Michael Harty (Clare, Independent) | Oireachtas source

I welcome the witnesses, particularly Ms Colette Cowan and Dr. Paul Burke, who, like me, are from the mid-west.

Most witnesses so far have alluded to the fact that if we are going to improve the health service, we will need a very strong, highly-resourced, efficient and effective primary care service, not only in general practice but also with all the other components involved. The difficulty I see is in the deficit in the integration of primary and secondary care. There are roadblocks in the patient flow from primary to secondary care, particularly in terms of casualty, bed capacity and recruitment. How does one bolster the communication between primary and secondary care? How does one integrate them to allow the patient flow freely through the system?

Deputy O’Connell referred to the Carlow-Kilkenny model. Representatives from that hospital appeared before the committee and it seems to be a very effective model. While it may not be transferable to every area, how would the witnesses see it transfer to other hospital groups?

On the transfer of services to model 2 hospitals, many outpatient services, day care services are concentrated in level 3 and level 4 hospitals. There is capacity in the level two hospitals to take on much work, particularly with outpatients, and to bring them closer to the patients who require treatment. What are the witnesses’ views on that?