The implementation of the long-mooted plan to transform the health service over a decade will be made more difficult because of the high level of spending already allocated to the health sector, the Taoiseach has said.
Leo Varadkar struck a note of caution about the Sláintecare plan, saying some of its reforms will have to be done at a "slower pace than maybe people would like".
The Sláintecare initiative, first announced in May 2017, requires a €3 billion transition fund to cover the cost of implementing the reforms over a 10-year period.
Minister for Health Simon Harris brought an implementation plan for the scheme to Cabinet on Wednesday.
Speaking after the special Cabinet meeting in Derrynane, Co Kerry, Mr Varadkar said this implementation plan sets out what will be done in the next three years.
However, he said that the overall implementation of Sláintecare “is going to be difficult”, particularly in the context of higher health spending generally.
It is understood the latest projections suggest that health overspending is on track to be well over €500 million for 2018.
‘Additional money’
“While we accept the Sláintecare report, at the moment health spending is already running about 8.6 per cent ahead of last year, so we’re already spending a lot of additional money on healthcare, and when you are increasing spending by 8.6 per cent per year already, it is difficult to find even more money on top of that to implement other programmes,” Mr Varadkar said.
“People will be aware there are proposals in Sláintecare, for example, to extend the number of people who have free GP care by an extra half a million every year, and we feel if we do it that quickly, we will overwhelm the existing capacity of the services. Some of those things will have to be done at a slower pace than maybe people would like.”
The Cabinet also heard an update from Minister for Housing Eoghan Murphy on the National Regeneration and Development Agency, which will seek to release State-held lands, particularly so-called brownfield sites, for housing development.
Mr Varadkar said state agencies, such as education training boards, the Health Service Executive and departments such as the Department of Defence, would see some of their lands used for houses.
However, he said the exact detail of which sites will be used by the new agency – which the Taoiseach renamed the “Landmark Development Agency” – will not be revealed until September.
Scepticism
It had been expected to be detailed by the end of the month, but sources said Mr Murphy was met with some scepticism at the Cabinet meeting as to how the new agency will work.
Mr Varadkar’s statement means the launch has now been delayed until the autumn.
Micheál Martin has accepted my offer to discuss the confidence and supply agreement, and its possible extension
The Taoiseach was also asked about a potential meeting with Fianna Fáil leader Micheál Martin on the current status of the confidence and supply deal which underpins the Fine Gael-led minority government.
The deal effectively runs out after the October budget, and Mr Varadkar wants an extension agreed before then. The Taoiseach claims a “cliff edge” is not desirable, given the ongoing Brexit uncertainty.
Mr Martin maintains that any talks on an extension cannot begin until after the budget, and the deal says a review should take place at the end of 2018. The pair were expected to meet this week, but Mr Varadkar indicated this had also been put back.
“Micheál Martin has accepted my offer to discuss the confidence and supply agreement, and its possible extension,” he said. “That meeting will happen before the end of the month – we’ll let you know after it’s happened.”
It is understood Mr Varadkar told the Cabinet meeting he will meet Mr Martin soon and request the confidence and supply deal be extended for two years.
The Taoiseach concluded, Cabinet sources said, by saying it would be difficult to deal with Brexit and introduce an October budget without an assurance from Mr Martin that he will extend the deal.