Professor Steve Thomas:

I think the points about overcrowding are well made. It is often a critical sign of system dysfunction when there is such overcrowding in hospitals and such high numbers of people on trolleys in emergency departments, EDs, etc. All this speaks to the massive need for system reform and the move to integrated care, which will be backed up through regionalisation. The Deputy could well be right that the regions are not getting their voices heard adequately. Certainly, the emphasis on regionalisation has not been pursued as fast it could have been. I think that move towards regionalisation and integrated care will shift some of the pressures out of hospitals into primary and community care settings. That is something that needs to be focused on and pushed forward. Certainly, the different voices of regions will be important to feed into that whole process at every level.