Kate O'Connell (Dublin Bay South, Fine Gael)
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I congratulate Deputy Shortall on her election as chairman and wish her the best of luck. We probably all need a bit of luck in terms of our endeavours in this area.

By way of background, I am a community pharmacist. I studied in the UK and my background is in the NHS where I specialised in primary care at undergraduate level. When I qualified, which is approximately 12 years ago, the NHS was in the process of restructuring. When looking to evidence-based solutions we could probably look to the NHS. While it is not a perfect model there are elements of it which we could, possibly, aspire to.

I come from an extended family of public and private medical practitioners. It is difficult when looking at the structural model of the HSE to get what is going on. I have tried in the past to overlap it with the hospital trust structure but I cannot do it. It would be useful to all of us if we could look first at what we have, where it is at and where possibly we might go with it. We cannot have all of these structures working in tandem or going off in different directions. It is important for us as a committee to see in diagram form what we have. I welcome Deputy Jim Daly's comments in regard to strategy in general. While I am not sure if any of us come from that type of background we could all benefit from that. There has been a lack of long-term vision in the health service. I agree that ten years is not that long, but it is a starting point. What has been done by successive Governments is something we need to move on from.

Data from the current structures of the HSE and the hospital trusts, should be mapped with the latest population data, showing disease burden, socioeconomic conditions and so on to enable us to determine why the sickest people in this country for some reason have the least access to health care. In focusing on that information we would not be focusing on any particular profession. I am always surprised when I hear the much used new phrase "the focus should be on the patient". Surely, the patient should always be the focus of any health system.

We are unique in this country in that because of our geographical land mass and population we could probably implement a system that no other country in the world could implement. I believe this committee has the opportunity to come up with a system that will work for the people of Ireland not only for the next ten years but into the future. My focus was preventive medicine in the primary care setting and that feeding into reducing the burden on the acute hospital structure. From the outset, we need to hear about strategy and what we have so that we are educated to some extent in regard to what we have as a country and what we can do with it. We are spending more per head of population on health services in this country than any other country and we need to question why that is the case. We also need to question why our outcomes are not necessarily ideal.

I look forward to working with all members. I hope we all have the common goal of progressing this issue. Let us get at it.