Mr. Barry O'Brien:

As a result of legislative requirements, the title of "clinical director" was already in use in the mental health system before the consultants' contract was finalised in 2008. Clinical directors had to meet specific requirements under mental health legislation. The title of "clinical director" was not in use outside the mental health service. As part of our negotiations on the 2008 contract, we sought to bring clinical leadership to the fore in the planning and delivery of all health services, particularly in acute hospitals. Some initiatives involving directorate and programmatic models, in which services are planned on a programmatic basis, had been pursued. As part of the negotiations on the 2008 consultants' contract, it was agreed that clinical directors would be put in place with a view to providing direct clinical leadership for the body of consultants. That was a significant change from the previous contract which identified each consultant as an independent contractor. This brought the management, governance and accountability of consultants into line. On that basis, a role was developed for clinical directors. This was included in Appendix 4 to the 2008 consultants' contract and became part of the agreement. We have introduced clinical directors across acute settings. The first positions were filled within a short period. They were introduced and the clinical directors appointed by way of nomination and agreement among the consultant body. That term is now up. We intend to open interviews to fill clinical director posts across our system.