Dr. Ambrose McLoughlin:

Deputy Kelleher has made a very good point. One of the reasons we have been delayed in presenting the small hospitals framework is the very issue he has outlined. We want to ensure that the small hospitals framework is aligned with the acute hospital groupings.

We want to make sure we have an alignment with primary care so that we have a joined-up system. Deputy Kelleher referred to integrated interdisciplinary care. Clinical reform programmes are working in a number of areas, such as diabetes. The programme, led by Dr. Barry White, is important in ensuring the patient journey, particularly for those with chronic illness, is managed properly and the patients are looked after at the lowest level of complexity. Deputy Kelleher is correct that this will be part of the approach we are taking.