Mr. Phelim Quinn:

In respect of the first point the chairperson raised on the issue in relation to commissioning, I would want to apologise. We have not made an assumption on the committee's commitment to a commissioning model. It is a concept that we are trying to promote to the committee as a potential concept within the development of a ten-year strategy. The chairperson was asking about the potential benefits of that. Our assumptions, from a HIQA perspective, are very much based on our experience of working within some of the services and from the outcome of some of our work, particularly in the area of accountability for the provision of services. In the course of the past number of years, we conducted a number of reviews and investigations within the Irish health care system and at points in time we have been frustrated within those finding around accountability for the provision of safe and effective services. What we have seen, as aligned to some of the comments that Ms Dunnion made here, for example, on matters such as physical infrastructure, is that a commissioning model, in terms of projecting both strategic need and infrastructural need, is contained within some of the observations that we have made as part of that review and investigation model. Our experience in working with the HSE in communicating about services that it currently procures from the voluntary and private sectors also highlights to us the absence of a responsibility for what is being purchased. Our ideas on commissioning emanate from that experience.