Mr. Robert Watt:

Our service delivers a huge amount every day for citizens. We are reforming in the context of ongoing delivery. We cannot stop the health system for six months and reform the structures.

In relation to reform generally, Mr. Mulvany and I are jointly responsible for the implementation of Sláintecare. We have set up the structure where management of the main blocks is devolved to senior leaders both in the Department of Health and the HSE. We have met six times this year. The teams below the senior leadership meet every fortnight. For example, Mr. Tierney and his colleagues in the HSE deal with electives and the elective hospitals in Galway and Cork are with the Government this morning. That is a very significant change and it is just one example. Sláintecare involves a variety of things, as the Deputy will know better than I do given that she was involved in writing it. It involves separating scheduled care through the electives; a massive increase in public sector capacity, as we have seen in recent years; integrated care in the ECC programme; affordability measures, which we discussed earlier; and ending private treatment in public hospitals. There are reports in the newspapers this morning about the consultant contract which the Minister is bringing to Government. We have made significant progress since the discussion about who is responsible for Sláintecare and the new procedure. Objectively, I think we can say we have delivered.

In relation to RHAs, this is about a structure that devolves. It is about handing responsibility, autonomy and, ultimately, accountability to the most appropriate place within the system. To follow on from Deputy Cullinane's comment, it is about the meat and the substance. Anyone can say they are in favour of devolution but one has to see exactly what that means in concrete terms. Looking at recruitment, for example, there is a budget set aside for each area. Within that, there will be a staff complement and each area will have resources to further increase staff. It is then up to the authorities to decide what they will recruit, the types of-----.