Dr. Rónán Collins:

The Chairman might be a fly fisherman. He has landed a fly in front of me knowing I might potentially snap at it. It is a difficult area and aspects of it need to be teased out. I will give a vignette to describe what happens. Last week, we experienced a severe weather event and people whose operations had been done in the private sector turned up at our hospital with post-operative issues. They turn up because we are open 24-7 and we deal with all-comers and cases of every complexity. I object to them being told by their insurance companies not to sign in a public hospital. I acknowledge in my area of medicine the fee from insurance companies is small but substantial money accrues to the public, not-for-profit, common good system from these fees. This needs regulation. As Dr. O'Shea alluded to, there is a co-dependency but we want to make sure that, however the model evolves, the public system can stay abreast of technology and that we have sufficient resources to buy the latest PET scanner, for example, in order that everybody can avail of it, otherwise, the public system will be driven into the ground like the veterans health administration system in the US, which became under-resourced and demoralised and nobody would work in it. We want to avoid that. Our public system is vibrant and we want to attract, in an appropriate way, investment and business that is regulated. However, there is a co-dependency and both sectors should not be mutually exclusive in delivering a proper health service.