David Cullinane (Waterford, Sinn Fein) | Oireachtas source

Regarding the regional health areas, I might ask Mr. Canavan and Ms Crehan-Roche to respond to my question. I am trying to understand how this could work at a local level. I can understand how at a regional level, you have a single management tier, which makes sense. You want to align your CHO services with acute hospitals. For me, it has to be more than an administrative alignment. It has to be clinical and be about patient pathways. I will give an example in my own constituency, which is the easiest one I can relate to. We have a CHO manager, a hospital manager and at least one building, if not more than one if you take mental health as well, which is located on the grounds of University Hospital Waterford. We have what is called a Dunmore wing, which is a unit housing a palliative care unit and acute beds, but we have different management layers making different decisions. It is the same across acute care, where hospital management can find it very frustrating to get step-down and recovery beds and home help packages. There are different management layers and different structures. Can the witnesses tell me how this will improve because that is crucial for me? Regarding what is happening in emergency departments and reducing waiting lists, sometimes the focus is too much on what is happening in the hospitals where we have to take two steps back and look at primary and community care as much. Could the witnesses give me some indication as to how that will work - not at a national level in terms of management but at a local level?