Mr. Robert Watt:

What I tried to do was to set out, in the context of the debate about what we are getting for the taxpayers' significant investment in the health service, the increases for the acute side. I tried to account for the price increases, look at the real increase and then try to relate that to various measures.

We have various measures of day case, inpatient, outpatient and so on and then the emergency departments - the number of people we treat - but that does not take account of the quality or level of treatment or the severity of the patients who are coming in. One thing we are aware from colleagues is the frailty of people coming to the system is greater and their needs are more complex, so there are more needs and this was necessarily reflected in the basic matrix we produce on hospital activity. Not only did we have more complicated cases but the outcomes are better. I gave the example of cancer services. Even allowing for that, there is a challenge in terms of how we drive productivity.