Section 9 of the Act of 2009 is amended -

(a) in subsection (1), by the substitution of "vary" for "reduce", and

(b) in subsection (5), by -

(i) the substitution of the following paragraph for paragraph (e):

"(e) the impact, if any, on the State's ability to continue to provide health services at existing levels;",

(ii) the substitution of the following paragraph for paragraph (f):

"(f) the fairness and efficiency of any method of effecting any amendment to payments having regard to the requirements of good and effective administration; and",

and

(iii) the insertion of the following paragraph after paragraph (f):

"(g) the need to retain firm control of current Exchequer expenditure so as to ensure ongoing access to international funding and improve competitiveness, while taking into account the continuing risks to the public finances which remain, and the need to meet the State's commitments to have a prudent fiscal policy under the Stability and Growth Pact and the Fiscal Compact.".