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

On the HSE management issue, I do not state that it is the ideal system or the one I want to see. I am merely contributing another angle in the interests of the debate. Of course, I have no difficulty with people holding the HSE to account and questioning it, but we must be aware of the other sides of the issue. I want the accountability and transparency to continue. The HSE should not be given a blank cheque to employ as many managers as it wishes. I agree with many of the points made by Deputy Durkan but I must put the issue in context and broaden the debate somewhat.

It is not in the interests of winning or losing, or scoring points, or politics, or having to be defensive as a Minister of State. I have no issue with taking challenges head on.

Deputy Durkan talks about the style of management within the HSE and if one considers how the private hospitals are run, some of them are run without the layers of management. I think the Chair wants to make the same point. There is no question that the private hospitals do not have the levels of management that are present in the public hospitals. The efficiency of the private hospitals is probably much more impressive, in many cases, than in the public hospitals. The private hospitals do not face the kind of issues that public hospitals face. They probably do not have the same level of union issues. They do not have issues of public accountability and do not have to come before the Department, or other organisations, or prepare parliamentary questions. They do not have to deal with freedom of information requests and media queries to the same extent that the public hospitals do. There is an element of that. I am just saying that by way of contribution to the debate rather than defending what is happening.

Many people in the Chamber would be vehemently opposed to any further privatisation of health services and their ideological position would be that that is not the way to go. There is a debate all around as to whether public or private is better.

The Deputy asked about the purchasing power the National Treatment Purchase Fund, NTPF, has been given and its increasing power to purchase. As we are aware, much of that is within the system itself. It is identifying where there is capacity and moving funds around a bit.

What was Deputy Durkan's last point?