Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I wish to raise the questions of structures. I do not want to get bogged down because I spent enough of my life dealing with them to want to leave them behind. I wish to raise the issue of local versus national accountability. I am aware of the Carlow-Kilkenny model - I am not sold on it as the be-all and end-all, as there are as many problems as there are fantastic things going on there - but there is a degree of local co-operation and local accountability that does not have any political involvement. On the structure, what exists, exists and as for trying to change it, I think the Chairman is correct that people have restructuring fatigue. Would it be more beneficial for us to look at what is there and try to build in the accountability, rather than change it? Should we try to structure accountability into the structures that are there already, rather than spending our time trying to devise another structure, which will simply sit on the system that exists at present and will not deliver the type of reform needed? We all recognise the need for reform but reform and restructuring are not the same thing. Is it a case of parking the restructuring and looking at accountability and of trying to build in accountability at a local level and facilitate the level of co-operation that goes on at local level? If one has ever hosted a conference for nurses, they will talk to one other about what is happening in their own areas and will learn from one other. A significant amount of that goes on anyway without anyone trying to facilitate it. Would we be better to ignore the restructuring that may or may not be required and has been done many times and try to build in more accountability at local level?