Dr. Catherine Day:

I would like to explain what we meant. The HSE knows what it gets for the money it pays. Our point was that no advance consideration was given to the services needed by the population. It is forecast that the population will grow by 1 million in the next 20 or 30 years. Rather than start with how much money we have, how much we can spend and what we spent previously, we need to look at the population, including the increase in it, and try to come up with an idea of what those people need and what services the State should be obliged to provide for them. Without oversimplifying matters, some continental countries involve the voluntary sector with the equivalent of the HSE. Together they work out which services are needed in order to take care of vulnerable parts of society. They debate how many services will be funded from the public purse and how many will be provided through voluntary fundraising. In times of budgetary cutbacks perhaps the list of publicly funded services might have to shrink, but at least there is clarity on what services are needed, what services are to be funded and how they are to be funded. If we were to adopt such an approach here, it would give much more certainty to families, parents and service users. Mapping needs to take place regionally and across populations to link with-----