Dr. Seán Healy:

We have argued strongly that the cornerstone of the health system should be primary care and community care. That is where the investment should go over time in order to try to ensure we can keep as much work being done as close to people as possible rather than having them head off to accident and emergency units as the access route into services. The health budget needs serious re-doing and it will take a number of years to do it. It needs to be more integrated than it is. It was close enough to that a number of years ago. There was a time when primary care, community care and the hospitals were together in different areas in the different regions. This was under the HSE. However, then a Government decided that hospitals would be split away. From that moment on, there was a problem, which is recognised in the budget and the Minister's statement, as the Government is looking now to set up another body to examine how to integrate the hospitals back into the health system. A number of years have been lost because the original break of the two of those should not have happened. However, that is the past. In the future there is a need for integration of the whole system and primary care and community care need to be the cornerstone. We would have primary care centres and health groupings at local level. These would be the starting point rather than hospitals and acute services. There is value in such an approach. For instance, were we to do better on home care packages and so on, that costs far less and older people want to live at home rather than be in hospitals or nursing homes.