Brian Cowen (Laois-Offaly, Fianna Fail)

What it means is that there is a need to manage the resource and direct it to the priority areas where it is required. It was directed not just in this specific case but generally to all boards of management in voluntary hospitals and to the HSE in respect of those hospitals that are run by the HSE. The reforms are ongoing and they are providing savings and putting clinicians at the front line. The whole purpose of the reforms the Minister has been leading is to bring hospital teams together to work for a better output for the resource that is available. That is being achieved by bringing forward clinical directors and involving clinicians in decision making and the management of hospitals, rather than have people acting individually as consultants within the hospitals. That is the case with many important services, including cancer services. It was suggested last week, for example, that cancer services would come to an end in Galway but that proved not to be the case either. If one looks at it simply on the basis of a status quo, against a background of a finite and challenging budgetary situation, then one has to make changes to ensure we get the outputs we need. The fact of the matter is that on page 19 of the Fine Gael Party's pre-budget statement it is suggested that efficiencies of 3% should be imposed on all health budgets.

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