Mr. Leo Kearns:

I cannot comment on the details. What the Senator has described is where we are. It is the same patient who travels across the entire service so today he or she is at home, tomorrow he or she is with a GP, the day after he or she needs to get into an emergency department and later that patient needs to get home but we have set the service up in complete silos so there is no way that it can work.

Front-line staff work incredibly hard and make huge sacrifices but they are faced with an impossible task so the system must be changed. The RHAs must establish a joined-up approach and create a plan that addresses all of the issues but does not leave pockets that are disconnected. It is like trying to play a game of football and the manager is on the side of the pitch but somebody else is managing the two corner backs so they are playing a different game, which means the system cannot work. This is why we must be passionate about the RHAs because it can be quite a dry topic as it is about governance and so on. Fundamentally, the way we have set up the health service ensures that it cannot function because we have split the service into all of these different buckets and that is before we even mention the people who do not work for the HSE such as GPs and others. Earlier the Senator gave a perfect example for why we need RHAs and he outlined the problem that they must address.