Dr. Susan O'Reilly:

First of all, occasionally, our voluntaries purchase a certain service in a very small volume. For example, they were having difficulty getting urology surgery done and they have purchased some private insurance. We understand what they spend. It is a fairly small volume in the scope of their budget. We typically get the rest of private services through NTPF funding. We do not control it and it is not in our budget but we know how many patients go out. We have a general sense of what is spent, but what comes to us is more in the line of national data. There are some creative ideas, one of which we are considering with Tallaght hospital. Tallaght hospital is very keen to provide some endoscopy services through the public providers but by purchasing private space and private support for so doing. That is a different model we can do.

Intrinsically, to get stability in health care, we should not just ping-pong into purchasing through the National Treatment Purchase Fund, NTPF. We need to resource our base to do the work. It will take some time to get there. The NTPF outsourcing is a very good safety valve for certain care, particularly elective surgery, right now. It is not a great model for medicine. People often need to come back to base to have a liaison between their community GP and the hospital for long-term care.