Professor Brian Lenehan:

It is down to a lack of alternatives. Other hospital groups have model 3 hospitals and some have model 4 hospitals. They also have private healthcare facilities that have accident and emergency units open. We have an ED and three local injuries units that treat 33,000 patients each year. One in three patients who seek unscheduled care in our hospitals group attend one of our local injuries units. One in four patients, or 100,000 patients out of our total patient population of 400,000, attend either our local injuries units or EDs. It is a volume effect. We are looking at alternatives and what further care primary care, the fledgling private sector, community health networks, pharmacies and out-of-hours GP services deliver. It is a combined effect and all of these factors combined are what deal with the burden. We have one large ED department, which was opened in 2017, and that is where the sickest patients are seen.