Dr. Brian Turner:

It means access to pharmaceuticals. We are overspending on pharmaceuticals relative to other countries but at least we are ranked number one on that.

Many people pointed to the high rank of the Netherlands as evidence that managed competition, the system introduced there in 2006, was working. Interestingly, it was ranked either first or second in 2005, in other words, prior to the reforms, so it was getting something right. The Netherlands has had problems particularly in respect of affordability in recent years.

Someone mentioned that consultants can work only a certain number of hours per day. In conversations with some consultants, they point out that they have access to theatres for only a certain number of hours in the day. They could make more use of the theatre time if it were available to them.

The optimal consultant number per 1,000 head of population is hard to say. The figure of 2.7 doctors per 1,000 includes specialists and non-specialists. The Organisation for Economic Co-operation and Development, OECD, average is 3.3. It is hard to know exactly what is the optimal number. That is the OECD average but the health systems are designed in very different ways. Some would have a higher focus on primary care, some would rely more on secondary care. It is hard to put a figure on it but we are below the average in numbers of doctors per 1,000, and a lower than average proportion of those are specialists.

Deputy Buckley referred to the reallocation of funding.