Ms Angela Fitzgerald:

Yes, and the other thing is that in the Government's current plan there are 114 additional beds planned for the model 2 hospitals. We have recommended in the advice that we should look very closely at the best use of those beds. We have seen that step-down beds can support earlier discharge. Limerick, of necessity, was one of the early adopters of shortened length of stay. We can see that they have the shortest length of stay and that they move people on. If one looks at other countries, that is what they do. That was a necessity there but it is a good model.

The other point is that the Government has supported elective hubs. We know that Nenagh has very good minor injury and minor surgery capacity and that should also be leveraged. In terms of looking at option A, it is also about looking at the potential to further develop what is a good model. If we look at the UK and other countries, we see that they leverage smaller hospitals in a way that we do not do so well. It would be a mistake to lose that. I know it is early days and it is 96 beds, but the early signs are very good in terms of the impact of that investment to date.

A point made by one of the Deputies earlier and picked up on by Mr. Egan is that the other critical ingredient is management capability. It is important to recognise that in recent years, the capability and capacity of the region has been leveraged by strong internal processes.

Mr. Egan's reviews show that Limerick is using what it has very well. It is also adopting new interventions in line with best practice. The ingredients are about having the right capacity in the right place. It is about leveraging model 2 hospitals and leveraging egress capacity, such as delayed discharges. It is about using what you have very effectively. All of those things are critical.

Going back to giving acknowledgement to staff, the review shows that in recent years the staff in Limerick have been doing the best with what they can. It is about trying to protect that going forward.