Mr. Jim Doherty:

At the moment, particularly with regard to health, there is a huge policy shift taking place within the Government. As chair of the co-ordinators' network and, personally, as a co-ordinator, we feel we are very much going to be policy takers, at least in the short term, rather than policy makers. That speaks to some of the organisational deficits and interactional deficits we have with various Departments and senior officials in various Departments we mentioned earlier. As a key delivery agency that will very much be part of implementing some parts of Sláintecare, our voice is not necessarily being expressed loudly enough within the direction of how that will be implemented locally. That speaks again to the weighting conversation and the recognition that the complexity of the communities we deal with and the complexity of the problem are really an order of magnitude different from many other health services. I am aware that all the health services have their challenges. My wife works in St. James's Hospital so I am acutely aware of the challenges of standard health services. Because our area has that overarching reach into justice, education, family support and other issues that cannot easily be captured on a health metric, there is a complicating layer for us. That conversation feels lacking and feels more lacking now than it has felt for 20 years. It feels like that conversation is not sufficiently expressed and sufficiently heard. As people have said, we have a lot of experience of our communities and we know them very well. It is not a question of saying we are not going to do this but of saying here is how we could do this better. It is because we lack those organisational structures that we are not able to express that very well.