Jim Daly (Cork South West, Fine Gael) | Oireachtas source

The overarching issue of public versus private and the challenges presented in that regard are, as the Chairman knows, the subject of the de Buitléir report, which the Minister expects by, I think, year end, judging from my last conversation with the Minister on the matter. It is certainly imminent. It will address a number of issues on both sides. There will be positives and negatives to it. It would have been agreed or recognised by Sláintecare as well. There will be a financial implication. How does one adjust for this? First, one must not only project for it, but also try to balance that on the other side of the house. This is why we introduced value improvement processes, VIPs, last year. The Deputy was trying to get to the heart of our identification of that figure. One can try to meet somewhere along the way there, and that will address some of it, but not all of it. Increased funding is probably the main answer to the question of how will we address that shortfall of €635 million as a result, if that is what it comes to be. We will try to mitigate it. I was recently in UCD for an event related to Lean Six Sigma, which is a very impressive initiative taking place in healthcare in association with academia whereby they are trying to identify cost savings. This is an annual and ongoing challenge that we must embrace more and more, to try to do more with less, to lower the level of care. Sending people into accident and emergency departments for everything under the sun is not the answer. We need to try to change our processes and reduce costs by getting people treated at a lower level and so on.