Mr. Leo Kearns:

What the Deputy has described is exactly how it should be. In fairness to the HSE centre that is getting multiple business cases, how is it to know what should be prioritised? We have created this scenario whereby everything funnels up to the top. Not only does it disempower the local but it swamps the top, which means people cannot focus on the things they need to. The people who are closest to the service should be prioritising and asking where should they best use their resources. It is difficult to know until we get into that, but our demand and capacity, particularly around acute and emergency services, have been so out of kilter that it will take time to understand those flows and get them properly set up. I could not agree more with what the Deputy said.

Multi-annual budgets would clearly be very beneficial. In a system as complex as healthcare, to operate on the basis of an annual budget is very challenging. I know that is challenging from a governmental perspective but it is something that has to be-----