Professor David Keegan:

There are existing pathways and co-operation between services. Specialist care is delivered in some units, such as ocular oncology in the Royal Victoria Eye and Ear Hospital. Detachment, rare eye disease and inherited retinal degeneration care services are in the Mater, for example.

There are those existing referral pathways, but we are talking about integrated care where things would happen more automatically.

I am glad the Deputy raised the example of Cork and the South Infirmary Victoria University Hospital and the move to Ballincollig, because it is an area I look at with great interest. The Irish College of Ophthalmologists ran a specialist symposium on integrating care and on the learnings from what is happening in CHO 6, CHO 7 and CHO 2 and in CHO 9, CHO 8 and CHO 1 with ourselves. We had four presentations, so there is shared learning. Mr. Eamon O'Connell, who is the lead in South Infirmary Victoria University Hospital, came to me after that to discuss it because the roadblock they run into is IT finance, service level agreements and how to get that working. If one needs equipment in Ballincollig but the funding sits in South Infirmary Victoria University Hospital, how does one convince the finance officer in that hospital or the south-west group to free up €80,000 to buy a key piece of equipment? That is the level we are delving into and we believe we need to create that transparent governance structure.

I acknowledge Deputy Shortall's comments about future-proofing that. It is our expectation, wish and hope that it slides across into the regional health authority model as well and that we will have demonstrated form. Then it is demonstrable across the country.