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Budget 2019

Dáil Éireann Debate, Tuesday - 16 October 2018

Tuesday, 16 October 2018

Questions (508, 509, 510, 511, 512, 513, 514)

Louise O'Reilly

Question:

508. Deputy Louise O'Reilly asked the Minister for Health the reason for the 58% increase to subhead E1 of the Health Vote as per page 216 of the budget 2019 expenditure report. [42521/18]

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Louise O'Reilly

Question:

509. Deputy Louise O'Reilly asked the Minister for Health if the €65 million estimate, inclusive of a €10 million increase indicated for subhead E3 - National Treatment Purchase Fund, NTPF, of the Health Vote, as per page 216 of the budget 2019 expenditure report, is the only voted expenditure for the NTPF; if not, the other subheads that include moneys for the NTPF; and the amount of same. [42522/18]

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Louise O'Reilly

Question:

510. Deputy Louise O'Reilly asked the Minister for Health the details of subhead H of the Health Vote on page 217 of the budget 2019 expenditure report and its contents; the reason no percentage changes are recorded for the subhead; the reason there are no pension lump sum payments recorded under the 2019 Estimates; the reason there were no net pension costs recorded under the 2018 Estimates; and the reason for the 24% reduction to Exchequer pensions included in the net total noted at the bottom of page 217. [42523/18]

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Louise O'Reilly

Question:

511. Deputy Louise O'Reilly asked the Minister for Health the breakdown of subhead I of the Health Vote on page 217 of the budget 2019 expenditure report; the way in which this subhead differs to subhead I presented in the budget 2018 expenditure report on page 205; if the €143,539,000 recorded under subhead J5 2018 Estimates in budget 2019 was transferred in whole or part into subhead I; and if so, if those moneys make up part of the 10% increase recorded for subhead I. [42524/18]

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Louise O'Reilly

Question:

512. Deputy Louise O'Reilly asked the Minister for Health the breakdown of, and the rationale for, the €86 million increase to the Estimates for the State Claims Agency under subhead J4 of the Health Vote as per page 217 of the budget 2019 expenditure report. [42525/18]

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Louise O'Reilly

Question:

513. Deputy Louise O'Reilly asked the Minister for Health the breakdown of, and the rationale for, the €98.4 million increase to the Estimates for subhead K1 of the Health Vote as per page 217 of the budget 2019 expenditure report; and if he will make a statement on the matter. [42526/18]

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Louise O'Reilly

Question:

514. Deputy Louise O'Reilly asked the Minister for Health the breakdown of, and the rationale for, the 12% increase estimated for appropriations-in-aid in the Health Vote as per page 217 of the budget 2019 expenditure report. [42527/18]

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Written answers

I propose to take Questions Nos. 508 to 514, inclusive, together.

The provision for E.1 in 2019 is €99.131m an increase of €30.013m (43%) over 2018. This increase is primarily the additional funding for the SlainteCare Integration Fund as announced in the budget. The remainder will be used for essential health care projects as required during 2019.

A data entry error occurred which resulted in €10m of NTPF funding being included in error in the subhead E1, instead of E3. The NTPF allocation for 2019 is €75m. The full allocation to the NTPF is now reflected in the published Expenditure Report 2019 available on www.budget.gov.ie and will be reflected in the Revised Estimates for Public Services 2019 published before year end.

Up to 2018 the H subhead reflected funding for statutory pension lump payments only. All other pension funding was held in the Health Service Executive subheads I1 to I5. To improve transparency and the linkage between the Health Vote subheads and the Health Service Executives National Service Plan in 2019 subhead H was amended to reflect all HSE pension funding including lump sums. From 2019 this subhead will now reflect the full pension costs as set out in the National Service Plan for 2019.

The 2018 Health Vote for net exchequer pension costs was €649.476m. Pension related deductions (PRD) were netted against pay. In 2019, as part of the Public Service Stability Agreement, PRD will convert to Additional Superannuation Contributions (ASC), and therefore, are also netted off pensions costs for the 2019 Health Vote. It is the presentation of these additional superannuation contributions that is driving the perceived 24% reduction in exchequer pension costs.

It was determined that the format of subheads for I1 to I5 causes confusion as they do not align with how HSE performance is reported. The HSE reports performance against their annual service plan which is set out by service division. The HSE does not plan or report on services delivery by HSE region or on a statutory/voluntary basis as indicated by the previous subheads I1 to I5. To improve the linkage between the estimates presentation and the NSP the following adjustments were made.

Subhead I now represents the funding allocated to HSE service areas set out in the National Service Plan with the exception of PCRS/Local Demand Led Schemes and Long Term Residential Care which are funded from Subheads K1 and K2 respectively. It includes funding for new operational services developments for 2019 and excludes all pension related costs. Pension costs are now reported in total in subhead H.

The 10% increase in subhead I arises due to the increase in health funding for 2019 of €1.5 billion as set out in the budget book, less the funds applicable to subheads E, H, K.1 and K.2 as above.

An actuarial assessment for potential claims under the CIS is prepared annually by the State Claims Agency and a determination is taken with regard to the level of funding that will be required by year end, under subhead J4.

Regarding subhead K1; Medicines play a vital role in improving the health of Irish patients. Securing access to existing and new and innovative medicines is a key objective of the health service. However, the challenge is to do this in an affordable and sustainable manner. The allocation provided under K1 for 2019 is arrived at following considerable consideration and analysis of a range of factors. The detailed allocation of the funding will be finalised as part of the preparation by the HSE of their 2019 National Service Plan.

Under EU regulations, where a person is employed in or a pensioner of one member state but residing or staying in another, the member state of employment or paying the pension must in general bear the responsibility for the cost of health services. As the number of Irish people living here who worked previously in the United Kingdom holding British pensions is considerable, a reimbursement agreement has been agreed between the two countries. The Appropriations-in-Aid receipt represents the U.K.'s net liability to this country. Following detailed engagement with UK officials it has been indicated that the net position due from the UK for 2018 will be €55m below planned on an ongoing basis giving rise to the 12% reduction in receipts reflected for 2019.

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