Mr. Liam Woods:

Deputy Brassil asked specific questions about numbers of beds. The Deputy is correct in saying that some hospitals are running at capacity and do not, for example, as referred to by Deputy Harty, have significant delayed discharged. In the context of Galway, there is good access to community services, there are relatively few patients clinically appropriate for discharge who cannot be discharged and the hospital is in that sense running at high capacity. Galway is putting in a 75-bed block which will open in February next and that is replacing existing capacity. We are looking at proposals to see can we also then retain another 30 beds because we see a need in Galway for increased capacity. Those 30 beds would be available within the existing facility and would require some upgrade.

Deputy Brassil mentioned that Dr. Pat Nash had referred to the Merlin Park site as a potential location. In many ways, in Galway it has long been thought that Merlin Park - even parking on the campus in Galway would indicate that it is difficult and challenging - would be a suitable site for another hospital over time. It has not happened yet. Some services, as part of the group's overall service design, are moving to Merlin Park.

Mr. O'Brien addressed the independence issue. On the notion of an independent review, it is already determined to be so. HSE has data that would help inform that but the review itself would be independent.

The Deputy asked how groups could work effectively if there were no restructuring, if I understood the question. In a way, where we see it working well is that there is a strong view of what the appropriate clinical pathways are and that they are adhered to. There are some examples of that working well, for instance, in neurology. I am not sure if Dr. Colin Doherty from St. James's was here but we were at the Joint Committee on Health recently. There is a model working which is connecting GPs, patients and neurologists, freeing up space in St. James's, providing better care for patients, and linking effectively with GPs and speedily providing GPs with advice online. On the idea of enablement through technology to manage care transitions, there will always be transitions between care locations independent of the structure.

The management of those transitions, and the use of technology in that context, is really important.