At no stage in the past five years have we seen a plan that outlined at the start of a year that "X" number of people were needed in a particular area by the end of the year. Local authorities present a five-year plan that outlines what they want to develop but that is not done in the health service. We have Sláintecare but we still need an overall plan. Mr. Donnelly made a valid point about many people ending up in accident and emergency units who should not be there at all. We need to consider how to deal with the issue. There are super clinics in other countries that offer a range of services. The minor injuries unit in St. Mary's Health Campus in Cork works very effectively and takes approximately 8,500 people out of the accident and emergency departments in the Mercy University Hospital and Cork University Hospital. Maybe we should consider a similar scene for around the country. Well over 75% of the people who present at accident and emergency units do not require a hospital stay. Yes, they require some care and treatment but they do not need a hospital bed. We need to work out how to move those people away from accident and emergency units into a proper care provision without clogging up the hospital system.

Forward planning seems to have disappeared and, by way of explanation, I will outline one of my big criticisms of the current recruitment of consultants. In the past the old health boards were aware that a consultant would retire in a particular year and 12 months before that a recruitment process would be put in place. Now we seem to wait until the person retires, then a locum is selected to cover for the consultant and only then the recruitment process is undertaken. Do witnesses know from their own experiences any way that process can be changed? Nurses are recruited in similar fashion. No one thinks outside the box when it comes to the recruitment and retention of staff in a whole range of areas.