Professor David Keegan:

Because this was the region covered. We had a problem at the Mater in the context of the greater north-east region. We had relationships and communication. We demonstrated effectiveness through the initiatives that we just outlined in the region. Historically, the patients from that region were referred to the Mater, which was the last point of call on the clinical pathway, depending on whether they needed surgery or expert care. We sought to do that region. We said that if we tackled a quarter of the country first and demonstrated the pathways, we would then have a model that could be demonstrated to other parts of the country or other specialties beyond that. This is quite novel. The VACO model, which arises out of the EVSA, is new to me. I totally agree. When we look at this, the question is why we did not do integrated care previously. We have done it partly historically, but to deliver the sort of change that we need in order to see the patients we have on our waiting lists now, and particularly looking at the demographic boom that is coming down the tracks, we needed to do something different. It was really ramping up the integration, which was there at some level, but we wanted to have a standard practice that is systematic, co-ordinated and governed by agreement.