Bernard Durkan (Kildare North, Fine Gael)
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There is a slight difference between what my colleague is saying and what I am saying, as the Chairman will have detected. As the guy said to someone looking for directions, "If I were going there, I would not start from here." By the same token, I am just a little worried about one of the points made by Deputy Donnelly. One member of the board could have a medical background but it could be tilted in the direction of one particular profession, which might not necessarily be of any great advantage to the board at all.

It could skew the authority of the board in a particular direction. I would be worried about that. It would not be truly representative, which would not be good. One might be as well off to have persons who do not have a particular bias.

My own strongly held view is that members of the board should represent those who are delivering the services on the ground directly. That would not necessarily enlarge the board to any great extent. I spoke about this during the Sláintecare hearings and on many occasions. Nobody agrees with me, the Chairman will be glad to know, and not for the first time. My view is based on long experience of listening to various boards associated with the health services over the years. We can never achieve a seamless delivery of health services unless we have such mixed representation from all of the staff - the nurses, the GPs, the consultants and pharmacists - who are involved in delivering the health services. It achieves the following aim. It creates an equilibrium within the deliverers of the service that one cannot get otherwise. Otherwise, one has a "them and us" situation where staff resent what they are being asked to do on the basis that those who are asking them do not have the necessary experience. It often happens that way.

I reiterate that my views are not the same as my colleague, Deputy Donnelly, but I hear what he is saying. If we were delivering a service to some executive, that would be a different story. We are not; we are delivering a service to the people. The people's practitioners on the ground need to have some access to that board, be represented on that board or have a representative on the ground from the board to keep the dialogue going in both directions. I have said it all before. I do not expect anybody to agree with me and I will not cry all the way home if nobody agrees with me.