Mr. Leo Kearns:

The fundamental difference is that while the health boards had autonomy, it led to considerable variability in the quality of care and outcomes. It depended on where people lived and their health board, and also on political issues. It is critical to have national standards. The HSE centre has a critical role in this regard. We have to say that we will not have multiple ways of delivering cancer care but a national model that deals with prevention and treatment and can decide certain facilities are just not fit for delivering certain types of care. While we are saying local ownership and joined-up care are critical, we believe one must work within national standards.

The other point is that there has to be strong accountability so that if an RHA is responsible and makes the decisions it needs to make, it has to be held to account for that.