Mr. Tony O'Brien:

I will make an observation. Pretty much the entire health and social care delivery system started out in the voluntary sector. Many of the organisations that we now refer to as section 38 organisations, or even some of the facilities and services that are provided as a core part of the HSE's business, were originally established in the voluntary sector. Dr. Maev-Ann Wren's book, Unhealthy State: Anatomy of a Sick Society, charts some of this in an interesting way. Slowly by accretion, we have turned what were voluntary bodies into State bodies. A hospital like Our Lady of Lourdes in Drogheda was a section 38-provided entity. Now it is fully part of the HSE. An entity like the Mater Misericordiae University Hospital was once truly voluntary but is now a section 38. There are a plethora of other organisations.

Philosophically, there comes a time when - the process that the Minister has established will contribute to this - we must ask what is the right relationship between the things that the State does versus the things that the State might pay others to do. This is the Deputy's point.