Dáil Éireann Debate, Thursday - 26 October 2023
2. Deputy Ged Nash asked the Minister for Public Expenditure, National Development Plan Delivery and Reform when he will publish the Revised Estimates for Public Services 2024; and if he will make a statement on the matter. [47188/23]
Amharc ar fhreagraMy apologies to the Leas-Cheann Comhairle and to the House for my late arrival, and to the Ministers and my colleagues. This was unavoidable. When will the Minister published the Revised Estimates with specific reference to the health Estimate and what will the Minister's planned Supplementary Estimate for health be for this year?
I thank the Deputy for the question. Expenditure Report 2024, published on budget day included budget Estimates. These budget Estimates for public services set out the allocations for the following year for each Vote at programme level. This represents a high-level summary of the budget and allocations for the following year. The Revised Estimates Volume for Public Service, REV 2024, outlines further information setting out the detail of allocations under each programme at subhead level. It also outlines the high-level goal of each programme and the public service numbers related to each subhead line. The Estimates are also supplemented with key performance information regarding outputs, context and economic indicators for each programme. In line with usual practice, it is expected that the REV 2024 will be published in mid-December. This publication date of the Revised Estimates Volume for Public Services allows for consideration of the Estimates by the relevant Dáil select committees at an early stage in 2024.
On the final question put by the Deputy to me regarding the Supplementary Estimate for the Department of Health for this year, for which there will be one and which I have acknowledged, my officials are working on that with the Department of Health at the moment and I hope to be in a position to give a clearer answer on that matter once we are clear on where we stand at the end of October. I am not in a position to give an accurate answer here today to the Deputy.
I think we can assume the Supplementary Estimate will be very significant indeed based on the information that is in the public domain at present. I think everybody in this House, or at least a very significant number of Deputies in this House, and indeed experts would be of the view that the Minister must re-examine the planned expenditure in health for next year. That is very clear. Quite frankly, I say to the Minister that he owes it to the 900,000 people who are on waiting lists who will inevitably suffer. The Minister for Health got his defence in first prior to the budget when he made it very clear that what the Government was prepared to provide to him in an Estimate for next year would not be sufficient. We are very clear on what the HSE chief executive has also said. Will the Minister, therefore, reopen that element of the budgetary process?
The Minister did say he did not want to get into a war of words with the Minister for Health or with anybody else about the health budget but it is the Dáil which passes the Estimate. The Minister is a serious politician, he takes his responsibilities seriously, he is accountable to the Dáil, and the Dáil has a very significant job of work to do constitutionally to pass an Estimate. An Estimate which is a fictitious one should not be presented to this Dáil as it is entirely inadequate to meet the health service needs for next year.
I thank the Deputy very much for his comments and, of course, I am well aware of my duties to the Dáil and the need to put forward factual answers to questions the Deputy raises, which at all points I endeavour to do.
I will just deal with the different layers of the question the Deputy has put to me. First, on the obligation we have to those looking for hospital and medical care within hospitals, this is the reason in my time as Minister for Finance and before that we enabled and added 22,000 extra staff to our health service, including an extra 6,700 nurses and midwives. That is why we have now increased our hospital bed capacity by 1,000 beds. We have seen a very significant increase in funding for the health service in recent years in recognition of the needs the Deputy is describing. Our Estimates and our budgetary process also has to deal with the availability of resources and the fact the Government is dealing with a variety of different demands across many different elements of our public services. Of course, I am aware of the issues the Deputy raises.
I find it quite extraordinary that we are in a position where the Minister for Health would be preparing to introduce plans here in this House and ask the Dáil to approve a budget which the HSE chief executive and he consider to be entirely inaccurate. This is about parliamentary accountability. Our primary concern should be for the well-being of all those of us who depend on a decent universal public health system. There is a question, however, of accountability. That the Dáil would be expected to pass an Estimate which the Minister himself feels he cannot stand over is quite extraordinary. The reality is in any other parliamentary democracy, that simply would not happen. I do not even think it would happen in the UK, even given the circumstances there at the moment, where a Minister would get his defence in first, acknowledge the Estimate itself is entirely inadequate, and would then ask his colleagues in the Dáil to pass it. It is quite extraordinary and I believe this process needs to be reviewed.
Again, I believe it is important to put this budget in the context of recent spending decisions. Over the past eight years, we have seen an effective doubling of our spending within our health services. Over recent years, we have seen an increase in investment in our health services of between €6 billion and €7 billion. We have seen very significant and needed increases in funding for health services at a time when they continue to face very many demands. I will continue to work closely with the Minister, Deputy Donnelly, on the different issues he has raised.
In the context that we have this increase in investment is also the fact the budgetary process is still based on an amount of money and resources that are finite and fixed and which have to be allocated across all of government. We have seen in recent years very significant increases in funding for health, as I said, and even with the funding that has been made available, which is a further €1 billion versus where we were on budget day one year ago, that is also an increase in the allocation.
