Mr. Dónal Clancy:

We have highlighted on many occasions that we are not involved with the group and that we do not know why that is the case.

Professor Crown stated that smoking should be a risk factor. It is not allowed to be included in the various risk factors at present and it would be very constructive if it were included. I agree with Mr. O'Dwyer that there might be implementation issues but we could work around those.

Public versus private is a difficult ask. I concur with much of what Mr. Moran said. Unfortunately, on the public side we are not in a position where we can outline how the protocols should be followed. It is true to say that if one has a particular illness involved or if one wants to obtain the best outcome in respect of a critical or chronic case, then a public hospital is the place one wants to be. There is a balance in this regard. However, there is an adverse incentive here. Incentive drives behaviour and much of what we are discussing here comes down to incentive. It has been clearly articulated to us on many occasions that certain hospitals perform certain procedures in a particular way. Much of this is due to the way the market behaves, both in the hospitals and among the insurers. We accept this and we should not do so, particularly when it comes to our members paying, as I have already indicated, for procedures on a day case basis when such procedures should only be performed in a consultant's surgery. Much of it comes down to convenience and habit but most of it is as a result of the fact that the incentive is there to do it. We have to pay the €700 or whatever is the amount.