Martin Mansergh (Fianna Fail)

I would welcome a debate on the relationship between informed public service decision-making in a complex world and the use of outside consultancies, which is a form of upmarket outsourcing. The health system is experiencing problems with its computer system, which should make us reflect somewhat. We have decided to centralise the health service and abolish the health boards. We were promised this would lead to greater efficiencies but it is a rather obvious example of centralisation leading to considerably greater inefficiency in the short term.

I would not be surprised if eight health boards around the country were to develop different practices to a degree, which decentralisation is all about. A lesson we should learn is that changing structures do not necessarily solve underlying problems and can sometimes exacerbate them. Having said this, we are committed to working with the Health Service Executive. We want it to be successful and get over its teething problems. We should not have any illusions about the sources of some of the problems.