Dáil Éireann díospóireacht -
Wednesday, 17 Dec 2008

Vol. 671 No. 1

Leaders’ Questions.

Deputy Enda Kenny

It now is patently clear that this is the most incompetent Government in the history of the State. On Sunday, the Minister for Health and Children announced she had approved and authorised a statutory service plan from the HSE involving cuts of €500 million. That plan was placed in the Oireachtas Library yesterday and is obsolete today. My understanding is the Health Service Executive prepared its service plan and submitted it to the Minister for Health and Children for authorisation.

However, in light of changing circumstances, the chief executive of the HSE will be obliged to seek a further €400 million in cuts. This will strike at the heart of the most vulnerable in our society as it pertains to a critical major public service plan. The Minister for Health and Children, who sat at the Cabinet table and heard of the changing economic circumstances from the Minister for Finance, should have been in a position to tell the HSE it was basing its service plan on the wrong figures, in the same way the budget was drafted using incorrect figures. Arising from the service plan submitted by the HSE that now must be amended, can the Taoiseach explain to the House the numbers of beds that will be cut and the number of people who will be made redundant? Can he spell out the impact on waiting lists and trolleys, 400 of which were occupied yesterday, as well as on capital projects for hospitals nationwide next year?

The Taoiseach

Deputy Kenny often has spoken of the need for efficiencies in the delivery of public services, which is precisely the context in which——

Deputy Pádraic McCormack

Front line services should not be cut.

The Taoiseach

——the HSE has devised its service plan.

Deputy Seymour Crawford

What about beds?

The Taoiseach

It has obtained efficiencies totalling €280 million during this year, which will be repeated next year. The figures being spoken about in the public debate this morning are not those of the HSE.

As Deputy Kenny observed, the HSE has set out a public service plan to support its goals, which are to maintain services to patients and clients in both hospitals and community settings in a manner that is fully consistent with patient safety and best practice. It is to expand certain services, particularly in respect of cancer and therapies for children with disabilities, to which additional funds of €15 million and €10 million, respectively, have been allocated, as well as an additional €120 million in other areas. Moreover, it is to support the reorganisation of services and the management of costs in such a way that services will be maintained and expanded. Furthermore, it is to work with the social partners in the health sector to achieve the objective of maintaining services to the public with a much tighter budget and to manage closely the significant risks of cost increases arising from the need to provide medical cards and other services as a result of the economic downturn.

The HSE service plan has been prepared and approved by the Minister on that basis. It refers to the budget of €14.7 billion that will be paid for health services next year, which constitutes an increase of 3.2% over this year's budget. Her approval and the finalised plan take account of all recent developments, including the budgetary position, the deterioration in the economy and the need to manage risks. In her letter approving the plan, the Minister also has set some specific and challenging requirements for the HSE.

This is a challenging and much-improved service plan, which sets out clearly the links between the services planned, the budget for those services and the staff needed. It is a plan that will require more than ever the active involvement of staff at all levels to make the changes necessary to deliver it. The goals desired by the Government across all areas only can be achieved with real co-operative engagement of management and staff from the outset of the year, drawing on the commitment of all to patients first and foremost. The HSE's management is engaged with staff representatives on these issues. I believe this is the best way to proceed and is the basis on which the plan was set up.

Deputy Pádraic McCormack

An injection of reality is needed.

Deputy Enda Kenny

Can the Taoiseach explain the reason this Health Service Executive service plan, which was placed in the Oireachtas Library only yesterday, is out of line by a further €400 million this morning? Everyone is in favour of efficiencies——

Deputy Noel Dempsey

In theory.

Deputy Enda Kenny

——and of giving patients the best level of service. While there were ten HSE employees at grade 8 in 2000, there were 713 in 2007. I asked the Taoiseach what are the implications, in respect of the cutting of front-line services, on foot of an amended plan involving cuts of €900 million from this service? What are the implications for front-line services, the employment of nurses and doctors and patient care? The Minister for Health and Children, Deputy Harney, appears to be the only person in Ireland who states that too many people are working in accident and emergency units nationwide. Last night, 400 people were obliged to lie on trolleys.

A Deputy

She never visited any of them.

Deputy Enda Kenny

Again I ask the Taoiseach, how many beds will be taken from the system by this cutback?

Deputy Brian Hayes

That is the question.

Deputy Enda Kenny

How many people will be let go from the Health Service Executive? What are the implications for waiting lists and patient care? What are the implications for any future development to take place in the health business in 2009? The Taoiseach should answer these questions clearly and unequivocally, based on the up-to-date information in his possession. As this is the Taoiseach's last morning in the House, this matter should be sorted out in order that Members know where they stand.

Deputy Charles Flanagan

Hopefully it will be his last morning.

The Taoiseach

Certainly——

Deputy Pádraic McCormack

Until next spring.

An Ceann Comhairle

The Taoiseach, without interruption.

The Taoiseach

The health service would never be sorted out were Deputy Kenny in charge, because he is in favour of the status quo plus——

(Interruptions).

An Ceann Comhairle

Please.

Deputy Dinny McGinley

The Taoiseach was in that Department for long enough. He was glad to get out of it. He called it "Angola".

(Interruptions).

Deputy Dermot Ahern

What did Fine Gael do?

An Ceann Comhairle

Please let the Taoiseach finish.

Deputy Paul Kehoe

He ran out of it.

Deputy Mary Coughlan

I do not know what the Deputy is on about.

The Taoiseach

Are the Deputies opposite finished?

An Ceann Comhairle

Let the Taoiseach finish.

Deputy Enda Kenny

The Taoiseach has blown his chance.

The Taoiseach

Are they finished?

Deputy Paul Kehoe

He was afraid to face up to the problems and he ran out of it.

An Ceann Comhairle

Allow the Taoiseach to finish.

Deputy Paul Kehoe

He ran out of it.

An Ceann Comhairle

I remind Deputy Kehoe this is Leaders' Questions.

The Taoiseach

Whenever the Whip is ready.

(Interruptions).

An Ceann Comhairle

The Taoiseach, without interruption.

Deputy Dinny McGinley

If the Taoiseach had his way, he would have——

The Taoiseach

Whenever they are ready.

Deputy Pádraic McCormack

The Taoiseach is seeking a diversion. He is trying to back out of it.

An Ceann Comhairle

The Taoiseach, without interruption.

The Taoiseach

The position with Deputy Kenny is that he calls for reforms but when they are being implemented he opposes them.

Deputy Enda Kenny

I asked the Taoiseach a question.

The Taoiseach

A continuing reconfiguration is taking place in the health service. There will be a continuing emphasis on more——

Deputy Brian Hayes

Beds.

The Taoiseach

——day places and day surgery.

Sorry, Deputy Brian Hayes is talking about beds.

Deputy Brian Hayes

Beds, yes, that was the question.

The Taoiseach

Beds do not determine the health service. There is more than a hospital service in developing our health service and the HSE is involved in a reform of the service.

Deputy Seymour Crawford

Tell that to my constituent who cannot get one this morning.

The Taoiseach

To stick to the point.

Deputy Brian Hayes

Bed numbers. Answer the question.

The Taoiseach

Sorry, Deputy Hayes. I will answer it in my own way. If he ever becomes leader, he can ask the questions.

An Ceann Comhairle

The Taoiseach is answering Deputy Kenny's question. Please allow him to do so.

The Taoiseach

The whole purpose——

(Interruptions).

Deputy Noel Dempsey

They have no idea.

The Taoiseach

——for driving these efficiencies is to maintain, not to cut, service.

Deputy Pádraic McCormack

They are being cut every day.

The Taoiseach

They are not being cut every day. In fact, there have been improvements in the health services in a range of areas. Where waiting times were two to five years, they are now two to five months. In 60% of all of those specialties for which there are waiting lists, they were reduced during the course of this year, if the Deputies look at the statistics that have been produced by the relevant authorities.

Deputy Pádraic McCormack

Does the Taoiseach believe that?

The Taoiseach

If Deputy McCormack wants to portray the health service being totally dysfunctional in every respect, that is his point of view but it is not fair on those who are working in the health service and it is certainly not the experience of the vast majority who receive health services in this country.

Deputy Enda Kenny

Nobody said that.

The Taoiseach

That is not to contend for a moment that we do not have problems, but those problems are being dealt with on the basis of reforms of health services and we all know, if we were honest enough to admit it, that the status quo plus will not give us a sustainable level of services. We need work practice changes.

Deputy Emmet Stagg

Why do they not do it then?

The Taoiseach

We must see——

(Interruptions).

The Taoiseach

——and we are already seeing in the engagement that is taking place——

Deputy Emmet Stagg

Ten years.

(Interruptions).

The Taoiseach

——between the management and staff representatives that we have had efficiencies of €280 million alone this year, which will be repeated next year.

(Interruptions).

The Taoiseach

What we have seen over the past ten years, to respond to Deputy Stagg, has been a continuing improvement——

Deputy Emmet Stagg

They poured money into a black hole.

The Taoiseach

——and an increase in funding to the health service.

(Interruptions).

The Taoiseach

It is also clear that resources alone will not provide the solutions to the health service, but continuing and concomitant reforms with it, and that is what the HSE management is engaged in. If people were fair and looked at the changes taking place, they would recognise that in many cases those changes have been for the better.

Deputy Brian Hayes

We only asked about beds. The Gettysburg Address all over again.

(Interruptions).

An Ceann Comhairle

I call Deputy Gilmore, without interruption.

Deputy Eamon Gilmore

The Taoiseach seems to think that things are fine in the health service. Yesterday there were 390 people on trolleys in accident and emergency units. That is just ten less than the number who were on trolleys on the day that the Minister, Deputy Harney, announced an emergency in accident and emergency in 2006.

On Wednesday last, the HSE published a service plan which stated that there would be €500 million cut from the health services and yesterday it emerged that the figure is now closer to €1 billion. There are 500 beds already gone out of the health service and it is proposed to remove another 600, that is, 1,100 beds. It costs €200,000 to provide a bed, in other words, €220 million that has already been spent in providing hospital beds will not be used under this plan.

We are faced with a situation this morning where the Taoiseach or his deputy will come in here tomorrow morning to propose that Dáil Éireann be suspended for six weeks — that we go out of business for six weeks — at a time when the country is facing its worst economic crisis, when our banks are in crisis and at a time when Ministers, including the Minister for Health and Children, are seeking additional cuts in services. This country needs a Government and leadership. It needs people who have got a handle on the problems that are facing the country and the people. It does not have that.

What we have——

Deputy Pádraic McCormack

A shambles.

Deputy Eamon Gilmore

——is a Government that is politically and economically dysfunctional, that is adrift and that is now staggering exhausted to the Christmas break.

One thing after another the Taoiseach is not getting right. He has not got the banks right. He told us on Sunday that there was going to be a €10 billion rescue plan and when I asked him direct questions on it yesterday, he could not answer a single one of them. We are no wiser today about what he is going to do about the banks than we were last week.

On the economy, the Taoiseach stated two weeks ago we did not need an economic recovery plan. At the beginning of this week he stated he had such a plan. We still have not seen it. We are now told it is some kind of a framework. When will we see this economic recovery plan that the Taoiseach has been talking about and dining over in Farmleigh? The problem is that the Taoiseach is not governing. The country has serious economic, social and service problems that are not being addressed by his Government and people are becoming increasingly depressed by that.

Everybody knows that the country is facing enormous challenges and economic difficulties and people are prepared to step up to the plate and to address them collectively. However, the problem we have in this country is that we do not have a Government which is giving leadership and direction and providing any sense that there is a solution and that we can get through these difficult times.

Is the Taoiseach serious about closing down the House for six weeks in these times? When will he tell us what the Government will do about the banks? When will we get the detail of these health cuts about which the Minister for Health and Children is talking? When will we see the economic recovery plan about which the Taoiseach has been talking?

Deputy Pádraic McCormack

There are more questions, as far as they want to go.

The Taoiseach

I reject the assertions that are being made by Deputies Gilmore and Kenny continuously in this House and that provide the soundbites for the daily business here.

(Interruptions).

The Taoiseach

Deputy Gilmore spoke about people being prepared to step up to the plate. I believe people are prepared to step up to the plate and when they do, under the social partnership process, I will be interested to see what the Opposition in this House will do. The Opposition all agree with everything in theory but when it comes to practice, they oppose everything on every day, and they have no alternative.

Deputy Ruairí Quinn

There were four questions.

Deputy Brian Hayes

We are the problem.

(Interruptions).

An Ceann Comhairle

Let him finish now.

Deputy Dermot Ahern

It is manufacturing.

(Interruptions).

The Taoiseach

With regard to the framework plan and what Deputy Gilmore stated about economic recovery——

An Ceann Comhairle

Hold on now. Fair is fair.

The Taoiseach

One will not get it here.

An Ceann Comhairle

Deputy Gilmore was listened to in silence. The Taoiseach must be listened to in silence as well.

Deputy Willie O’Dea

The blueshirts are back.

Deputy Michael Ring

What was that, Deputy O'Dea, about the Blueshirts? He himself is wearing one.

Deputy Pádraic McCormack

The Taoiseach is losing it.

Deputy Noel Dempsey

Another leader in the Fine Gael-Labour benches.

An Ceann Comhairle

Deputy McCormack, I have told you before this is Leaders' Question.

The Taoiseach

Another intellectual giant on the second bench over there.

Deputy Michael Ring

Deputy O'Dea is wearing a blue shirt.

Deputy Noel Dempsey

Another Mayo leader.

The Taoiseach

Whenever they are ready. I would like to answer to the Deputy.

Deputy Michael Ring

The Sunday Independent will hear from Deputy O’Dea but we do not hear anything from him.

Deputy Noel Dempsey

We heard Deputy Ring was moving to the Labour Party.

An Ceann Comhairle

Have a chat about that later.

(Interruptions).

The Taoiseach

On the other points raised by Deputy Gilmore, on the question of economic recovery, the Government has based its programme on the agreed programme for Government. A new economic situation has emerged over the past six months and we will set out a framework which will shape the debate around the social partnership talks that will take place in the coming weeks. What we must do is rely on some of the strengths of this economy which we have built up over the past ten years. The totally negative way in which this economy is being portrayed in every respect by the Opposition is not a fair appraisal of an economy that is under stress and——

Deputy Fergus O’Dowd

He is €8 billion out.

(Interruptions).

The Taoiseach

——faces huge challenges, but one that has some strengths it can market and utilise.

With regard to the recapitalisation of the bank, I made the point yesterday that the negotiations between Government and banks continue and that we will protect the taxpayer in respect of any exposure in which it involves itself. We will do that in the way that we have done it up until now.

Deputy Dinny McGinley

When will they be walking the plank? That would be one idea.

The Taoiseach

Other countries have welcomed the initiatives that we have taken.

Deputy Joan Burton

That was 11 weeks ago.

The Taoiseach

We will continue to protect the taxpayer in the context of trying to maintain confidence and stability in our banking system.

Deputy Ruairí Quinn

Look at the Taoiseach's backbenchers.

The Taoiseach

With regard to the final matter Deputy Gilmore raised, it is our intention in the Government to continue to lead. It is our intention to engage with the social partners and to provide ourselves with the means by which we can deal with these challenges. These challenges will not be dealt with in the partisan way in which Deputy Gilmore wishes to deal with them. They will be dealt with through social partnership where we will set a credible timeframe within which health can be restored to the public finances on an agreed basis, which is the best and only way forward to deal with the magnitude of the challenge that faces us.

Deputy Pádraic McCormack

Will Deputy Cowen be here to do that?

Deputy Olivia Mitchell

I am not sure there is any leadership there anyway.

Deputy Eamon Gilmore

The Taoiseach's problem is not the Opposition.

(Interruptions).

An Ceann Comhairle

Let Deputy Gilmore put his question now please. Put your question. Deputy Gilmore, without interruption.

Deputy Eamon Gilmore

The Taoiseach's problem is the Government that he is leading. It is not doing its job.

Deputy Dinny McGinley

You know a lot about co-operation. We have memories.

Deputy Eamon Gilmore

The Taoiseach received more co-operation from the Opposition than any other Government in a long time and, frankly, a lot more than he deserves.

Deputy Simon Coveney

Face up to it.

Deputy Eamon Gilmore

He received co-operation from the Opposition on Lisbon, when a problem arose last week in regard to the pig industry and generally over the past several months in respect of the economy.

Deputy Seán Power

What about the banks?

Deputy Joan Burton

We were right.

Deputy Eamon Gilmore

The Government received the Opposition's co-operation——

Deputy Noel Dempsey

The Deputy speaks out of both sides of his mouth.

Deputy Brian Hayes

That is good coming from Deputy Dempsey.

An Ceann Comhairle

Deputy Gilmore should put his question.

Deputy Seán Power

What about the banks?

Deputy Joan Burton

Our analysis was correct.

Deputy Eamon Gilmore

As far this party was concerned, we have turned out to be absolutely right in terms of the criticisms we made. What the Taoiseach is seeking, and what he will not get, is a silent Opposition.

Deputy Brian Hayes

Silent like his backbenchers.

Deputy Eamon Gilmore

He does not want a Opposition at all. He wants silence.

An Ceann Comhairle

Deputy Gilmore, put your question please.

Deputy Eamon Gilmore

The one thing that constrains me in saying what I really want to say about the incompetence and the lack of drive, initiative and effort on the part of the Government, is that I might cause damage by doing so.

Deputy Johnny Brady

Spit it out.

Deputy Eamon Gilmore

That is the biggest constraint that I have.

An Ceann Comhairle

Deputy Gilmore, put your question.

Deputy Eamon Gilmore

I will be absolutely clear lest there be any doubt. This Government is appalling. It is a deadbeat Government.

An Ceann Comhairle

Put your question.

Deputy Noel Dempsey

Eamon in Wonderland.

Deputy Eamon Gilmore

It is not able to lead this country out of the problems it created in the first place.

Deputies

Hear, hear.

Deputy Eamon Gilmore

It has driven us into the worst economic problem the country has experienced in decades.

Deputy Dermot Ahern

We have to deal with the problem.

An Ceann Comhairle

Deputy Gilmore must put a question.

Deputy Dermot Ahern

Deputy Gilmore just comes here to criticise.

Deputy Eamon Gilmore

It has no idea about how to get out of it.

Deputy Pádraic McCormack

It squandered it all.

An Ceann Comhairle

I ask the Deputy to put his question.

Deputy Eamon Gilmore

I asked the Taoiseach four questions but with all his bluster he forgot to answer them. Is he serious about closing the Dáil for six weeks during this very difficult period? When will we be told exactly what he intends to do about the banks? What cuts will be made to the health service, when will they be outlined to us and will we have an opportunity to debate them or is it his intention to reveal them when the House is closed down for six weeks? Finally, when will we see the economic recovery plan? There is no point in telling us about discussions with the social partners in regard to the plan. It is the Taoiseach's responsibility to produce it. Neither is there any point in telling us that negotiations have been entered into with the very same bankers who got us into the banking problem in the first place.

Deputy Noel Dempsey

Deputy Gilmore has asked the questions, so let the Taoiseach answer.

Deputy Eamon Gilmore

When will the Taoiseach tell us what he intends to do about recapitalising the banks?

The Taoiseach

I have already answered Deputy Kenny regarding the health situation and have indicated that the need for more efficiencies and effective delivery of services is a critical part of maintaining services in the health service next year. That is on the basis that €14.7 billion is being made available to the health service, an increase which takes account of the €580 million cost of the nursing home subvention scheme over this year. Negotiations are ongoing between management and unions and there is every indication that we will achieve the work practice changes necessary to ensure that we have flexibilities, deliver services to the front line to the greatest extent possible and minimise adverse impacts on patients. That is the purpose of the exercise.

In regard to the banks, I have outlined the situation to the Deputy. The recapitalisation policy was enunciated in detail last Sunday. Proposals must now come from the banks with which we are in negotiations. It must be understood that the only interests I have are the stability of the financial system so that we have a banking system that serves the modern economy we have built and protecting the interests of the taxpayer in that effort. These are our primary considerations in dealing with the matter. We have indicated that proposals should be brought before the Government in early January.

The committees will return on 7 January and we will be involved in trade delegations to support Irish industry abroad. We will ensure the Government returns on 7 January. The Government is working hard, despite what Deputy Gilmore wants to say.

Deputy Eamon Gilmore

Bring the Dáil back on 7 January.

The Taoiseach

The Deputy can do all the name calling he wants because he is good at it. That is part of the rough and tumble of politics and I have no problem with it.

Deputy Pádraic McCormack

The Taoiseach seems to have a problem with it.

The Taoiseach

However, I assure the Deputy that the Government will work hard on maintaining this country's reputation as a good economy, a place to do business and a location where enterprise can prosper. We also know that an Irish recovery can only happen when a global recovery takes place because this is an open economy and we are affected by what happens abroad. We are not total masters of our own economic destiny in every respect——

Deputy Seymour Crawford

You claimed we were.

The Taoiseach

——when one considers our membership of the eurozone and the fact that exchange rate policy is not decided here.

Deputy Pádraic McCormack

Pretend you did nothing.

The Taoiseach

We also know we have inherent strengths on which we can build. While we experience these difficulties in the economy, can we please desist from suggesting that the past ten years were an illusion and that we did not create the numbers of jobs that were created or improve the quality of life of our people?

Deputy Olivia Mitchell

Where has the money gone?

Deputy Joan Burton

You blew it.

Deputy Pádraic McCormack

The chance was squandered.

The Taoiseach

We certainly did these things. We are now facing higher unemployment levels and we need to put in place policies that will help us to deal with the situation. This phase will pass. We have to indicate to the public where this economy can be in a number of years if we take the correct decisions now. I believe the correct decisions — the elephant in the room if Deputies would prefer — involve the discrepancy between expenditure and tax revenues which has emerged during the course of this year in particular as a result of the international downturn.

We have to be prepared to work with the social partners on finding a way to deal with the problem so that everyone gets behind the wheel to ensure we come through the difficult time that lies ahead. That is the approach of the Government and it is the right strategy. It is not a matter of instant gimmicks, soundbites for the media every morning or saying that we should have change but we will oppose change every time it is proposed.

Deputies

Hear, hear.

The Taoiseach

I am not asking the Opposition to be silent. That is a matter for Opposition Deputies.

Deputy Brian Hayes

Thanks a lot, that is great.

The Taoiseach

They are capable of articulating their own points of view and that is a part of our democracy.

Deputy Brian Hayes

Fantastic.

The Taoiseach

However, I will not have it said when I defend this Government's record that I am suddenly attacking the Opposition.

Deputy Fergus O’Dowd

Why not defend the economic plan in here?

The Taoiseach

I am entitled to defend our record.

Deputy Pádraic McCormack

It is indefensible.

The Taoiseach

It has been a proud record and now that we have entered a new situation, this Government will ensure our response is appropriate to the challenges we face.

Deputy Olivia Mitchell

No change there.

Deputy Fergus O’Dowd

Are we going to see the recovery plan?