Mr. Leo Kearns:

There are maybe three major areas. I will outline them broadly. One of the first things we have to do is be clear about and say what the roles of the HSE, the RHAs and the Department will be. We have to develop the organisational model for the RHAs in order to address some of the issues about being really clear about this which Deputy Cullinane brought up earlier. We have to appoint the leadership teams in the RHAs. If there are no leadership teams within the RHAs, they effectively do not exist, so let us do that really quickly. Now there is an entity that can start developing that.

We also need to design models as to how workforce, IT, finance, estates and so on will be dealt with in the context of the RHAs. Those are the practical things that will give clarity to people such that they will be able to see how this can begin to work. The overall clinical programmes are critical because, ultimately, these are services we are providing. How do we enhance the national clinical programmes we have at the moment and the integrated programmes and make them more effective and more connected to the front line?

Then we have to admit that this will not happen on a wing and a prayer. There has to be significant engagement with all the people I have mentioned. As I said, there are multiple organisations involved. There has been some engagement, but there needs to be a way in which all those organisations can contribute and design this new service.

Then we have to invest in the support for the implementation. One of the challenges we have is that the people leading on this are also dealing with all the crises we have. That is a difficulty. It is incredibly challenging for them and they need support.

It is just a matter of getting right some of the basics such as putting the right leadership in place, the right support for the implementation and, then, being really clear about what we are implementing.