Mr. Tony O?Brien:

We have not moved to that way of thinking because for probably 20 years in this country we have been talking about a fundamental shift to primary care, community-based care and changing what we do in the hospital systems. However we have never reached an opportunity to really develop our community and primary care services to the point where we can remodel our acute hospital system. It is clear that the funding we have and the way we are organised currently are inadequate to meet the health care needs of Irish society. This is evidenced by access issues such as the inability obtain services, time spent on waiting lists and time spent on trolleys. Demand for services is growing and even though our capacity is increasing, there is a continuing mismatch.