Mr. Bernard Gloster:

I could not agree with the Deputy more. I just want to be clear so there is not any sense of unfairness, perceived or otherwise. These hospitals do and have done good work. There is no disputing that. There is some clinical excellence in these services of the very highest standard. I have two views, though, that I am happy to share after 38 years in this work now. First, I think Ireland has too many health governance systems for the size of the country. I think there are too many entities as opposed to a single system. Second, for whatever entities we choose to have that are not the HSE, that are charitable status, NGOs or whatever we want to call them, I believe the relationship between the State and those organisations is fundamentally misplaced and misunderstood in terms of what independence and autonomy mean. If the State is 100% funding your costs, then it is entitled to mandate the system and the controls and checks and balances of the discharge of that expenditure. It is as simple as that.