I propose to take Questions Nos. 847, 932, 1115 and 1159 together.
Government Departments are required to manage expenditure within the allocations set out in the Estimates for each year, agreed by the Dáil. Any underspend that arises against agreed allocations is surrendered to the Exchequer at the end of the year.
At end June 2017, the Health Vote is €55m under profile in Vote terms. However, this largely reflects profiling issues and the timing of cash disbursements to the HSE in particular. Expenditure on capital construction and equipping is currently under profile due to timing issues on the progress of a number of projects which have not progressed as initially projected. Expenditure is expected to progress steadily as construction begins. My Department does not anticipate any surplus on the Health Vote in 2017.
Whilst the Vote is below profile, a deficit exists in income and expenditure terms in the HSE, with pressures evident in acute hospital and disability services in particular. My Department is engaging with the HSE in relation to the issue, cognisant of the need to minimise any potential deficit.
It is too early, at this stage, to accurately assess any projected overall deficit in 2017. The Department will continue to work with the HSE to ensure that every effort is made to maximise cost containment and cost avoidance measures while delivering on the commitments set out in the NSP 2017 and, as provided in the Health (Amendment) Act, that all expenditure must be managed within the level of the net non-capital determination notified to the HSE.