David Cullinane (Waterford, Sinn Fein)
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-----integrated waiting list management systems and getting a better bang for buck. Those are the outputs we are talking about. When we look at the big numbers of people waiting, they just do not make sense in the context of the size of our population.

One of the issues that has come up in respect of expenditure is that of aids and appliances. Spending in this regard has, again, gone up substantially. My understanding is that approximately €180 million was spent in Dublin alone over a three- or four-year period on crutches, wheelchairs, Zimmer frames, walking sticks, etc. These items cost a great deal of money and are not always returned after use. There is a lot of waste in the system. I want to understand the process here. What follow up is done? There is a great deal of money involved. Hundreds of millions of euro are being spent every year on this. Manufacturers have been saying that they would prefer to be issuing what are referred to as single-use client appliances. That might not be suitable in all areas but it would be suitable in some. Again, are we getting bang for buck here? Are there proper checks and balances within the healthcare system? Culturally, do we need to say to people that they have to bring back the appliances given to them? If we are talking about waste, we have to look at every element of the healthcare system. This is one of the areas where there is a problem. Can Mr. Mulvany indicate how much we are spending and outline the checks and balances the are in place to ensure that we are getting value for money ?