Dr. Tony O'Connell:

We are already moving activity out of the bigger, busier hospitals and making much greater use of the smaller hospitals, so we are increasing our rates of things like endoscopy and day care procedures in hospitals like Ennis, Nenagh, Roscommon, Louth and Bantry. As the first step, it is addressing the issue that Professor Keane referred to. In an ideal world, day case procedures would be done in a quarantined separated procedure - a cold surgery factory, so to speak, where there is no pressure on beds and where the business is very much attuned to churning through people, getting them ready to be sent home and providing them with standard information packages, etc. That is the first step.

The next step of getting the GPs to do the procedures involves a much higher level of difficulty because it requires the GP to be somehow financially incentivised to do that because GPs are not my direct employees. We need to cajole and pay them in a way which makes it worth their while to do these minor procedures when they are under a lot of pressure to churn through cases every 15 to 20 minutes from non-surgical procedures.