Professor Orla Hardiman:

It depends on what part of the country we are talking about. In Dublin, we get a reasonable field of people with maybe five to seven people applying to the Dublin hospitals and it is a similar situation for Cork. If we move outside of those areas, the numbers of people who apply for posts in the hubs for neurology that are under development is much lower than that.

The length of time between a funding stream becoming available, approval by the consultant applications advisory committee approval and an advertised appointment depends on the structure of the hospital. As the committee knows, different hospitals have different governing structures. The signing off process varies across hospitals and there are some regional tensions that we should probably mention. Some centres may feel that they are being undermined or disenfranchised and, in some instances, they may attempt to slow down the appointments. We have certainly seen that in parts of the country.

To answer the question, it really depends on where we are talking about. In local geographic areas there are local politics as well. However, that should not stop our mission to ensure we provide the best care as close to the community as possible, and that involves building up ten regional hubs for neurology, resourcing them properly, ensuring they operate within a geographic region within which everybody can access high-quality care at minimum discomfort to them. We are not quite there yet and there is quite a bit of work to do.