Steep increases in charges for healthcare and medicine are expected today when the Government publishes Budget Estimates that will allow only a minimal rise in public spending next year.
The rise in charges will come despite the Government's decision to push health expenditure above €10 billion for the first time.
Pay awards and the medical card scheme take up the bulk of the rise in health expenditure, which will be significantly above the €500 million suggested previously.
Mr Martin will say that benchmarking and other pay awards will account for some 70 per cent of his increased allocation. The allocation to the medical card scheme, which cost €963 million this year, will account for another 17 per cent.
Mr Martin is expected to increase accident and emergency fees and hospital bed charges at the bottom end of the 10-15 per cent range mooted last night by informed sources.
A 10 per cent rise, for example, would increase the €40 consultation fee at accident and emergency wards and the €40 per night hospital bed charge for uninsured public patients to about €44.
Mr Martin is also expected to increase the threshold at which the drug refund scheme kicks in. The threshold was increased to €70 per month last year from €65 and a similar €5 increase was suggested last night.
The Minister for Health is also expected to increase by 10 per cent the amount charged to health insurers for the use of private beds in public hospitals. A similar rise last year raised €15 million, although it is likely to lead insurers such as the VHI and BUPA to charge higher premiums.
Health will be the biggest beneficiary of the increased expenditure, alongside education. However, the priority given to these two areas means that the allocations to some other major Government Departments will fall by 2 or 3 per cent.
Measures to maximise Government revenue will be signalled after the Minister for Finance, Mr McCreevy, publishes a Book of Estimates in which the overall rise in voted public expenditure will be set at about 5 per cent. This will be enough to bring voted expenditure to more than €40 billion next year from €38.18 billion in 2003. However, the Benchmarking and Sustaining Progress pay awards will account for more than half of the Government's increased expenditure.
In addition, the real rise in spending could be as low as 1.3 per cent because inflation, estimated at 3.7 per cent this year, will account for most of the rise. However, Mr McCreevy will leave himself room to introduce social welfare increases on Budget day, on December 3rd.
While the overall increase on Budget day is expected to be near to the 7 per cent budgeted rise this year it will be significantly below the 14 per cent increase in 2001 and the 23 per cent rise in 2000.
With the economic downturn continuing to limit the Government's capacity to raise tax revenue, Cabinet members are expected to argue that they cannot spend money the Exchequer does not have.
Measures to reduce the Government's actual expenditure in some major Departments will include moves to extend by €100 million the State guaranteed borrowing limit of CIÉ.
This measure will be used by the Minister for Transport, Mr Brennan, to claim that he is maintaining the real rate of investment in the transport network, even though the Department's expenditure increase of 2.5-3 per cent is below inflation.
Other measures to be signalled today will include a "well above average" allocation to the school building and equipment fund.
Some €168 million was allocated to the fund this year, meaning that the Minister for Education, Mr Dempsey, has secure a increase in excess of €8.4 million in this category of expenditure.
In addition, the Minister for Communications, Mr Ahern, is expected to allocate some €32 million to the national broadband initiative.
This represents a rise of 1 or 2 per cent over the expenditure this year, less than the inflation rate.
Mr Ahern will increase public investment in the seafood conservation and management programme to €37 million from €34 million.
He will also increase the allocation to the sustainable energy programme by some 2 per cent to €13.7 million.
