Dr. Ambrose McLoughlin:

I need to make it clear that there was no impropriety on the part of any official in the Department of Health. I also need to make it clear that the Department did not organise the trips. Departmental officials were invited to participate in the trips. In respect of why they went to the US or Canada, I was not around at the time. I can see some advantages in checking in and visiting state-of-the-art facilities and ensuring evidence-based learning is available from other countries. Certainly, I would be like Deputy Nolan in looking more to the UK or perhaps EU countries such as Finland but there are lessons to be learned from the US. Many of the cutting-edge developments in health care come from the US, Canada and Australia. There is no doubt that because of our relationships with those countries, there is much exchange of information. There are good sides to that. In the areas of pharmacology and pharmaceuticals, there are large benefits in terms of areas like medical devices. The health system benefits from learning about how they do business in a better way in other jurisdictions so I would be strongly of the view that connections with the US, Canada and Australia are worthwhile. Of course, we have technologies that enable us to do it online and there is a range of other methodologies for learning. I am quite clear that we are in a very different environment than we were during those years where we were in a partnership environment and where issues were driven in a particular way by the senior political figures of the day. They were trying to enhance the process within the health system. There was a major change agenda in terms of the establishment of the HSE. Hindsight is perfect vision but all I can do as Secretary General is look forward and assure the Deputy that we will learn the lessons, be vigilant, ensure that we get value for money in everything we do and be accountable through this and other committees of the Oireachtas for that.