Mr. Phelim Quinn:

I will start with Deputy Brassil's question on commissioning and cover some of the other questions in that context. One of the questions was who the purchaser would be in that circumstances. Critically, within the Irish context and the proposals we have made, I see the introduction of a commissioning model as very much a longer-term strategy. We could not introduce a commissioning strategy all at once. There are a number of critical elements within that, one of which is around improving accountability. It is interesting that Deputy Louise O'Reilly raised the issue of loss of control in the provision of resources to a private provider. In my opening statement, I referred to the concept of current block funding. In that instance in the current circumstances, we actually do lose some control because the actual block funding itself is not specified to the specific needs of individuals in receipt of services. We see that as an example in the purchasing of services for people with disabilities in residential care. As to who the purchaser would be, I note that if we were to start somewhere within that longer-term strategy, local community health organisations might be purchasing care on behalf of individual service users. In that case, the actual community health organisation would be in the purchaser role based on individual needs assessment.