Mr. Derek Tierney:

We have 174 operational primary care centres. We deliver these primarily through three means. The first is traditional construction, where the State invests in design and build. We then have a PPP bundle. The final one, to which I think the Deputy is referring, is our operation-and-lease model. We try to maximise either the use of capital or current funding, depending on what is available. On the operation-and-lease model, we use a public procurement model to go out to the market to look for expressions of interest from those interested in partnering with the State to deliver. There is a qualification test around developers' financial stability, financial standing and ability to deliver because it is a 25-year lease. In fairness, the developers are taking on risk on upfront property acquisition, design and construction and the State is guaranteeing a 25-year rent roll.

In the last two to three years, we have seen the impact of an inflationary environment spin out in two ways. One is the financing cost for the private sector and the second is the cost of input. Because it is public procurement, we had to abide by that set of rules. Where we could negotiate, we have done so, but clearly some developers have entered into an agreement to deliver on. We have given them an extended opportunity to commit to that or we retender. In fairness, many of the developers are best placed to do well in that retender. We had about 18 to 20 stuck in that period and we worked our way to resolve those and we are through to the other end. I do not think we will move away from having that blended mix of delivery formats. It is good because it allows us to leverage market capacity and maximise our own funding within it too.