Dr. Peter Greally:

I can base it on my own experience. In addition to being a respiratory paediatrician I cover the acute and general on-call roster, so it is unselected patients coming in with any number of disorders. I am based in Tallaght Hospital where we are co-located with adult services. Over the last year I have had three cases of adolescent patients who have presented with conditions that are relatively rare in children, and there was not necessarily the expertise within paediatrics to deal with them, where we called in the relevant specialists in the adult services to help us. That was just my experience and other colleagues in Tallaght would have had the same experience. Sometimes it can work the other way. Again, these are rare situations but it is one piece of a jigsaw. It is not just one thing that dictates whether co-location or tri-location is important, it is the totality. Sometimes adult physicians encounter rare disorders which are more commonly seen in children, so it works the other way. We are occasionally consulted to give our opinion on those disorders. It is part of the overall picture. It is not necessarily the key driver, but it is an important contributor.