Mr. Kilian McGrane:

If one looks at that in the maternity context, one can see some of those impediments because with the hospital groups, there is not a clear direction as to how they are performing, so they are all doing their own thing within reason. When one looks at the maternity networks, getting delegated authority, even within the HSE construct, is extremely difficult. What does delegated authority mean when it is provided? We mentioned earlier on the issue about budgets. Does one separate budgets out on the basis of a clinical directorate model like maternity, or does one leave them embedded in the individual institutions? Moving from stand alone institutions into networks, whether they are clinical networks or governance networks, is problematic and the blueprint is not as clear for maternity. It is very clear that we have six and we are trying to work through that. We are encountering some difficulties as we move along but it is not insurmountable. When one looks at it on a broader scale, what is the infrastructure that will support the delivery of Sláintecare? Is the hospital groups and community health organisations, CHOs, aligned or not? Those questions are out there and in the absence of having clarity, people make their own decisions.