Fourteen months ago, in the run-in to budget 2019, I advocated additional new net policy spending, including new revenues, especially for the Departments of Health, Education and Skills, Housing, Planning and Local Government, Justice and Equality, and Children and Youth Affairs. However, the Fine Gael and Fianna Fáil austerity Governments since 2008 have resolutely refused to fund essential services for people across all those and other sectors of government. Once again, we need large Supplementary Estimates, in this case of €634 million, just to fund the crucial day-to-day operations of hard-pressed Departments and the HSE.
Mr. Paul Reid, CEO of the HSE, told the Oireachtas Joint Committee on Health in early October that he thought the HSE could break even this year because he had instructed HSE managers to limit overspends by curbing staff levels, overtime and the spend on agency staff. Members know that for the past nine or ten months Mr. Reid and the Minister for Health, Deputy Harris, have imposed an embargo on the recruitment of additional staff to provide desperately needed therapies and hospital operations. Despite those measures, we now see in the Supplementary Estimates that Vote 38 needs an additional €338 million for 2019. The bulk of this funding seems to be needed for HSE health and social care services and primary care reimbursement services. At a meeting of the Joint Committee on Health yesterday, Mr. Reid said the overrun at the end of September was almost half that of the same period in 2018 and that the HSE workforce of 138,080 represented 119,473 whole-time equivalent staff. The question we must ask is why Mr. Reid and the HSE board only recently submitted a service plan for 2020. How can we allocate budgets in this House if the HSE and its chief executive do not give us a service plan for the next calendar year? That seems to be an incredible anomaly.
The key problem with supplementary budgets and overruns in the health area is that we know there are horrendous waiting lists for acute hospital treatment. Yesterday, Deputy Micheál Martin referred to there being 200,000 children on waiting lists for health services. It appears that the 2019 and 2018 budgets and previous austerity budgets did not realistically allocate the necessary funding for health, social care and disability services. Does the 2020 HSE service plan, which the Minister and the Cabinet now have, remotely meet the delivery costs of those services or will this Dáil or probably the next Dáil have to revisit Vote 38 for a Supplementary Estimate in autumn 2020, or perhaps much earlier due to Brexit?
The Committee on Budgetary Oversight has been raising anomalies in Vote 38 for the past three years. Dr. Seán Healy of Social Justice Ireland, in a presentation, drew attention to what we all know are the predictable shortfalls in health expenditure. Two or three years ago, the shortfall was more than €800 million. This means the health service had almost €1 billion less than was needed to operate. The Irish Fiscal Advisory Council and the Parliamentary Budget Office, PBO, have both drawn attention to the same situation. IFAC defines a prudent fiscal policy as one “where net policy spending growth does not exceed sustainable growth in revenues”, but that does not preclude ensuring we have sufficient revenue in our budgets in this House to run a modern, universal and quickly accessible health service.
As colleagues have said, budget 2020 was a regressive, standstill budget for citizens on social protection benefits, assistance and pensions. We might as well not have had a budget, especially for lower paid workers generally. The payment of a Christmas bonus, which I understand amounts to €100 million net in the books, cannot erase the cynical failure by this “Varadkar” Government and its imposition of possible disorderly Brexit costs entirely on the most vulnerable citizens. In terms of transparent management of the public finances, we should decide on Christmas bonuses for the following year and provide for them in the main budget. We should stop this messing and pretending year after year.
In education, an additional €68 million has been provided. The PBO has drawn attention to the demographic bulge, which is moving on from primary to post-primary level. It will possibly peak in 2025 and then move on to third level. I advocated at the Committee on Budgetary Oversight that the additional teachers who may be released by the changes in the demographic bulge should be used to dramatically reduce the pupil-teacher ratio. I welcome that the Committee on Budgetary Oversight has been engaging with larger Departments and that the focus of the committee early next year, prior to the general election, will be on accurate forecasting and management of demographic factors. That is the key point. The committee is rightly concerned about the use of outdated demographic projections in budget 2020 and the need for budgetary allocations to accurately reflect demographic pressures. I hope we will have that and the additional spending that is essential. Perhaps this will be one of the last years we have this kind of charade and we can consign the annual Supplementary Estimates to history and instead have realistic annual budgets year in and year out.