Mr. Tim Daly:

I will begin with Senator Colm Burke's question about what it will take and how to drive it forward. Mr. Nightingale might address the staffing numbers and skill mix, while Mr. MacGinnis might address the fair deal scheme questions, after which we can address Deputies Stephen S. Donnelly's and Bernard J. Durkan's questions.

I will highlight four aspects that we believe are important if progress is to be made in the reform and provision of capacity, the first of which is securing and maintaining clinical leadership in order that there is ownership of the reforms by the clinical body.

The second aspect is how one supports hospital groups in operating effectively as a network, including legal regulatory elements to ensure there are incentives for people to work and deliver care in a more integrated way. In particular and linked with the Senator's question about some of the problems in having the children's hospital established, there is the question of how to win hearts and minds among the clinicians and the public for service reconfiguration. With specialist services in particular, there is a good case for specialising when necessary and localising where one can, but there is also a hearts and minds element because in these situations care is often moving to a different location.

The third aspect we wish to highlight is aligning the hospital groups with the CHOs in order that Ireland can start moving towards population health planning.

The final aspect is detailed control, management and planning of any provision of extra capacity. Unless one monitors the position closely, one can easily provide extra capacity without getting the reform that is supposed to go with it. Behind it comes a load of more detailed work that one would need to do, particularly on the workforce. Mr. Nightingale will discuss the units of workforce that we used. The detailed work can be more nuanced in terms of the skill mix that lies behind some of the job titles that we have used in our modelling.