Mr. Odhr?n Allen:

Yes, that is what is happening. The stool has fallen over.

We are not opposed to standard operating procedures, SOPs. Most health services internationally are developed with SOPs. We are opposed to SOPs that put something meaningless in place that compromises basic standards. Part of the problem we are trying to deal with is in the legislation. The Act provides for an entitlement to an assessment of need. It does not provide for an entitlement to the services to meet that need. Imagine that people who think they have broken an arm are entitled to go to the accident and emergency department. They get an X-ray and are told they have a broken arm and are then sent away. They are told pain management is not available, a cast will not be applied - "you are not entitled to that" as it were. That is an analogy for what we are doing with disability and the Disability Act. That needs to be reviewed. Ideally the Disability Act would have been reviewed in tandem with the Education for Persons with Special Educational Needs, EPSEN, review, but that is not happening.

Collaborative thinking and new practices can deliver some short-term solutions while we try to address the workforce planning issues. A number of our professions have accelerated graduate programmes through which a competent, ready-to-practice professional can be delivered in two years. We need to urgently increase the number of places for all professions. The accelerated graduate programme is one way to accelerate the production of graduates but there is no point in doing that if we do not address the clinical placement system. Practice-education placements - practical, on-the-job training - are important and our system is creaking at the seams. I will go back to what I said previously, that if we had a HSCP strategy the issues of workforce planning, clinical placements, recruitment and retention and models of service delivery and pathways could be dealt with in a joined-up way in that framework.