Dr. Orla Healy:

I will deal with three points. One was on catchment, one was on governance arrangements and the third was on the academic health centre and the research and innovation environment.

Hospital groups were set up with a governance and management structure and did not prescribe catchments, nor have we have prescribed catchments for our area. We have looked at population bases and at where people go to hospital and people generally use their local hospital. As a group we are self-sufficient and provide over 95% of the care for our population. Waterford is a model 4 hospital providing tertiary level services across a range of specialties. There are particular specialties such as nephrology, which operates across the entire former south-east region, and orthopaedics, which also operates across the entire former south-east region and draws from outside the region, as does the national cancer control platform, NCCP. The population base has not been interfered with by the establishment of hospital groups. The county populations are calculated at more than 800,000 but the catchment extends beyond that. The methodology used by Herity involved looking at the actual cardiology activity in the hospital and where patients came from and he extrapolated from that, which is legitimate for him to do. The remainder of specialties are drawn from the wider south east.

The point about pharma and academic health centres is part of the wider issue about developing an academic health centre model and fostering an environment of research and innovation within the hospital group. We do not receive direct funding from the pharma industry but we are working with our partner in UCC to develop an academic health centre model and we are looking at the health innovation hub and the clerical research facility. This point came up at the time of the development of the reconfiguration roadmap for Cork and Kerry. We have a very important pharma industry in the region which is a major source of employment in the region. It was suggested the industry use Cork for research and development and it was noted that, for clinical trials and research at the next stage up, the industry goes outside the region, back to the United States or elsewhere where it has access to wider patient bodies and patient populations. A group would have to offer a wider population and patient base to further that agenda. We are working towards that with our academic partner but it is not something we would do ourselves It is a matter for UCC through the health innovation hub and the clinical research facility. The question was not specific to pharma and another example from the reconfiguration of the health innovation hub, which was its predecessor, was the development of an electronic GP to outpatients referral system, which we piloted in Cork and Kerry and was subsequently taken up and rolled out nationally.

Deputy Brassil asked about cross-group governance arrangements and cross-group specialty working. We do not have these but we do want them. We are working towards them and, as we mentioned in our submission, we had 40 specialty group meetings across the group with a view to supporting the smaller and stand-alone units.

That is why we are working towards a cross-group directorate structure as well. We have started with maternity services. We are about to appoint a clinical director for maternity services who will embed the cross-group collaboration and co-operation for the specialty.