This was pointed out by a number of consultants who were part of the Hanly group. One can cite the example of a speciality such as rheumatology. There is only one rheumatologist in the entire mid-west region. Until quite recently, there were no rheumatologists in the west. Also, up to quite recently there was not even a neo-natalogist in the Western Health Board region. Everyone focuses on trauma and acute emergency treatment – this is where the debate immediately leads. There is a wide range of specialities and services for which people in the regions have to travel to Dublin or other areas. The Hanly report says this need not be the case. With the exception of tertiary treatment, such as cardiac surgery, liver transplantation and so on – obviously they will take place in national centres – the vast array of other specialities can be delivered in the regions. There is no reason why we cannot give additional services to local hospitals in terms of routine elective surgery. For example, there is no reason local hospitals cannot do routine ENT surgery, or offer a much greater range of diagnostic facilities, pre and ante-natal services and so on. The Hanly report says local hospitals might not do everything they allegedly do. There is a large question mark over what people think happens in emergency services and what actually happens. Hanly makes the point that local hospitals can provide services which they currently do not provide. The type of services provided by hospitals, in the appropriate setting and in a safe context, is at the core of the debate.