Mr. Damien McCallion:

Yes, and as one of the Deputies referred to earlier, the ultimate advantage of separating scheduled and unscheduled care is that when there is pressure on an emergency department in other hospitals, part of the protocol is to utilise those beds in what is called surge. That, unfortunately, impacts on day work.

As was said, in Tallaght they able to use that to go from 30% to 80% in 12 weeks and the balance is in more complex procedures, perhaps, that need to be undertaken on the hospital campus because of other needs, like access to ICU and so on, so there is clinical judgement. As I say, the greater the number of procedures, and we are seeing more changes where more and more procedures can be done on a day case basis, the more that demand will grow. They are still limited in scope, size and procedures. The elective hospitals have a much bigger footprint in the range of procedures and specialties they will be able to undertake and the access to other services that are there. Essentially, the Tallaght facility is very effective. It has reached 80% of the day case work within 12 weeks nearly, which is in line with the Sláintecare targets. That is a huge jump from 30% previously and we would see that volume coming through.

The other benefit some of those procedures is that there are a small number of outpatient rooms there, so there is also a benefit in each of the centres that, as well as day case, it allows the clinicians to do some additional outpatient work in those areas that will assist where capacity is an issue for the relevant specialties operating out of it. There are significant advantages to it both in improving day case access and additional OPD and in making more effective use of consultants and their teams. It is not just the consultants but also the nursing and the other teams that are there. Having walked the floor in Tallaght, it is a very successful model and there is potential to develop it out further if the demand increases in terms of increasing hours and so on, because the whole flow is designed around people moving quickly versus, perhaps, going into a hospital with the existing infrastructure and an assessment room in one block, going to another block for other work and so on. There are a range of advantages, the separation being one, but the flow is also critical in undertaking the volume.