Dr. Diarmuid O'Shea:

Senator Conway-Walsh commented on rural-proofing. Dr. Collins tells me he is going to throw a grenade and I have worked with him long enough to be able to hold the pin and go over and put it back in. I had not used the term "rural-proof" but one might consider what has been done with the frailty education programme, which is located in 26 sites around the country, one of which is in County Mayo, and the integrated care programme, which is also in County Mayo and is among the sites that has a local governance group established. The establishment of that local governance group, which is the first step in the ten-step framework, speaks to the value of clinical programmes that are clinically-led. We get a significant input from colleagues on the clinical advisory groups in the Royal College of Physicians of Ireland and from the inter-professionals. We will see the benefit in terms of delivering improved care around the country. If one takes stroke as an example, one will want the thrombectomy care done on a particular site but one will want to be back in one's own locality getting rehabilitation services in an appropriately-staffed rehabilitation unit. That is what the model of care is clearly showing.

The models of care, such as the integrated care framework and the local governance group and learning from the frailty education programme sites that are effectively integration ready when they are in place, will make a significant difference.

In response to the question on Versatis, to be fair, I think Professor McDonald gave a very good answer about the importance of cost effectiveness and it is probably not within our remit to give an answer to that.