Ms Yvonne O'Neill:

To respond to Senator Flynn, regarding accountability, I am the national director for community operations and I am before the committee with accountability on behalf of the HSE. We are accountable for the delivery of health and social care services to people, including people with a disability. That accountability is part of my presence and that of my colleague today and how we report on the service we provide within the funding available to us and within the legislative and policy contexts, of which there are many. Mr. Walshe articulated the point as to how we reconfigure services when there are multiple policies and legislation which require us, on a statutory basis, to fulfil some duties and in policy, to aim for objectives which are policy objectives. We are always balancing all of those requirements within an overall framework of accountability for services. Personally and professionally, in my role, I hold accountability. That accountability is devolved into a delivery system.  My colleague represents one CHO structure. Multiplied by nine, Ms Hanley also holds that delegated accountability.

I hear the point strongly this morning and as a health and social care system, we are trying to move to patient and service user-designed services. That is part of our policy, that is, nothing for you without you. For any of the constructs I have been involved in establishing or that I have seen currently in the HSE, when designing services, we have service user and patient involvement, as there will be in the working group on PA services.

Second, we are trying to move to an outcomes focus, rather than counting the number of hours. I was going to respond to the question by saying what is different from last year. I could say there are 450,000 more hours than there were last year and 250 more people receiving the service-----