Mr. Paul Gilligan:

The referral pathway is from general practitioner to our dean clinics. Our dean clinics are our first port of call. Since we established them, approximately 50% or 60% of the people who come to us have come through the clinics directly. Accessibility in the first instance is, therefore, through dean clinics. They offer free assessment so they is pretty much available to anybody. However, there is no point in our seeing people at dean clinics for free assessment if there is no identifiable care pathway for them. That is where service level agreements become an issue. We have had some very successful service level agreements whereby we have done work for the HSE. We have helped clear child and adolescent waiting lists in some areas but, as an overall philosophy or strategy, the service level agreement is difficult to negotiate. Quite rightly, the HSE wants to build its own services, but that is the core reason we are here today: partnership and all of us playing a role is the way forward. The HSE on its own cannot build a world-class mental health service; neither can any of the independent providers. Therefore, we all need to work together to break that barrier. There is a need to try to get all of us around the table talking about how we would best do that.