Ms Cliona Loughnane:

Partly, it is to do with budgets. If one looks at the budget that goes to primary care as opposed to the budget that goes to acute hospitals, one sees that we are completely prioritising the latter field. As Dr. O'Brien was saying, there are knock-on effects on all these different areas. When one has very high waiting lists, it is understandable that a lot of budget goes to the acute sector. However, while we have talked about the development of primary care, the budget has not really shifted in that direction as yet. As we have discussed, there are serious staffing issues at primary care level. The other thing, as Dr. O'Brien pointed out, is that in certain areas it is not clear who is entitled to or eligible for these services. We have spoken a great deal about moving care out into the community, but we have not achieved it. Budget and staffing have a lot to do with it.