Seán Crowe (Dublin South West, Sinn Fein) | Oireachtas source

Many of us remember the old health boards. People ask if RHAs will mean the same again. We discussed the importance in establishing RHAs of accountability so that it is not Paul Reid, Mr. Gloster or whoever who comes in and defends the situation by saying the system has collapsed in Sligo, Galway, Limerick or wherever else, but the CEOs of the regional authorities. Do the witnesses agree that is the only way the decentralised structure will work?

The implementation board was replaced by a centralised structure. Where is the pushback coming from? It is difficult for us. We are having meetings. Regional authority, we are told, is happening and is full steam ahead; but you talk to people in the service then and it is not happening. Why is the system reluctant? We are in agreement politically across the spectrum that this is the way forward and the health service is supposed to agree. Is the pushback that people do not want to release that power? Is it that they feel the current structure, bad as it is, will deliver and that if we give people power, some areas will not deliver? We accept some regions will be better than others.

I agree with what has been said on innovation. Regarding pathfinder, what is the delay? It has been established in Beaumont Hospital and rolled out in many areas but not across the State. We raised this with the ambulance service. It does not make sense. Everyone believes this will work. Where is the pushback? Is it this thing called the dead hand, where you cannot get movement on it? It would be useful to get insight on that for the committee's next meeting we have with-----