Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

It surprised me HIQA assumed that was the best model without necessarily providing any evidence to that effect. Experience, for example, in the UK, would indicate that a commissioning model is extremely costly and convoluted and adds another layer where one is into the area of expensive consultancies with all that involves.

I want to note that there is no evidence to support that approach over and above any other accountability system.