Mr. Robert Watt:

Absolutely. Does the Deputy have a copy of the paper? Deputy Cullinane does. The three options are keeping things as they are, establishing the model on an administrative basis, and establishing the model on a legislative basis. I shall go through the differences between the options. I will try to proceed quickly. Option 1 would effect no change in the current structure, with its nine CHOs and the hospital groups. That is obviously not where we want to get to with Sláintecare. Option 2 would involve what we call a HSE local model, with RHAs set up administratively within the HSE structure. There would be six RHAs geographically aligned, involving integrated subdivisions of the HSE that replace the nine CHOs and six hospital groups. The model would provide regional management authority and accountability and one population-based budget per region. Critically, the RHAs would not have separate boards, and they would not have legal status on their own. They would be set up administratively and the legal entity would continue to be the HSE, which would remain the employer. There would be a strong HSE centre regarding the reforms Mr. Reid has set out.

The third model, which we call the separation model, entails six legally separate RHAs with a contractual relationship with the HSE. We hope that it, too, would provide regional management authority and accountability and one population-based budget per region. However, each RHA would have its own board. Each RHA would be an employer, not the HSE. The structure of the HSE centre would be broadly the same.

The difference between the two options that require change is that one would involve establishment on an administrative basis while the other would involve establishment on a legal basis. Our preference would be to set up the system on an administrative basis. We would ascertain how that would work, set up the structures and deliver on the policy objectives. If legislative underpinning were required later, it could be achieved; however, to make progress on this within the timeframe, which would entail implementation and significant progress next year, we believe the administrative model is the best way to go. Again, we have an open mind on it. If legal powers were required, we might have to amend the existing legislation. However, we do not envisage a full RHA Bill at this stage. It could become necessary when we see how the model develops.