Mr. Stephen Mulvany:

The HSE is establishing costing programmes across the community because it is a significant and complex area in which, historically and internationally, visibility of the specific unit costs of a service and why there are differences between service A and service B has been difficult to achieve. On the hospital side, there is an activity-based funding programme. It is still in its early stages and is supported by considerably more information technology and software systems than we have on the community side. Generally speaking, there is a significant lack of information systems across the community sector. If we can secure investment, our electronic health record, EHR, programme will seek to address that over the next ten years.

In the meantime, we have been making improvements. Committee members will see mention in the Comptroller and Auditor General's report of clear performance indicators that we are trying to gather so that we can reference performance, including financial performance, in the community. Even abroad, it is traditionally more complex to determine why a service costs more or less in one area than in another. This is a large piece of work that is only now starting and will need to be supported through significant IT investment.