Róisín Shortall (Dublin North West, Social Democrats)
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Right. The other issue is that of restructuring. There is restructuring fatigue within the health service and the constant churn of the past 20 years or so has been disruptive. Each time that there is a change in Minister, there is a restructuring. As a committee, we must address the question of how our health services are structured and the administration of health. For example, our six hospital groups and nine community health groups are not aligned. Given that integration is critical in a well-functioning health service, it is difficult to know how we can operate and conduct an assessment or measurement of outcomes when these two parallel systems have not been integrated. The committee is grappling with the question of whether we should take on the issue of the current structure and recommend a restructure. Bearing in mind what Dr. Burke said about the constant churn, this fundamental question needs to be addressed. How do we get integration and how do we measure activity and outcomes when never the twain - hospitals and community services - shall meet? What are Dr. Burke's views on this?