Dr. Peadar Gilligan:

It can be a major issue. One may develop an understanding and relationship with a management colleague but that person could move from the hospital or out of the health care system. An area that has suffered within the hospital system is not at the middle or higher management level but rather the administrative staffing level. For example, there is something as simple as the typing of letters, which can be much delayed in many hospitals because there is not the administrative support to the clinical team. The result is the GP would not be aware of what has happened in the hospital because the letter would not be received. It is just one area where the stripping away of staff in the context of cuts in the acute hospital system has had a very significant impact in clinical care provision and communication around that provision. Does this create inefficiencies? The short answer is that it does. Having a working relationship with somebody in order to move things forward is the way we would all like to work but it is not always the case.