Mr. Martin Varley:

Two elements are being commented on, first, the totality of the general expenditure on health and, second, the spend on acute hospitals with which we interface more and are more familiar. I understand the statistics we are talking about in terms of the general expenditure on health but if we consider the spend on acute hospitals, we have spent relatively less on two fronts. First, we have not invested adequately in capacity in terms of capital spend during the past decade or two. That obviously creates its own problem in terms of efficiency and effectiveness in delivering care. Second and very important, our assessment indicates that we are not spending as much as others in terms acute hospital spend on a per capitabasis. We have to segment out the expenditure. Whatever expenditure is taking place, we are not seeing a sufficient amount of it at the front line, where patient numbers have increased because of an increase in population and demographic factors. There is a need to segment and analyse it in more detail. We are quite convinced that we are not providing adequately for acute hospital care. As was mentioned, we have the lowest number of beds, we have the highest occupancy level, 97% or 98%, and we have a medium or relatively short length of stay. We have a large number of people, unfortunately on waiting lists and trolleys, all clear indicators of a lack of capacity and front-line capability to deliver care.