Mr. Liam Woods:

Deputy Kate O'Connell has correctly identified that portable solutions are not a strategic response to the medium-term needs of the population for health service provision. There are two types of solutions for which we have tendered that would allow hospitals and hospital groups to move more quickly than potentially bricks and mortar-type solutions. One is a solution where a third party provider may arrive on site, bring a facility and operate that within the public environment. The other is where a facility is provided and the staff come from within the current health sector employment or through some growth in that. The intention is simply to provide a short-term flexible option while the longer-term discussions around capacity are under way. It is not intended to replace or in any way supplant that and, indeed, it would not have that capacity. However, there are a small number of interesting proposals that hospitals have looked at that would give them protected scheduled care and, in particularl, protected day care space. There is such a proposal for Merlin Park in Galway. We want to try to create some central support for that kind of initiative. The intention of the framework agreement was to leave the groups in a place where they could flexibly consider that as part of response to both waiting list and demand.

There is a strong place for mathematics in health, as the Deputy rightly implies. We have population health doctors and epidemiologists whose job it is to study the nature of demand and the changing nature of demand. We have commissioned and received reports on trends in emergency work, in elective work and, indeed, the source of admissions, that is, the percentage of people that may come through a GP or by direct walk-in. Around 47% of people nationally go through a GP first, but there is a lot of variation. In Dublin, only 24% of people go to a GP first, whereas in Letterkenny maybe 54% would go to a GP and in Cork, it is 47 %. The variation is primarily driven by proximity to service, which is well understood. The age cohort and triage categories of people presenting are also well understood.