Dr. Diarmuid O'Shea:

The questions have been informative and instructive for us but having listened to us for the past two hours, that question on its own could take an entire committee session and more. To be brief but not glib, there is a co-dependency. When I talk about age attuning and being age accommodating and age friendly, there is a need for the private healthcare sector to recognise that it is encountering a larger and increasing cohort of frail older people and its staff needs to be upskilled and geared to deal with that. Generally, from a societal point of view and from a financing point of view, we need to understand that there is co-dependency. If the private sector no longer lowers costs or drives an expectation that people will not sign for private healthcare cover when they are in a public hospital, that will result a huge amount coming out of the public purse. This is probably a question for another meeting but we need to recognise the co-dependency and understand how to work better. This goes back to the benefits of the clinical programmes, clinical advisory groups, working advisory groups and the HSE breaking down the silos and barriers that exist.

One of the great experiences that I have had recently is looking at the provision of education for interdisciplinary staff in nursing homes. When everybody is in the same room, one can experience the informed discussion and the learning from each other that goes on. That is as much about networking and breaking down barriers and we need to do more of that.

I refer to the discussion between Deputy O'Reilly and Dr. Collins and the deadline in June. I have been working as clinical lead since the clinical programme started and something I have learned is that things have to be progressed slowly in certain circumstances. I regard launch dates and other dates for documents as iterative. The fact is that we will be in discussions on that and will influence initially a document; it will not just happen on the basis of one launch in June. It will be an ongoing, iterative process. Once we are sitting in the same room, we are making progress.