Mr. Ciarán Devane:

The strategy is clear. It says what it says and I do not want to question that on day three. Starting from the premise that the HSE is a public service, we should ask what conditions we need to ensure our mission is delivered as well as possible and what can support or get in the way of that. How we interact with private providers of equipment, pharmaceuticals or clinical services is a key part of that. From experience, the difficulty arises when the two get muddled up and one is not clear which is which. Perverse incentives then appear. It might be unclear, for example, whether an operating theatre is being competed for within a particular institution. If there is a vision for the end point, we should first ask what gets in the way of delivering great services today. How can we make the best use of this theatre and what is preventing us from doing that? I would start with the outcome. Are we restricting access in the public service, which the taxpayer is paying for, in some of the things we do? I would start from that point.