Mr. Bernard Gloster:

I must first admit what is perhaps a bias in my background in that I was never part of a centralised structure. I came from a regional structure in the health service and I think I understand both components very well.

That was the premise on which I restructured Tusla into six regions, with six regional chiefs and a reduced and redefined centre with a redefined role. There is always going to be some element of a centre. There has to be for things like consistency, allocation and performance of systems and so on. My view is perhaps best contained in the comment I made about the fact that while we have very good people doing lots of different jobs in the HSE, the centre is just too top heavy. We have to call it out. Part of that is about the shift in the balance of power and decision making to an appropriate level regionally, so that people in the regions can make timely decisions. Equally, we must be careful that there is consistency across the six regions, or we just end up with six very different entities and quite similar problems for people locally. The governance piece is a complex environment, but it is not as complicated as we can sometimes portray it to be. My view is that we need to move to the six regional administrative entities within the HSE, with significant and reasonable authority, and with appropriate accountability.