Mr. Liam Woods:

In reference to price reductions, I understood the Deputy was asking whether it is an issue if we undertake a tender, for a group of hospitals or nationally, for a service or product and negotiate a price in the marketplace, but some hospitals which were on a lower price are then mandated to go onto the contracted price. It can be an issue but it is not a major issue. It does not happen all the time but we do sometimes face it. When we need to take a national approach to driving value, our observation to a tenderer is that if it has a price that is lower in one hospital and we run a tender, it should bid that price and give it to us nationally, and then we have good value nationally. If it comes around the back of the scrum after we have done a tender saying there was low price, we will not tolerate that. We want national value up front. Individual hospitals may experience loss - this came up in some of our dialogue with some larger voluntary hospitals - and we did undertake that, subject to review, we would balance our cost-cutting targets to reflect that. If one hospital was truly suffering a loss this year, we would consider rebalancing slightly, and the adjustments would be very small to ensure that, while we are getting something that is for the common good of the whole system, nobody loses as a result of an independent or single competition. We have the other experience of tenderers seeking to come back in having lost a contract and offering a lower price, and that is not something we tolerate.