Pat Buckley (Cork East, Sinn Fein) | Oireachtas source

I thank the witness for the presentation, which has touched on many of the issues I wished to raise. My main issue is primary care and the bottom-up approach we need to examine. Having seen the presentation slides, I find it strange that Spain and Ireland had very similar proportions of spending. There was 67% or 68% in government funding, with private out-of-pocket spending at 21% in Spain and 20% in Ireland. They were very similar but Spain seems to have one of the best primary care systems across the OECD. Why is that?

The witness mentioned the raising of extra statutory revenue from taxes on fizzy drinks or fatty foods. We spoke about legislation a while ago. If we were to legislate for that, would it be a good idea to ring-fence the funding and put it directly into the health system? We speak to people at the doors and they do not mind spending money if they get a proper service for it. I had many more issues to raise but the witness covered most of them in responding to previous speakers. The skill mix and the strengthening of primary care has been covered, as well as performance issues. There is the matter of linking provider payment to performance. I do not know if that would work here or if it would cause friction. Will the witness elaborate on that?