Mr. Jim Breslin:

In my view, two things were going on. First, it was not getting significant management focus. Second, the hospital inpatient inquiry looks at inpatient activity and not the full range of activity, but it is a good starting point. It does not answer every question but it is enough for a manager or clinical director to sit down with a consultant to discuss, say, that the hospital inpatient inquiry shows that there are 30% to 35% private patient admissions as part of their practice. They can then go through that with the consultant to see whether that is wrong. The consultant might be able to come up with satisfactory reasons, including accuracy. After the chapter, we now have the situation where the HSE is required through the management system to put in place a monitoring framework and to follow up on breaches. Deputy Connolly is right that there are policy questions involved in private practice in public hospitals. For as long as it exists, it needs to be managed and monitored.