome, and while some valuable things are being done, I put it to the Minister that there is an enormous opportunity for the country for someone to come along - such as the Minister alone or in conjunction with the Minister for Health because this is both a health care and an expenditure issue - to acknowledge we do not have a whole-Ireland strategic view. This was done in Northern Ireland three or four years ago, which now has a strategy that states this is what its desired health care system looks like and this is how it will get there. We do not have one of those and as a final point, I suggest the Minister might consult with the Minister for Health, because I believe this issue crosses both Departments, to ascertain whether experts should be brought in and whether that sort of strategic planning and thinking should be put together.
All these questions are appropriate for the Minister for Health and not for me. While I obviously must mind the money and make sure the Government gets value for money, specific policy issues regarding the Department of Health come to the Government from the Minister for Health. However, there is a Cabinet sub-committee on health at which these matters are thrashed out clearly. There is a strategic view and plan and the Government is moving from over-dependence on acute hospital provision to the development of effective primary care provision. However, all these matters can be spelt out by the Minister for Health and the best way to so do probably is at a committee, where one has time to interact and bring along officials from both the HSE and the Department of Health for the discussion.
