Mr. Tony Canavan:

It is fair to say that Ms Crehan-Roche and I have been working very closely on this for more than two years since both of us took up our posts because of the importance of integrating the services between the community and hospitals. We have been trying to create the environment through which a enhanced community care programme can be rolled out successfully. From a governance perspective, the key way we do it is, as Ms. Crehan-Roche pointed out, through the joint enhanced community care oversight group, which is jointly chaired by Ms. Crehan-Roche and me. It has everybody you could imagine from the point of view of delivering services within and outside the hospital meeting in a forum. It is quite a large and unwieldy forum but it is a great way for people to get to know each other and understand how their individual services work and how they can work together. Ms Crehan-Roche has already given examples of how that is rolled out in real life. We have other examples. For example, we have good joint working arrangements in radiology. Radiology is really important for a GP in determining whether a patient needs some further investigation or admission to hospital or otherwise. If that can be ruled out, again, it avoids an unnecessary admission to hospital. General X-Ray is available in the primary care centre in Castlebar. It is a regular primary care centre with public health nurses and all the other staff you would expect to see in a primary care centre, along with GPs, but we also have a radiology facility there that allows for direct referral from GPs. Patients are seen, have their images taken and a clinical decision can then be taken as to whether they need to be admitted to hospital or whether some other approach needs to be taken. We are looking to roll that out in a number of other locations. It is a key resource within the community. If we can provide that kind of diagnostic capacity before the patient goes into hospital, it removes another reason for a patient to be sent to the emergency department.