Ms Averil Power:

From a patient point of view, it helped at the start. In particular, we saw a lot of things like chemotherapy moving to private hospitals, which meant that we were able to provide safe Covid-free pathways for patients at the start of the pandemic. It also helped to get some of the other lists down in areas like surgery and clear backlogs. I will not comment on the commercial arrangements for that but I definitely think the more capacity there is for the system the better. If there are ways of making good value-for-money arrangements with private hospitals and being able to have access to that capacity for public patients, that is a good thing, although Dr. Colleran's point about the advantages of insourcing is very well made. Insourcing is obviously far better where that is possible. It is much better to build capacity in our public hospitals.

That was just one thing. Positive things have happened during Covid as well with the use of the private hospitals being one of them. Other innovations that have benefited patients include things like chemotherapy in the community. The Mater Hospital has a really good project delivering chemotherapy in Glasnevin. There have been other innovations. Where they have had that local autonomy that was mentioned earlier, our healthcare staff have really stepped up. People have stepped up and found creative and good ways of delivering services. Another thing that has worked well is giving more responsibility to nurses. We have fantastic nurses in this country who are such an untapped resource, particularly compared with their colleagues overseas. The advanced nurse practitioner posts were mentioned earlier. We really need to invest in upskilling our nurses and giving them more responsibility and a key role to play because they are a key contact for patients and can really help to address some of the capacity issues relating to staffing in hospitals.