The health system is a failure. When the HSE was set up, the people of the country were promised a world-class health system. These were the very words spoken by the Minister for Health and Children. We have world-class doctors and nurses but we do not have a world-class system to support them. We are now told by the Minister for Health and Children that the cut expected in the budget will be of the order of €600 million to €1 billion. This announcement was made without any commitment not to affect front line services. Front line services are what save lives. They provide care at the front line. The Government has always taken the easy option in distinguishing between waste and service. I ask the Taoiseach to give an assurance to the Dáil and the people of the country that, whatever cutbacks are made in the health budget for 2011, they will not have a direct impact on front line services.
Leaders’ Questions
It is the objective on every occasion to ensure whatever allocation is made in the service plan this year, which is being exceeded in respect of when the plan was drawn up earlier this year, front line services are provided to the greatest extent possible with the money provided. The framework of the Croke Park agreement provides us with an unprecedented opportunity to ensure the changes that can and will be made——
The Government will cut from the bottom.
Where else will they cut?
The Taoiseach without interruption please.
The Croke Park agreement provides us with the framework to ensure we can make changes on the ground that will minimise the impact at the front line. The current Estimate for health is approximately half of the total receipts coming into the national Exchequer.
That is of little consolation to the people of the country. I asked that the Taoiseach, irrespective of the cuts made in the health budget, can give a guarantee front line services will not be cut. The reason I ask is that front line services save lives. Two weeks ago, Fine Gael tabled a motion in the name of Deputy James Reilly. We listed many actions that could be taken by the Government to save money in the health budget. At least €200 million could be saved by using generic drugs. Why has this not been acted on? Why has the Government not followed the €92 million spent on agency staff or the 6,000 redundancies promised by the Minister for Health and Children and identified by the former chief executive Brendan Drumm before he left office as ways of dealing with a reduction in the health budget without having an impact on front line services? I recognise this Government has led the country into economic quicksand. Reductions must be made across all Departments. In the interests of the hundreds of thousands to be affected by this and irrespective of the size of the cutback in the health budget, can the Taoiseach give the people an assurance that the cut will not affect front line services, which save lives?
My first reply reiterated that patient safety is of the highest priority. Many of the structural changes and financial constraints in the health service have led to a response from the health service employees that has ensured patient safety remains the highest priority.
What about patient services?
The service that is provided is in excess of the service plan agreed at the beginning of the year. That service planning is crucial if one is to apply resources properly and ensure every area of the health service is funded to meet the basic requirements. Patient safety is of the highest priority. We have an industrial relations framework, through the Croke Park agreement, that will see negotiated change across a range of areas to ensure the people who work in the health service provide the best possible service for the funds available for health in the coming years. That must be accelerated and done as quickly as possible. On the basis of the Estimates and the allocation of resources to various parts of the health service that will emerge in the budgetary process, the talks at local level can work. We have already seen practical examples where it has happened, where nursing staff have moved from Croom and Ennis into Limerick General Hospital in order to meet the requirements. In the absence of an industrial relations framework that might never have happened.
Limerick General Hospital was top of the list for use of trolleys yesterday.
We would not have had the process or mechanism by which this could happen. Redeployment is a key factor in maintaining services to the greatest extent possible for the funds provided. Patient safety is the highest priority for the professionals who work in the service.
No guarantees.
There is considerable debate and discussion about the forthcoming budget and the possibility of a four-year budgetary plan over the coming years. Obviously such discussion must be based on sound, solid information which only the Government itself can provide. As we know, the projections which the Government gave us last year for economic growth were seriously wrong, as a result of which we are now told the projected budgetary adjustment over the next four years is significantly greater than the €7.5 billion that was originally expected.
We need to have a number of pieces of information if there is to be meaningful discussion on budgetary matters. I ask the Taoiseach this morning if he will provide that information. First, can he tell us what is the growth forecast for 2011 and the projected growth for the next four years? Second, what budgetary adjustments does the Government propose for the coming year, 2011, and what is the total adjustment that is projected for the next four years? What is the forecast for unemployment next year? There are currently approximately 450,000 people on the live register. The total has been more than 400,000 for the past 16 months. What is the Government's forecast or projection for unemployment next year?
First, Deputy Gilmore will be aware from the briefings that his finance spokespersons have received that data are currently being compiled for the plan. When the plan has been agreed and approved by Government in due course, it will be published and can be debated in the House. We can set out the various assumptions that are in the plan.
Deputy Gilmore was talking about forecasts being wrong. Forecasts, by their very nature are set out on basic assumptions that are made at the time. The real question is whether they were justifiable at the time. What has happened is that on the 2010 budget forecasts for the subsequent years the Government took forecasting models from the high growth and low growth scenarios that were set out in the ESRI reports at the time. The forecasts for the years ahead were justifiable at the time. It was the received view that this was the case. We were talking about increasing growth rates of between 3% and 4% over the period. In one of the years a growth rate of 4.5% was predicted. The figures set out are in documentation that is publicly available. I do not have them in front of me.
What has happened since then, which must be taken into account, was not part of the forecast at the time. Forecasts, by definition, have that constraint. They are forecasts. The Greek situation occurred in April and it had an impact on bond markets. We had a further review of what growth prospects in the American economy would be, which were downward. We have had downside risks emerging in terms of the growth potential in the European economy. All that has changed.
Forget about the Greeks, what about the Taoiseach?
Ah Tom.
What about Bertie?
Deputies, the Taoiseach should be allowed to speak without interruption please.
What about the Bailey brothers?
In broad terms, what has emerged is that growth prospects for the future from 2011 on are less now. When we have finalised the production of the data, we will convey that and deal with it. The reason the forecasts from 2011 to 2014 have to change from what was predicted in 2010 is that the borrowing costs of sovereign debt have increased and need to reduce. The reason we need to reduce is because we have to bring forward a four-year plan to assist in achieving the confidence necessary internationally and domestically so that will happen.
The Taoiseach is changing his story every day.
In addition, we have a situation where growth forecasts are down. Therefore, that involves an acceleration of how one brings the public finances into order more quickly. Those are the facts. Specific issues arise from that. It is not the case that the forecasts were wrong. They were justified on the basis of what was set out at the time. There have been changes during the course of this year in world and European economy fundamentals which are changing the forecasts of everyone, not just the Department of Finance but the Central Bank, the European Central Bank, the International Monetary Fund, the OECD and others.
Anglo Irish Bank.
It is because of everyone else.
That is a continually evolving situation. In reply to Deputy Gilmore, the growth rates will be decided upon when the Department of Finance has finalised its view on those matters. Data are incoming to the Department as we speak. A technical exercise was provided for spokespersons to enable them to see what the scale of the operation would be.
It is half of what the Government was saying.
I am sorry.
Deputy Burton, only one speaker is allowed at a time.
The spokespersons were also briefed on market sensitivities in terms of finalising the figures so that we can make sure that we get the very best possible outcome from the Irish economy's point of view.
That is why the markets will not sell the Government bonds.
No.
Deputy Burton.
Those questions will be answered with full clarity when the four-year plan has been completed.
When?
Deputy Burton, please.
Joan, leave him alone.
We have indicated also.
Is the Taoiseach saying they will make up the forecast again next year?
It is not a question——
Deputy, we must proceed. Whoever is in possession must be allowed to speak without interruption.
You have to admit it was a good question, a Cheann Comhairle.
If we are to have a responsible discussion about a serious situation, let us have it.
Hear, hear.
The Taoiseach will be judged on his record.
We do want to have a responsible discussion about the economic and financial situation but one cannot have it in a vacuum. Basic information needs to be provided. In his response the Taoiseach has taken us on a tour around Europe and the Mediterranean and to the United States——
Disneyland.
——all over the place rather than focus on the actual question. The first piece of information we need to know is what are the growth forecasts for next year and if we are to have a four year budgetary plan the forecasts for the four years. The Taoiseach can justify it all he likes but we know that the growth forecasts he gave us last year were way out, as a consequence of which the budgetary projections for next year and the following four years also have to be adjusted. We need to know what is the growth forecast. I accept the Taoiseach is not in a position to tell us today what the growth forecast is but when is he going to settle on the growth forecast and when will he be in a position to tell us? Until we know that we cannot calculate, and neither can the Taoiseach nor anyone else, what the size of the budgetary adjustment will have to be. While he is waiting to decide what the growth forecast is he might give the House some indication as to where he thinks it is likely to end up in terms of the budgetary adjustment that has to be made for 2011 and over the next four years.
The Taoiseach is correct that a briefing was given to the finance spokespersons but the information provided in that briefing is entirely conditional on what the level of growth is likely to be and therefore what the budgetary adjustments are then going to be as a consequence. If the Taoiseach is not in a position to tell us what that is today, can he tell us at least when he is going to be in a position to provide us with that information because until we have it we cannot have — nobody can have — a meaningful discussion on where the budget for 2011 and beyond is going to go?
The Taoiseach did not make any response to my request as to what the forecast for unemployment will be next year. I invite him to have a stab at that when he is replying the second time.
First, on the question of growth, growth scenarios were provided to spokespersons on what the consolidation will be——
Scenarios.
Scenarios are not forecasts.
——were the growth over the period to be 1% or 2% per annum. It has been conveyed to the spokespersons what the rate of consolidation would be in those scenarios of 1% or 2% growth. That has been provided. That was the discussion that took place. It is possible for the Opposition to glean from that and to decide on that based on the 1% or 2% scenario.
Ah no. The Government has the figures, it must tell us what it is suggesting.
If I was let answer the question it would help.
The Taoiseach must be allowed to answer.
This is Leaders' Questions and, with respect, Deputy Burton is not the leader of the Labour Party. Her leader has asked a question. He indicated to the House that he has no idea what the growth scenarios will be. Deputy Burton was told, as a finance spokesperson, under a 1% scenario and under a 2% scenario for growth, what the rate of consolidation of the public finances would be to 2014. That information is available to the Opposition.
We are asking the Government for its projection.
It is not Deputy Burton's purpose to make a comment at this point in the proceedings.
The Taoiseach would make a good Ceann Comhairle.
In the normal course of events, as we prepare for a budget in December, we provide for the pre-budget outlook, where much of the information is provided officially and that normally comes in November. On the plan we must now bring forward, once the Government has decided on the growth figure it will run with, which will provide for a credible path to a solution to the public finance problem by 2014, we will provide it to the Opposition.
When will we get that?
In the coming weeks.
Will we get it before——
This is Leaders' Questions and Deputy Burton is not entitled to ask questions, it is a matter for her party leader.
This is becoming childish. As the spokespersons are aware, there are certain market sensitivities. I would hope that at the meeting today between leaders, we could have a discussion about some of these scenarios in a way that respects the confidentiality and seriousness of those discussions. If at Leaders' Questions we prejudge the publication of the four year plan by providing it prior to its being approved by Government, it would not be the proper way to proceed. There is no point in our using these occasions to seek information that Deputies know will be provided by Government in due course.
I thought the Taoiseach was to open the books.
If we want a serious discussion about what the country faces, if everyone is signed up to the 3% deficit target by 2014, the various growth scenarios outlined in the briefing the Opposition party obtained where confidentiality and market sensitivity is being respected, the Deputy will know what the rate of change is and what the rate of consolidation must be. That is available and we can have a discussion on that basis.
These people have to be spoon fed.