Dr. Sara Burke:

Deputy Louise O'Reilly referenced Carlow-Kilkenny hospital group. I am aware that a delegation from it appeared before the committee but it might be worthwhile for members to go down to see what they are doing and to witness the meetings where the GPs and consultants share information. The Minister has recently done that. I think it is really good practice. If one looks at what is happening there, it has nothing to do with the structure, because they have the exact same structure as anywhere else but it has to do with work processes that have been pioneered by GPs in the community and a couple of visionary people in the hospital. It has, however, taken decades to develop and it is not like they started to try to do this two or three years ago; they have been doing it for decades. That brings us to a useful point. This is about resourcing processes in order that it is not dependent on the goodwill of a few innovative GPs and hospital doctors. There is a GP and a hospital doctor who are married to each other and I bet that is crucial to the success of the Carlow-Kilkenny model. It is about putting in place the processes in order that they are resourced and that people are paid to take time out to work out what is the best way for Sara Burke. Does she need to go into hospital today or can she be managed at home or in the community for two days and then can she go in a planned way, rather than her ending up on a trolley tonight? That is the nitty-gritty work they do at those meetings. I think the effort is about resourcing those processes and putting them in place. The processes in Bluebell might be different from the processes in Carlow-Kilkenny or in the Beara Peninsula or in Ballinasloe. That is something about respecting the services but also the people and the needs within the local communities.