Mr. Liam Woods:

I will begin with the questions relevant to the HSE. The Chairman raised questions about outpatient services and points about eligibility. It is correct to say the waiting times in many specialties to access outpatient consultations are too long. There is work ongoing in the acute division of the HSE to create new models of care to accelerate the rate of outpatient referral and do more work with GPs and other services in the community under revised models of care; that would provide more care in the community. We can consider individual specialties like urology and we know 35% of patients coming in need to see a urologist but the balance could be managed in some other way. We must move to those new ways of doing care. The Chairman's query about eligibility is more a legal policy question. The Chairman asked if it is feasible to see a consultant privately and come into a public list. When a patient arrives in hospital, he or she can choose whether to be public or private, and that is not a choice we make. The Chairman clearly understands that. That is not within the control of the HSE or the clinician. The Chairman was referring to a policy issue.

The Chairman also asked about a patient presenting as a public patient in the accident and emergency department but finding subsequently that a billing took place, with an insurance company paying the bill on the person's behalf. That should not happen without prior consent and the patient would, in effect, have to waive entitlements under the 1970 Act to be public. If that did or is happening, it is not appropriate. It is our role to ensure that is reviewed and does not happen.