Mr. Kilian McGrane:

The cancer control programme did not have a mastership type model or equivalent but protected invested resources. It had cancer networks and protected at network level both the existing resource and all new development money. The latter was held by the cancer control programme and then allocated to resources.

The model that we seek to establish at group level is equivalent to a clinical directorate in a hospital. Most hospitals have clinical directorate models. Ms Fitzgerald, from her days working in St. James's Hospital, and myself from my days working in St. Vincent's Hospital, have experienced how the model operates. One has a dedicated individual who is the clinical director and he or she is accountable for everything that happens within that service. He or she is supported exactly as has been said usually in a hospital context by an assistant director of nursing and a business manager. We are replicating this process at group level. One will have a named clinician who becomes the clinical director or clinical lead; I am not sure if we have clear titles yet. One would also have a director of midwifery, somebody at administrative level who can provide business intelligence and support and, also, a quality and patient safety person because that is central to how this model works. All of that will ensure there is clear governance and accountability. It does not mean that there will not be robust discussions on whether obstetrics and gynaecology get investment over general surgery, cancer services or anything else. Robust discussion will still happen but the voice of the obstetrics and gynaecology will be clearly heard, well identified and supported at national level by the programme office and, indeed, by the political commitment that has been given in the Department and by the Minister. We see this model as taking something that works well in the acute hospital sector at the moment. I appreciate that the strategy goes much beyond the acute hospital. This model will allow us to put a governance structure in place at group level that supports the direction of travel for the acute hospitals system.