Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

You referred earlier to the many perverse incentives within the funding model of the health service at present. How does one deal with an issue where it makes absolute sense from a patient's and a financial point of view to move a service out? A key decision must be taken by the hospital whereby it says it is prepared to give somebody X amount of money to do something in the community. Presumably, it is very hard to get hospitals to do that, because there are turf wars taking place. You are dealing with the community and St. Luke's. It is further complicated, obviously, in situations where there is the community, a HSE hospital and a voluntary hospital, which is another kettle of fish. At present, they appear to be getting the co-operation on a voluntary basis but with regard to rolling out this type of model nationally, presumably there would have to be clear decision making in terms of top slicing funding that currently goes to hospitals and switching that into the community. How is that addressed?