Mr. Simon Nugent:

To address Deputy Kelleher's question on collaboration, there is a range of ways whereby private and public hospitals can work more closely together. The National Treatment Purchase Fund is a good example. Where there is excess demand in the public system for elective procedures, the NTPF works increasingly well in that patients are transferred to private hospitals to be treated there. In a range of other areas, if we join the systems up more closely, we can loosen up all of the resources that are available across the health system and make them work effectively together. For example, private hospitals from time to time also have issues of delayed discharge of patients who are not able to leave and free up the beds, just as in public hospitals. It would be advantageous if we could have a better arrangement with community health organisations in order to arrange the discharge of those patients so they could avail of services in the community. That is just one example.

Much of this boils down to arrangements at local level. The challenges facing hospitals in the public system vary from geography to geography, and the availability of private hospitals to respond varies from geography to geography also. To take places like Cork or Galway, a lot could be achieved if there was a policy of encouraging the private hospitals and the hospital groups to sit down and work out what they might effectively do together. There are quite a few things that could be done in that area. As I said, we have set up a working party with the Department of Health to work through some of these issues. It met in December and is due to meet again at the end of the month.