Professor Frank Casey:

This is a really important issue. When units or specialties start to collaborate, for a paediatric cardiology service the surgical aspect of the service is key to it. Parents want to be confident that when they attend, say, the unit in Belfast or somewhere else, the people there retain the skills over time and that they will not get a lower standard of care. We work very hard within both units to make sure that we have specific areas of expertise. A really important thing in the future is to be able to attract young and dynamic staff to work within both jurisdictions. We are very sensitive about that in all our discussions, and it is relevant across all specialties, not just ours. For instance, I was talking to someone from Cavan yesterday and looking at collaboration across there. Although they can see all of the benefits of that, their fear also would be that a service will be sucked from their hospital. It has to be truly a network solution where each person and each unit feels that they are an integral part of that and that they are an important cog in the wheel and it is not just someone taking their patients from them.

It makes absolute sense that we do this, but some of the reluctance that Senator Murphy talked about, of things not happening, is a fear among some people of perhaps opening up to a different option from what they are used to. As I said in my presentation, I think it needs a change in thinking and that is slowly coming about. Traditionally, people have thought within their own jurisdiction about delivering health care in an isolated sense. We are moving away from that gradually. I hope the examples that we have can foster the belief in others that it will do this. There are still many steps to be taken.