Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I know Deputy Durkan is a traditionalist in regard to looking back at these figures. I mean that in a positive sense. While this is the way the document is laid out, as I said at the start, it is sometimes not terribly reflective of the way the programmes are delivered and that is the bridge we need to try and cross. I expect all four regions, without fear or favour, to come in on budget and to fulfil their commitments in the performance and accountability framework. That commitment is not just to come in on budget, it is the three other metrics that I spoke about last week, which do not often get talked about as much. These are access to services, quality of services and how they are harnessed.

We now have the hospital group structures and we have our community healthcare organisations, CHOs. While I defer to the Committee on the Future of Health Care as I want to see a cross-party view on this, my personal view is that the CHOs and the hospital groups should be integrated in a more seamless manner. We talk about home care packages and delayed discharges. It does not make sense if one section of the health service is responsible for hospital beds, but to free up a bed they need somebody to be provided with a home care package and that is the responsibility of a different organisation within the HSE. They need to be realigned. Hopefully some of that work can be done in 2017 once the Committee on the Future of Health Care reports in April.

The Deputy is correct to say that different regions have different pressures. If one looks at the country's demographic profile, some of our hospital groups and CHOs have a higher proportion of older people. There are areas that have a higher level of social deprivation and therefore generally a higher level of health need. The HSE's job is to try and reflect that in the submissions that it receives from the hospital groups and from the community health organisations. I expect that they will do that through their operational plans.