Mr. Leo Kearns:

The RHAs will have to address this situation. I refer to bringing things local. Ultimately, joined-up care only means something if it happens to individual patients. It must be done at the system level. At the end of the day, however, when people go to their GP, there must be a connection between that visit, the diagnostics, the hospital and the community and so on. This does not happen unless it is planned for it to happen. The only people who can plan for this particular thing to happen are the people who are doing it.

The RHAs in themselves do not solve it but create the means and approach that will. That is why we need to get on the path now. At the HSE centre, the staff just cannot spend time on what they should be spending time on, namely the strategic framework, the overall programmatic approach and accountability. They are sucked down. Everybody is operating two or three layers below where he or she should be, meaning we can be critical, but it is impossible for the staff. It has also had an impact on the Department in the past and, therefore, we have to be-----