Mr. Jim Breslin:

If one looks at the phases of this arrangement, I would see plan A as when the surge was imminent. I would see plan B as being when that surge did not materialise, and efforts by the HSE to ensure we got other priority work through those hospitals. Plan C is from last Friday and where we are going to enter into negotiations on a new arrangement. The Government told us that plan A should be public only. The rationale was that if we all had the virus were we going to have different access depending on whether we had private health insurance or not? A legitimate policy rationale was provided at that time, and that is the arrangement that was put in place.

When we moved from the surge into essential and more routine treatments, one of the issues that arose was continuity of care for private patients. We were still able to tell consultants that those patients can be treated, but as public patients. Consultants then asked what was the position with regard to those rooms that bear costs and that they have to fund. We put an arrangement in place with the HSE whereby if those rooms were needed for the purpose of continuity of care, it could enter an arrangement to pay for them and have the use of them. This was very much as we moved along from plan A to plan B.

Where we go next will be plan C, which will be different. It will have a stream of public funds going in, but it will also see the private health insurance money come into play with the protection that if we have a surge we are able to take over 100% capacity again.

These are all decisions that are being made in real time. I do not see it as an issue that one changes one's position as something changes in the environment one is dealing with. It was the right thing to do at every stage.