Dr. Kevin Kelleher:

That is done primarily via general practitioners. In addition, when such children arrive in school, we have school immunisation teams which will pick up on that. It is done at that stage when the child comes in contact with the system, primarily via general practitioners. I cannot say every general practitioner will do so, but virtually every general practitioner will ask a parent who brings in a one, two or three year old child what vaccinations the child has received if they have come here from abroad and, on noting what the child needs, the general practitioner will provide it. The State provides for that and also pays for it. It is not a major difficulty.

I find it slightly problematic when people suggest that we do not talk about the problems. We have repeatedly spoken about the problems concerning immunisation. I recognise as much as anybody that the programmes have risks, and we are very clear about this. I spoke to the committee when the report on immunisation was published in 2001; one of the recommendations made by the health boards at that time was that a vaccine damage scheme should be introduced. We were strongly of that view. We believe that to support the programme, something of that nature needs to be put in place. The provision of such a scheme is very important. Even without such a scheme at present, we have made great strides in rates of immunisation. We have hit the target set for the HPV; the immunisation rate has gone over 80%, which is the desired level. It is an amazing rate to have achieved quite rapidly and in quite a short period. We have made those changes.

We are currently in the process of putting together a single IT system for the country. It is quite complex but incredibly necessary. One of our difficulties has been that during the past five years a number of short-term projects, such as the introduction of new vaccines for pneumococcus, pandemic influenza and HPV, have diverted us from such longer-term projects. We are very clear that we will not introduce any vaccine in this country unless the benefits totally outweigh the risks at the population level. My colleague Dr. Gilvarry will speak about the issue of adverse events.