Mr. John Connaghan:

To give a direct answer to a very direct question as to whether the activity was expected, in terms of emergency department, ED, attendances over the period, I am talking about those who were over 75 years old because when we look at the cost we tend to think there is more cost associated with the elderly than with those who are perhaps in their 30s. Over the time period, ED attendances of people aged 75 years and older were up 6.7% and ED admissions over that period were up by 6.4% for the over 75s. ED attendances across the whole population were up 4.8% so there is considerable pressure that I do not think was anticipated at the start of the year. The other factor, which is important in relation to those who are over 75, is that it is quite clear - and this is very welcome - that with the population living longer, there are more patients presenting with more complex needs inside our hospital system. There are some marvellous studies available about the level of comorbidity or multiple chronic conditions currently in the population. I think I said in my opening statement that this is a factor, so the complexity of care is also increasing.