Mr. Bernard Gloster:

With regard to the waste agenda, it is important to recognise and put out there that there is a very strong clinical view and body of evidence that certain appliances are not worth recycling for infection control reasons and with regard to the benefit on return. There are certain things that can only be used by one person. The general point is on the principle.

Two factors are the ageing demographic because of the association of the use of appliances with frailty and the increasing number of physiotherapists and occupational therapists. Every time the number of occupational therapists or physiotherapists is increased, we increase the appliance budget because they are prescribing. That is what they do. They are the tools that people use. It is increasing and it is within this I take Deputy Cullinane's point on where probity and productivity needs to come in.