Mr. Éamonn Donnelly:

There are many observations in that. First, about managers, I want to be clear that managers form less than 1.5% of the entire health workforce. The percentage is low by comparison with international comparators. I was talking about the poor individual soul who is charged with the entire responsibility of running a hospital such as Portlaoise who, as soon as there is a logjam, should be held to account, and that would will never work.

Deputy Durkan is absolutely right. Bed capacity was always an issue. I do not know how it was decided that bed capacity should be reduced. The question is who is in the beds. I have personal experience of my own mother being in one for four months - when, quite clearly, what she needed was a step-down facility with a hoist to deal with her incapacity to get herself up in the morning - in a big hospital in Drogheda where there were trolleys all over the place. Definitely bed capacity is one issue.

The number of people who land in accident and emergency is a problem. I would say it is at best probably more than it should be. I refer to the lack of primary care interventions and the referral system as well. I do not know, if one is ever to get Sláintecare off the ground, whether we will ever tackle the general practitioner, GP, model but the entire referral system creates logjams in the hospital system because we have grown up over 90 years with a hospital-centric healthcare system and everything lands there. Until we get away from that, one will have this. One can increase the number of beds. If one increases the number of beds by 3,000 one will have probably 1,500 fewer trolleys but one will not solve the problem.