I propose to take Questions Nos. 35 and 200 together.
The HSE is overspent by €318m to the end of August and if no action is taken is projected to have a deficit of €500m at the end of the year. The HSE is facing a serious challenge and has to make very significant savings in the current year. There is intensive engagement between my Department and the Health Service Executive to address the overrun in health expenditure. In the short term to address the 2012 position I have instructed the Executive to impose cash limits on agency and overtime. Furthermore, there will be more intensive management of absenteeism, travel and subsistence will be limited, and there will be more intensive management of stocks in order to better manage cash. Other measures are also being undertaken in order to achieve a balanced budget. These include reductions on services, the use of capital to fund revenue on a once-off basis and the transfer of Department funds to the HSE on a once-off basis.
I have instructed the Executive to provide fortnightly reports on the cash situation, and the Regional Directors are being required to more intensively manage the cash so as to achieve a balanced vote. On a strategic level my Department has undertaken a number of initiatives to address concerns around financial control in the HSE. These included engaging an expert from the UK NHS to examine the financial management of the HSE and make recommendations regarding strengthening and improving the management of its finances. PA Consultancy has been engaged to prepare an Action Plan for implementation of these recommendations. In addition, a new Director General Designate has taken up position in the HSE and has been given a clear mandate in respect of controlling expenditure this year and putting forward proposals that deal with the challenge in 2013 and beyond.
My Department is working intensively with the HSE on proposals for submission to Government to address structural expenditure issues in the context of the 2013 Estimates. This includes reconfiguration of services, maximising the potential for flexibility under the Croke Park Agreement and curtailing expenditure in the Primary Care Reimbursement Service.
This is entirely appropriate and in keeping with the focus in the Programme for Government on reforming the way health services are funded and delivered to achieve greater productivity and more cost effective services.